应用叙事医学培养医学生社会化能力的实践

The Practice of Narrative Medicine in Training the Socialized Ability of Medical Students

目的医学本身的社会属性要求现代的临床医生能够满足患方社会需要,但目前的医学培养模式下医学生的社会化能力普遍不足。为探索医学生社会化能力的有效培养途径,本研究将叙事医学引入到临床实践中,进行以叙事医学模式为基础的医学生社会化能力培训教学。方法本研究对在本院内分泌科实习的126名高年级医学生进行了随机对照研究,叙事医学组按要求进行三步法的叙事医学临床培训,对照组予以同样课时的传统教学。结果叙事医学组的社会化能力得到了明显的提高,尤其在职业道德与职业技能社会化评价指标上显著优于传统教学的对照组(P<0.05),且患者满意度更高。结论叙事医学模式给医患双方提供了充分了解患病个体背后社会属性和自身体验的途径,通过在临床上的有效实施,能够显著改善现有的以生物模式为主导的医疗行为,为医学生的社会化能力培养提供可行的操作模式。

Objective Because of the social nature of medicine,the modern clinician must be able to meet the social needs of the patient.However,the socialized ability of medical students is generally insufficient now.In order to explore an effective way to cultivate the socialization ability of medical students,this study applied narrative medicine to clinical work and carried out the practice of the socialization ability training of medical students based on narrative medicine model.Methods In this study,a randomized controlled study was conducted on 126 senior medical students rotating in the department of endocrinology in our hospital.The narrative medicine group received the three-step narrative medicine clinical training according to the plan,while the control group received the traditional teaching with the same time.Results The socialized ability of narrative medicine group was significantly improved,especially in the socialized evaluation index of professional ethics and professional skills,which was significantly better than that of the control group(P<0.05),and the score of patient satisfaction was higher.Conclusion Narrative medicine model provides both doctors and patients with a good way to fully understand the social attributes behind individuals and their own experience.It can significantly improve the existing medical behavior dominated by biological model,and provides a feasible operation mode for the social ability training of medical students.