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“一个被严重忽视的领域”:一项关于急诊医学住院医师自我报告的人文接触情况的多中心研究。

"A sorely neglected field": A multisite study of self-reported humanities exposure among emergency medicine residents.

作者信息

Balhara Kamna S, Irvin Nathan, Zink Korie L, Mohan Sanjay, Olson Adriana S, Tackett Sean, Regan Linda

机构信息

Department of Emergency Medicine Johns Hopkins University School of Medicine Baltimore Maryland USA.

Division of Medical Toxicology, Ronald O. Perelman Department of Emergency Medicine NYU Grossman School of Medicine New York New York USA.

出版信息

AEM Educ Train. 2022 Jun 29;6(3):e10772. doi: 10.1002/aet2.10772. eCollection 2022 Jun.

Abstract

BACKGROUND

The Association of American Medical Colleges has identified the humanities as fundamental to medical education across all specialties. Evidence from undergraduate medical education (UME) demonstrates the humanities' positive impacts on outcomes that could be relevant to patient care and trainee well-being in emergency medicine (EM) residency training. However, less is known about the humanities' role in graduate medical education (GME).

OBJECTIVES

The objectives were to describe EM residents' self-reported exposure to the humanities and its relationship with their empathy, tolerance of ambiguity, and patient-centeredness, and to assess their attitudes toward the humanities in GME.

METHODS

This cross-sectional survey-based study was conducted at six U.S. EM residency programs in 2018-2019. Quantitative analyses included linear regressions testing for trends between humanities exposures and outcomes, adjusted for sex, year in training, and clustering within programs; adjunct analysis of free-text responses was performed using an exploratory constructivist approach to identify themes about views on the humanities' role in medicine.

RESULTS

Response rate was 54.8% (153/279). A total of 65% of respondents were male and 28.1% of respondents had a preceding humanities degree. Preceding humanities degree and current self-reported humanities exposure were positively associated with performance on empathy subscales ( = 0.02). Seventy-five percent ( = 114) of respondents agreed humanities are important in GME; free-text responses revealed perceived positive impacts of humanities on generating well-rounded clinicians and enhancing patient care.

CONCLUSIONS

Engagement with the humanities may be associated with empathy among EM residents. Although the magnitude of associations was smaller than that seen in UME, this study demonstrates resident interest in humanities and suggests that extracurricular engagement with the humanities may be insufficient to prolong positive impacts seen in UME. Further research is needed to explore how to sustain these benefits through integration or addition of the humanities in existing GME curricula.

摘要

背景

美国医学院协会已将人文学科确定为所有专业医学教育的基础。本科医学教育(UME)的证据表明,人文学科对与急诊医学(EM)住院医师培训中的患者护理和学员福祉相关的结果具有积极影响。然而,关于人文学科在研究生医学教育(GME)中的作用知之甚少。

目的

目的是描述急诊医学住院医师自我报告的人文学科接触情况及其与同理心、对模糊性的容忍度和以患者为中心的关系,并评估他们对研究生医学教育中人文学科的态度。

方法

这项基于横断面调查的研究于2018 - 2019年在美国的六个急诊医学住院医师培训项目中进行。定量分析包括线性回归,测试人文学科接触与结果之间的趋势,并对性别、培训年份和项目内聚类进行调整;使用探索性建构主义方法对自由文本回复进行辅助分析,以确定关于人文学科在医学中作用的观点主题。

结果

回复率为54.8%(153/279)。共有65%的受访者为男性,28.1%的受访者拥有人文学科先修学位。人文学科先修学位和当前自我报告的人文学科接触与同理心子量表的表现呈正相关( = 0.02)。75%( = 114)的受访者同意人文学科在研究生医学教育中很重要;自由文本回复显示,人文学科对培养全面发展的临床医生和加强患者护理有积极影响。

结论

参与人文学科可能与急诊医学住院医师的同理心有关。尽管关联程度小于本科医学教育中的情况,但本研究表明住院医师对人文学科感兴趣,并表明人文学科的课外参与可能不足以延续本科医学教育中所见的积极影响。需要进一步研究以探索如何通过将人文学科融入或添加到现有的研究生医学教育课程中来维持这些益处。

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