Williams G C, Deci E L
University of Rochester, University of Rochester School of Medicine and Dentistry, and The Genesee Hospital, New York 14627, USA.
Ann Intern Med. 1998 Aug 15;129(4):303-8. doi: 10.7326/0003-4819-129-4-199808150-00007.
Many thoughtful leaders in medicine have asserted their belief that when physicians are more humanistic in their interactions with patients, their patients have more positive health outcomes. Consequently, many advocates have called for the practice of teaching students and residents to provide more humanistically oriented care. This article reviews research from motivational psychology, guided by self-determination theory, that suggests that when medical educators are more humanistic in their training of students, the students become more humanistic in their care of patients. Being humanistic in medical education can be achieved through support of the autonomy of students. Autonomy support means working from the students' perspectives to promote their active engagement and sense of volition with respect to learning. Research suggests that when educators are more supportive of student autonomy, students not only display a more humanistic orientation toward patients but also show greater conceptual understanding and better psychological adjustment.
许多富有思想的医学领袖都坚信,当医生在与患者互动时更具人文关怀,他们的患者会有更积极的健康结果。因此,许多倡导者呼吁开展教学,教导学生和住院医生提供更具人文关怀导向的护理。本文回顾了以自我决定理论为指导的动机心理学研究,该研究表明,当医学教育工作者在培训学生时更具人文关怀,学生在护理患者时也会更具人文关怀。在医学教育中实现人文关怀可通过支持学生的自主性来达成。自主性支持意味着从学生的角度出发,促进他们积极参与学习并增强自主意愿。研究表明,当教育工作者更支持学生的自主性时,学生不仅会对患者表现出更具人文关怀的取向,还会展现出更强的概念理解能力和更好的心理调适能力。