共情训练在医学生医患沟通实践教学中的应用效果

Empathy training in doctor-patient communication exercise of medical students

目的探讨共情训练对医学生同理心及其情绪症状的改善效果,为进一步改进医患沟通实践教学提供实证依据。方法选择某医学院2012级和2013级八年制临床医学专业三年级64名学生为研究对象。采用试验对照方法,按照不同级次将64名学生分为试验组(2012级)和对照组(2013级),试验组34名学生,对照组30名学生。试验组学生接受包括6学时共情训练在内的常规课程教学,对照组学生接受没有包括共情训练的常规课程教学。采用人际反应指针问卷和流行病学调查中心抑郁量表,分别于教学前和教学后1周评估两组学生的共情能力、抑郁症状和积极情绪。结果试验组学生除年龄稍大于对照组学生外,两组学生性别、共情各项指标、抑郁症状、积极情绪评分比较,其组间差异均无统计学意义(均P>0.05);两组学生教学前后共情各项指标、抑郁症状、积极情绪评分比较,其组内差异均无统计学意义(均P>0.05);试验组男生共情训练后的积极情绪评分显著高于训练前评分[训练前(8.23±2.72)分,训练后(8.89±2.72)分,t=-2.126,P=0.039],试验组女生共情训练后的观点采择因子评分显著高于训练前评分[训练前(11.26±2.91)分,训练后(12.48±4.05)分,t=-2.634,P=0.013],其差异均具有统计学意义;对照组男生和女生教学前后共情各项指标、抑郁症状、积极情绪评分比较,其差异均无统计学意义(均P>0.05)。结论共情训练对医学女生观点采择能力的提高和医学男生自身情绪状况的改善有一定效果,有必要继续尝试在更大样本中进行更长时间的共情训练效果的研究。

Objective To evaluate outcomes of empathy training in medical students, and to provide empirical evidence to the comprehensive training of doctor-patient communication skill.Methods A parallel group controlled trial was implemented in this study. Participants included 64 junior students in eight-year- program. They were assigned to be intervention group (n=34) or control group (n=30). In addition to the traditional teaching as that in control group, the intervention group received six-hour empathy training. During the study period, the two groups received equal number of classes. Interpersonal Reactivity Index (IRI) and Center for Epidemiological Survey Depression Scale (CES-D) were adopted to evaluate empathy (perspective taking, empathy concern et al), depressive symptoms and positive emotion of medical students respectively before and one week after the training.Results Except that participants in intervention group are slightly older than that in the control group, there is no statistically significant difference in gender, empathy, depressive symptoms and positive emotion scores between the two groups (all P>0.05);There is no statistically significant difference in empathy, depressive symptoms, and positive emotion scores between baseline and one week after training in intervention group or control group (all P>0.05);Male participants receiving empathy training had a significantly increase in positive emotion score as comparing to the baseline (baseline: 8.23±2.72, post intervention: 8.89±2.72, t=-2.126, P=0.039). Female participants receiving empathy training had a significantly increase in perspective taking score as comparing to (before training: 11.26±2.91, after training: 12.48±4.05, t=-2.634, P=0.013);There is no statistically significant difference in male or female participants in control group in the field of perspective taking, empathy concern, depressive symptoms, and positive emotion scores (all P>0.05).Conclusions The empathy training does have effect on the improvement of perspective taking, emotional state of medical students. However, further research is still needed for longer observation and larger sample size.