Kimball C P
J Psychosom Res. 1983;27(1):5-8. doi: 10.1016/0022-3999(83)90101-0.
Psychiatric education for the medical student addresses itself to students' and potential non-psychiatric physicians' needs in identifying and addressing the biopsychosocial aspects of patient care. The education is best based on the clinical method, using the extended interview to identify the relationship of environmental and social circumstances to the anlage, onset and reaction to illness in the patient. Within this pattern, genetic, epigenetic developmental patterns, earlier illness, behavioral and personality patterns are identified. In addition, family and social variables, including the effects of treatment procedures, hospitalization and interaction with the health team are reviewed. To whatever extent possible, the student is sensitized to this approach at the earliest phase of his(her) education, preferably in the preclinical years. The approach is reinforced during the introduction to clinical medicine and physical diagnosis. In the clinical years, individual patient consultations are arranged for students working with medical, surgical, pediatric and obstetrical patients on these services in which they review with patients their illness experiences. This is viewed as both an analytic and synthetic experience having an educational value for the student and a therapeutic one for the patient. Preceptors of such programs need thorough grounding in general and sometimes specialty medical disciplines as well as considerable exposure to psychological, behavioral and psychiatric medicine. Evaluation and support of these programs remain in question and should be addressed in discussion.
针对医学生的精神科教育旨在满足学生以及未来非精神科医生在识别和处理患者护理中的生物心理社会层面问题方面的需求。这种教育最好以临床方法为基础,通过扩展性访谈来确定环境和社会状况与患者疾病的成因、发病及反应之间的关系。在这种模式下,识别遗传、表观遗传发育模式、既往疾病、行为和人格模式。此外,还要审视家庭和社会变量,包括治疗程序、住院治疗以及与医疗团队互动的影响。只要有可能,就要让学生在其教育的最早阶段,最好是在临床前阶段,对这种方法有所认识。在临床医学入门和体格诊断阶段强化这种方法。在临床阶段,为参与医疗、外科、儿科和产科患者治疗服务的学生安排个别患者咨询,学生在咨询中与患者回顾其患病经历。这被视为一种对学生具有教育价值的分析性和综合性体验,对患者则具有治疗作用。此类项目的带教老师需要在普通医学以及有时还包括专科医学学科方面有扎实的基础,并且要大量接触心理、行为和精神医学。这些项目的评估和支持仍存在问题,应在讨论中加以探讨。