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医师的谦逊:回顾与复兴医学美德的呼吁。

Physician Humility: A Review and Call to Revive Virtue in Medicine.

机构信息

Mayo Clinic, Rochester, Minnesota (C.L.M., E.L.U., J.T.R., D.A.S., A.N.L.H., A.P.S.).

Mayo Clinic Alix School of Medicine, Scottsdale, Arizona (A.M.A.S.).

出版信息

Ann Intern Med. 2024 Sep;177(9):1251-1258. doi: 10.7326/M24-0842. Epub 2024 Jul 30.

Abstract

Physician virtues, including humility, are crucial for shaping a physician's identity and practice. The health care literature offers varied views on humility, and the rising call for discussing virtues as a framing for professional identity formation underscores the need for a clearer understanding of physician humility. This review aimed to develop a cohesive conceptualization of physician humility and to define how it functions in medical practice. To achieve this, a comprehensive search was done across PubMed, Ovid MEDLINE, Web of Science, Embase, ERIC, and PsycInfo, covering all records up to 30 October 2023. Articles were included if they discussed physician humility and excluded if they were unrelated to physician humility, focused on nonphysician health professionals, lacked conceptual depth, or focused solely on cultural humility. An applied thematic analysis was conducted. The results provide a synthesized conceptualization of physician humility across stances toward self, others, and the profession. The included articles identified the pivotal role of physician humility within the following 5 domains of medical practice: learning and professional growth, navigating error, uncertainty tolerance, trust and entrustment, and teamwork and communication. The authors highlight some of the intrapersonal, interpersonal, and sociocontextual challenges to cultivating and practicing physician humility. These findings highlight the importance of promoting humility in shaping physicians' actions, thoughts, and relationships with patients, colleagues, and their profession. Integrating such virtues as humility into medical education is essential for upholding the ideals of the medical profession and cultivating moral agents who engage in self-reflection and embody the principles of exemplary physicians.

摘要

医生的美德,包括谦逊,对于塑造医生的身份和实践至关重要。医疗保健文献对谦逊有不同的看法,而越来越多的人呼吁将美德作为职业身份形成的框架来讨论,这突显了需要更清楚地理解医生的谦逊。本综述旨在对医生的谦逊进行连贯的概念化,并定义其在医学实践中的作用方式。为了实现这一目标,对 PubMed、Ovid MEDLINE、Web of Science、Embase、ERIC 和 PsycInfo 进行了全面搜索,涵盖截至 2023 年 10 月 30 日的所有记录。如果文章讨论了医生的谦逊,则将其纳入;如果与医生的谦逊无关、关注非医生卫生专业人员、缺乏概念深度或仅关注文化谦逊,则将其排除在外。进行了应用主题分析。结果提供了医生谦逊在自我、他人和专业立场方面的综合概念化。纳入的文章确定了医生谦逊在以下 5 个医学实践领域中的关键作用:学习和专业成长、应对错误、容忍不确定性、信任和委托以及团队合作和沟通。作者强调了培养和实践医生谦逊所面临的一些内在、人际和社会背景方面的挑战。这些发现强调了在塑造医生与患者、同事及其职业的互动方式、思维方式和关系方面促进谦逊的重要性。将谦逊等美德融入医学教育对于维护医学职业的理想和培养进行自我反思并体现模范医生原则的道德代理人至关重要。

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