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“森林与树木”:住院医师为住院医师开设的叙事医学课程。

"The forest and the trees": a narrative medicine curriculum by residents for residents.

机构信息

Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA.

Department of Pediatrics, NewYork-Presbyterian Morgan Stanley Children's Hospital/Columbia University Irving Medical Center, New York, NY, USA.

出版信息

Pediatr Res. 2024 Jul;96(2):313-318. doi: 10.1038/s41390-024-03142-2. Epub 2024 Mar 22.

Abstract

A 7-session narrative medicine (NM) curriculum was designed and facilitated by pediatrics residents for pediatrics residents in order to unpack challenging experiences during clinical training and strengthen relationships with colleagues and patients. The primary facilitator, a resident with a master's degree in NM, provided facilitator training to her co-residents with whom she co-led the workshops in the curriculum. We conducted, transcribed, and analyzed individual interviews of 15 residents, with three resultant themes: reflection on personal and professional identity; connection to others and community building; and reconceptualization of medical practice. Residents shared that they experienced greater solidarity, professional fulfillment, appreciation for multiple facets of their identities, recognition of holding space for vulnerability, and advocacy for marginalized populations. Our study highlights the feasibility and effectiveness of peer-led NM workshops to enhance clinical training through self-reflection, inclusion of persons from underrecognized backgrounds, and promotion of values consistent with humanistic care. IMPACT: A novel narrative medicine curriculum was designed and facilitated by pediatrics residents for pediatrics residents. The curriculum was feasible and acceptable to pediatrics residents and required a facilitator with content and methodology expertise in narrative medicine to train additional facilitators. Three themes emerged from resident interviews: reflection on personal and professional identity; connection to others and community building; and reconceptualization of medical practice on individual and global levels.

摘要

一个 7 节叙事医学(NM)课程由儿科住院医师设计并为儿科住院医师实施,旨在探讨临床培训期间的挑战性经历,并加强与同事和患者的关系。主要的协调员是一位具有 NM 硕士学位的住院医师,她对她的同事进行了协调员培训,与他们共同领导课程中的研讨会。我们对 15 名住院医师进行了个人访谈、转录和分析,得出了三个主题:个人和职业身份的反思;与他人的联系和社区建设;以及对医疗实践的重新概念化。住院医师们表示,他们经历了更大的团结、职业满足感、对自身身份多方面的欣赏、承认自己有脆弱的空间、以及为弱势群体发声。我们的研究强调了同伴主导的 NM 研讨会通过自我反思、包括来自未被充分认识的背景的人以及促进与人文关怀一致的价值观来增强临床培训的可行性和有效性。影响:一个新颖的叙事医学课程由儿科住院医师为儿科住院医师设计并实施。该课程对儿科住院医师来说是可行和可接受的,并且需要一位具有叙事医学内容和方法专业知识的协调员来培训其他协调员。从住院医师的访谈中出现了三个主题:个人和职业身份的反思;与他人的联系和社区建设;以及在个人和全球层面上重新概念化医疗实践。

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