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一种全国性视角:整合医学人文以应对中国医学教育中的职业倦怠和压力

A national perspective: integrating medical humanities to address burnout and stress in Chinese medical education.

作者信息

Zhai Huiwen, Xue Jiaolong, Wu Haotan, Liao Shuang, Lavender Christopher, Lv Yangludan, Xie Wanfei, Wang Di, Cheng Yu

机构信息

State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, China.

Business School, Sichuan University, Chengdu, China.

出版信息

BMC Med Educ. 2025 Feb 25;25(1):304. doi: 10.1186/s12909-025-06875-8.

Abstract

BACKGROUND

The significance of issues in medical humanities, such as empathy, professionalism, patient-orientation, disclosure of harms, and communication skills, has been widely acknowledged in previous studies. While these studies have showcased the impact of individual facets of medical humanities on clinical practice, there exists a dearth of comprehensive assessments that encompass these constructs and their relationship with burnout and distress among medical students. This study aims to fill these gaps by exploring Chinese medical students' overall perceptions of medical humanities across different educational phases and shedding light on the intricate associations between perceptions of humanities, burnout, and stress.

METHODS

We conducted a nationwide survey using a web-based questionnaire across 38 Chinese universities. The questionnaire includes Medical Humanities constructs, the Maslach Burnout Inventory constructs and the Perceived Stress constructs. The survey was administered using the snowball sampling method, with the data collection period running from September 8, 2022, to September 22, 2023. Participants included a national sample of 904 students (out of a total of 969) enrolled in medical schools. To investigate the relationships among all the constructs, PLS-SEM analysis was conducted by using the SmartPLS 3.3.9 software in this study.

RESULTS

The student's perception of medical humanities was significantly influenced by several factors: years of medical school education (β  = -.077; P = .045), work burnout (β = -.208; P < .001), and perceived stress (β = -.467; P < .001). Work burnout was impacted by clinical clerkship experience (β = .106; P = .001), whereas perceived stress was influenced by the number of years in medical school (β = 0.102; P = .002). Additionally, work burnout acts as an intermediate variable between clinical clerkship experience and students' perception of medical humanities.

CONCLUSION

This study illuminated the complex relationship between medical education, burnout, stress, and students' perception of medical humanities issues. It underscores the critical importance of balancing technical proficiency with humanistic values in medical training. Implementing strategies that support students' well-being and foster empathy is essential in nurturing a compassionate and effective healthcare workforce.

摘要

背景

医学人文领域的诸多问题,如同理心、职业素养、以患者为导向、危害告知以及沟通技巧等,其重要性在以往研究中已得到广泛认可。尽管这些研究展示了医学人文各个方面对临床实践的影响,但缺乏全面评估,未能涵盖这些构成要素及其与医学生倦怠和困扰之间的关系。本研究旨在通过探索中国医学生在不同教育阶段对医学人文的整体认知,并揭示人文认知、倦怠和压力之间的复杂关联,来填补这些空白。

方法

我们通过基于网络的问卷在中国38所大学开展了一项全国性调查。问卷包括医学人文构成要素、马氏倦怠量表构成要素和感知压力构成要素。调查采用滚雪球抽样法进行,数据收集期为2022年9月8日至2023年9月22日。参与者包括来自医学院校的904名学生(总样本969名)的全国性样本。为了研究所有构成要素之间的关系,本研究使用SmartPLS 3.3.9软件进行了PLS-SEM分析。

结果

学生对医学人文的认知受到多个因素的显著影响:医学院校教育年限(β = -0.077;P = 0.045)、工作倦怠(β = -0.208;P < 0.001)和感知压力(β = -0.467;P < 0.001)。工作倦怠受到临床实习经历的影响(β = 0.106;P = 0.001),而感知压力则受到医学院校就读年限的影响(β = 0.102;P = 0.002)。此外,工作倦怠在临床实习经历和学生对医学人文的认知之间起中介变量作用。

结论

本研究阐明了医学教育、倦怠、压力与学生对医学人文问题认知之间的复杂关系。它强调了在医学培训中平衡技术能力与人文价值的至关重要性。实施支持学生福祉并培养同理心的策略对于培养富有同情心和高效的医疗队伍至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1fc/11863532/83817ff4c411/12909_2025_6875_Fig1_HTML.jpg

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