Associate Professor, Department of Pediatrics, Vanderbilt University Medical Center.
Associate Professor, Department of Neurology, Vanderbilt University Medical Center.
MedEdPORTAL. 2024 Jul 12;20:11414. doi: 10.15766/mep_2374-8265.11414. eCollection 2024.
Empathy is critical within medicine and improves patient outcomes and satisfaction. Empathy declines during the clerkship years due to the hidden curriculum, where students observe emotional distancing and desensitization by providers. Studies show arts curricula can preserve empathy but are limited by sample bias and preclerkship occurrence. We implemented and evaluated a brief pediatric clerkship arts curriculum to improve empathic behaviors.
We created two 1-hour required small-group sessions for pediatric clerkship medical students. The first session paired arts observation techniques with various paintings. The students then applied these techniques to video-based simulated patient interactions in the second session. We used the Toronto Empathy Questionnaire (TEQ) and an empathy behavior checklist (EBC) as pre/post assessments to gauge self-reported empathy and empathetic behaviors. We compared responses of learners who attended the sessions (curriculum group) to learners unable to attend (control group).
Thirty-four students participated in the curriculum; 19 were in the control group. Neither the control nor the curriculum group had a significant change in pre/post TEQ scores. Students with pre-TEQ scores less than 45 who participated in the curriculum had significant improvement in post-TEQ scores compared to their control group counterparts ( = .02). On the EBC, there was a significant difference between the curriculum and control groups for those who explored more about the child/family's experience ( < .05).
Our work suggests that a brief clerkship arts curriculum is useful for improving self-reported empathy ratings and empathetic skills, particularly for students identified as having below-average empathy.
同理心在医学中至关重要，它可以改善患者的治疗效果和满意度。由于“隐性课程”的存在，医学生在实习期间的同理心会逐渐下降，因为他们会观察到医务人员的情感疏远和麻木。研究表明，艺术课程可以保持同理心，但由于存在样本偏差和实习前发生的情况，其应用受到限制。我们实施并评估了一项简短的儿科实习艺术课程，以提高同理心行为。
我们为儿科实习医学生设计了两个 1 小时的必修小组课程。第一节课将艺术观察技巧与各种绘画作品相结合。然后，学生们在第二节课中应用这些技巧来处理基于视频的模拟患者互动。我们使用多伦多同理心问卷（TEQ）和同理心行为检查表（EBC）作为预/后评估，以衡量自我报告的同理心和同理心行为。我们将参加课程的学习者（课程组）与无法参加课程的学习者（对照组）的反应进行了比较。
共有 34 名学生参加了课程，其中 19 名学生在对照组。对照组和课程组的 TEQ 评分都没有显著变化。参加课程且 TEQ 得分低于 45 分的学生，与对照组相比，TEQ 得分在后测中有显著提高（ =.02）。在 EBC 上，课程组和对照组在那些更深入地探讨儿童/家庭经历的学生之间存在显著差异（ <.05）。
我们的工作表明，简短的实习艺术课程对于提高自我报告的同理心评分和同理心技能非常有用，特别是对于那些被认为同理心较低的学生。
