坚忍训练能否培养医学生的同理心和适应力？一项混合方法研究。
Can stoic training develop medical student empathy and resilience? A mixed-methods study.
机构信息
Health Professions Education Unit, Hull York Medical School, University of York, York, UK.
Department of Psychology, University of Bath, Bath, UK.
出版信息
BMC Med Educ. 2022 May 3;22(1):340. doi: 10.1186/s12909-022-03391-x.
BACKGROUND
Empathic erosion and burnout represent crises within medicine. Psychological training has been used to promote empathy and personal resilience, yet some training useful within adjacent fields remain unexplored, e.g., Stoic training. Given recent research within psychology suggesting that Stoic training increases emotional wellbeing, exploring this type of training within health professions education is important. We therefore asked: What impact would a Stoicism informed online training package have on third year medical students' resilience and empathy?
METHODS
24 third year medical students took part in 12 days of online training (SeRenE), based on Stoic philosophy, and co-developed with psychotherapists. A mixed-methods study was conducted to evaluate impact. Pre- and post-SeRenE students completed the Stoic Attitudes and Behaviours Scale (SABS), Brief Resilience Scale (BRS) and Jefferson Scale of Empathy (JSE). All students completed semi-structured interviews following training and 2 months post-SeRenE. Thematic analysis was employed to analyse qualitative data, whilst within subjects t-tests and correlational analyses were conducted on quantitative data.
RESULTS
Quantitatively, stoic ideation, resilience and empathy increased post-training, with correlational analyses suggesting resilience and empathy increase in tandem. Qualitatively, four themes were identified: 1. Negative visualisation aids emotional and practical preparedness; 2. Stoic mindfulness encourages students to think about how they think and feel; 3. Stoic reflection develops the empathic imagination; and 4. Evaluating the accessibility of SeRenE.
CONCLUSIONS
Our data lend support to the ability of Stoic-based psychological training to positively influence resilience and empathy. Although, quantitatively, results were mixed, qualitative data offers rich insight. The practice of negative visualisation, promoted by SeRenE, encourages student self-efficacy and planning, domains of resilience associated with academic success. Further, this study demonstrates a connection between Stoic practice and empathy, which manifests through development of the empathic imagination and a sense of empathic bravery.
背景
同理心的侵蚀和倦怠是医学领域的危机。心理培训已被用于促进同理心和个人适应力，但相邻领域中一些有用的培训仍未得到探索，例如斯多葛学派的培训。鉴于心理学最近的研究表明，斯多葛学派的培训可以提高情绪幸福感，因此在健康专业教育中探索这种类型的培训很重要。因此，我们提出了一个问题：基于斯多葛哲学并与心理治疗师共同开发的斯多葛在线培训包对三年级医学生会对其适应力和同理心产生什么影响？
方法
24 名三年级医学生参加了为期 12 天的基于斯多葛哲学的在线培训（SeRenE），并与心理治疗师共同开发。采用混合方法研究来评估影响。在 SeRenE 之前和之后，学生完成了斯多葛态度和行为量表（SABS）、简短适应量表（BRS）和杰斐逊同理心量表（JSE）。所有学生在培训后和 SeRenE 后 2 个月完成半结构化访谈。采用主题分析法分析定性数据，同时对定量数据进行了受试者内 t 检验和相关性分析。
结果
从数量上看，斯多葛观念、适应力和同理心在培训后增加，相关分析表明适应力和同理心同时增加。从质量上看，确定了四个主题：1. 负面可视化有助于情感和实际准备；2. 斯多葛正念鼓励学生思考自己的思维和感受；3. 斯多葛反思培养同理心的想象力；4. 评估 SeRenE 的可访问性。
结论
我们的数据支持基于斯多葛的心理培训能够积极影响适应力和同理心。尽管定量结果喜忧参半，但定性数据提供了丰富的见解。SeRenE 推广的负面可视化实践鼓励学生的自我效能感和计划，这是与学业成功相关的适应力领域。此外，这项研究表明斯多葛实践与同理心之间存在联系，这种联系通过发展同理心的想象力和同理心的勇气感来体现。
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