医学人文学科在医学教育中的弱势地位：丹麦医学生的定性研究。
Weak inclusion of the medical humanities in medical education: a qualitative study among Danish medical students.
机构信息
Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløwsvej 9 A, 5000, Odense, Denmark.
Department of Psychology, University of Southern Denmark, Odense, Denmark.
出版信息
BMC Med Educ. 2022 Sep 5;22(1):660. doi: 10.1186/s12909-022-03723-x.
BACKGROUND
The modern medical education is predominantly grounded in the biomedical sciences. In recent years, medical humanities have been included into the medical curricula in many countries around the world one of the objectives being to promote patient-centred, empathic care by future physicians. Studies have been made of the impact of inclusion of medical humanities components within the medical curriculum. Although some results suggest increased empathy, others remain inconclusive. To gain insight into the depth, context, and impact of inclusion of the medical humanities for future physicians, this study aimed to explore Danish medical students' understanding of and reflections on how the medical humanities relate to the medical education, including the clinic.
METHODS
We conducted a qualitative research study, involving semi-structured interviews with twenty-three Danish medical students across years of curriculum and medical schools. Interviews were recorded, transcribed verbatim and analyzed using Braun and Clarke's thematic analysis.
RESULTS
The findings demonstrate the subordinate role of the medical humanities in the medical educational system. Students prioritize biomedical knowledge building in the preclinical curriculum, partly as a reaction to an unbalanced institutional inclusion of the medical humanities. Observing how structural empathy incentives are lacking in the clinical curriculum, the values inherent in the medical humanities are undermined.
CONCLUSION
Danish medical students become part of an educational environment with lacking institutional conditions and structures to promote the strong inclusion of the medical humanities. A focus is therefore needed on the values, norms and structures of the medical educational systems that undermine a strong inclusion of the medical humanities into medical education.
背景
现代医学教育主要以生物医学科学为基础。近年来，许多国家已将医学人文学科纳入医学课程，其中一个目标是通过未来的医生促进以患者为中心、富有同理心的护理。已经对在医学课程中纳入医学人文学科内容的影响进行了研究。尽管一些研究结果表明同理心有所增强，但其他研究结果仍不确定。为深入了解将医学人文学科纳入未来医生医学教育（包括临床实践）的深度、背景和影响，本研究旨在探讨丹麦医学生对医学人文学科与医学教育之间关系的理解和反思，包括临床实践。
方法
我们进行了一项定性研究，对来自不同医学课程和医学院的 23 名丹麦医学生进行了半结构化访谈。访谈进行了录音、逐字记录，并使用 Braun 和 Clarke 的主题分析进行了分析。
结果
研究结果表明，医学人文学科在医学教育系统中处于次要地位。学生在临床前课程中优先构建生物医学知识，部分原因是对医学人文学科在机构中不平衡的纳入做出反应。学生观察到临床课程中缺乏结构性同理心激励措施，医学人文学科所固有的价值观受到了破坏。
结论
丹麦医学生成为教育环境的一部分，该环境缺乏机构条件和结构来促进医学人文学科的大力纳入。因此，需要关注破坏医学人文学科强有力地融入医学教育的医学教育系统的价值观、规范和结构。
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