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探讨医学生同理心发展的学生认知 - 一项现象学研究。

Exploring student perceptions of empathy development during medical school - A phenomenological study.

机构信息

Dermatology, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne NE1 4LP, UK.

Institute of Medical Education, Newcastle University, Newcastle upon Tyne NE1 7RU, UK.

出版信息

Patient Educ Couns. 2022 Dec;105(12):3515-3520. doi: 10.1016/j.pec.2022.08.015. Epub 2022 Aug 29.

Abstract

OBJECTIVE

Empathy is an essential attribute of a good doctor. There are multiple dimensions to empathy, yet many curricula are limited to empathy display. This study's aim was to understand the relationship between teaching, learning and development of empathy from the perspective of medical students.

METHODS

A qualitative approach was used with interpretivist methodology. Ten final year medical students from a single UK University were interviewed. Findings came from inductive thematic analysis.

RESULTS

Five major themes were identified: 'The Empathic Process'; 'Self'; 'Patient'; 'Teacher/Clinician'; 'Environment'. Sub-themes included personal qualities, patient factors, role-models and assessment. Students value authentic patient encounters, focused feedback and opportunities for debriefing. Barriers include cognitive load, time-pressures and being observed. Students can maintain empathy through self-checking and addressing biases.

CONCLUSIONS

Students are aware of their motivations and barriers towards empathy development and can describe meaningful experiences relating to this during medical school. Students acknowledge controversy surrounding assessment of empathy, but clearly value authentic patient experiences and an environment which is free from scrutiny and distractions.

PRACTICE IMPLICATIONS

In addition to teaching communication skills, undergraduate programmes should focus on students' inner growth. This may be achieved by guiding students through meaningful reflection and open dialogue with supportive mentors.

摘要

目的

同理心是一位好医生的必备特质。同理心有多个维度,但许多课程仅限于同理心展示。本研究旨在从医学生的角度理解同理心的教学、学习和发展之间的关系。

方法

采用定性方法和解释主义方法。对来自英国某大学的 10 名即将毕业的医学生进行了访谈。研究结果来自于归纳主题分析。

结果

确定了五个主要主题:“同理心过程”、“自我”、“患者”、“教师/临床医生”、“环境”。子主题包括个人素质、患者因素、榜样和评估。学生重视真实的患者接触、有针对性的反馈和讨论机会。障碍包括认知负荷、时间压力和被观察。学生可以通过自我检查和解决偏见来保持同理心。

结论

学生意识到自己在同理心发展方面的动机和障碍,并且可以在医学院期间描述与这方面相关的有意义的经历。学生承认评估同理心存在争议,但非常重视真实的患者体验以及不受监督和干扰的环境。

实践意义

除了教授沟通技巧外,本科课程还应注重学生的内在成长。这可以通过引导学生进行有意义的反思和与支持性导师进行开放对话来实现。

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