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医学教育中同理心的质性见解:来自学生、医生和教育工作者的观点

Qualitative insights into empathy in medical education: perspectives from students, doctors, and educators.

作者信息

Yang Fan, Lei Fuhao, Li Yong, Yang Tao

机构信息

College of Teacher Education, East China Normal University, Shanghai, China.

School of Management, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.

出版信息

BMC Med Educ. 2025 Apr 2;25(1):473. doi: 10.1186/s12909-025-06882-9.

Abstract

BACKGROUND

Empathy is the cornerstone of high-quality medical education and clinical practice. It not only serves as a vital link for establishing trust-based doctor-patient relationships but also significantly impacts patients' treatment compliance and recovery outcomes. In medical education, an empathetic approach can cultivate future medical professionals' humanistic care awareness, enabling them to better understand patients' physical and mental sufferings.However, the understanding and cultivation of empathy vary remarkably across different cultural backgrounds.Thus, there is an urgent need to conduct in-depth research to clarify these issues and promote the better development of empathy-based medical education.

METHODS

A total of 24 participants, including medical students, practicing doctors, and medical teachers, were recruited for this study. Semi-structured interviews were employed as the data-collection method. Each interview lasted approximately 30-60 min, and all interviews were audio-recorded and then transcribed verbatim.For data analysis, a three-level coding approach was adopted. The analysis was independently conducted by two members of the research team to ensure reliability and consistency.

RESULTS

This study delves into empathy ability within medical education. The theme analysis yields significant results: the definition of empathy involves basic understanding with distinct emotional and cognitive emphases, multi-dimensional attributes showcasing empathy's roles in clinical scenarios, and the need for regulation due to its contradictoriness. Expression of empathy hinges on establishing doctor-patient trust and communication, with diverse expression ways and impacts on treatment and relationships. Influencing factors encompass educational background, clinical environment, and individual differences. Strategies for cultivation include teacher guidance, varied methods, and curriculum integration in the first classroom, and activity practice and values guidance in the second. These findings offer valuable insights and practical implications for enhancing empathy in medical education.

CONCLUSIONS

This study's core findings from cross-group analysis of medical students, doctors, and teachers show empathy in medical education is complex and multi-dimensional, involving emotional and cognitive empathy. Empathy abilities change dynamically during medical education, with students initially having high emotional empathy and later developing stronger cognitive empathy. Cultural differences in empathy, like between Western and traditional Chinese medicine, offer new perspectives. Practical implications include: designing curricula to cover both empathy types and adding cross-cultural content; using diverse teaching methods and optimizing clinical internships; organizing teacher training and improving teaching skills; establishing a comprehensive evaluation system with timely feedback. These insights and suggestions guide enhancing empathy in medical education.

摘要

背景

同理心是高质量医学教育和临床实践的基石。它不仅是建立基于信任的医患关系的重要纽带,还对患者的治疗依从性和康复结果有显著影响。在医学教育中,采用同理心方法可以培养未来医学专业人员的人文关怀意识,使他们能够更好地理解患者的身心痛苦。然而,不同文化背景下对同理心的理解和培养差异显著。因此,迫切需要进行深入研究以阐明这些问题,并促进基于同理心的医学教育更好地发展。

方法

本研究共招募了24名参与者,包括医学生、执业医生和医学教师。采用半结构化访谈作为数据收集方法。每次访谈持续约30 - 60分钟,所有访谈均进行录音,然后逐字转录。数据分析采用三级编码方法。由研究团队的两名成员独立进行分析,以确保可靠性和一致性。

结果

本研究深入探讨了医学教育中的同理心能力。主题分析得出了重要结果:同理心的定义涉及具有不同情感和认知重点的基本理解、展示同理心在临床场景中作用的多维度属性,以及因其矛盾性而需要进行调节。同理心的表达取决于建立医患信任和沟通,表达方式多样,对治疗和关系有不同影响。影响因素包括教育背景、临床环境和个体差异。培养策略包括在第一课堂中教师指导、多样化方法和课程整合,以及在第二课堂中进行活动实践和价值观引导。这些发现为提高医学教育中的同理心提供了有价值的见解和实际意义。

结论

本研究对医学生、医生和教师进行跨群体分析的核心发现表明,医学教育中的同理心是复杂且多维度的,涉及情感同理心和认知同理心。在医学教育过程中,同理心能力会动态变化,学生最初具有较高的情感同理心,随后发展出更强的认知同理心。同理心的文化差异,如中西医之间的差异,提供了新的视角。实际意义包括:设计涵盖两种同理心类型的课程并增加跨文化内容;采用多样化教学方法并优化临床实习;组织教师培训并提高教学技能;建立具有及时反馈的综合评价体系。这些见解和建议指导着提高医学教育中的同理心。

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