叙事医学教育对临床医学专业学生共情能力和学业成绩的影响:一项随机对照试验  

Influence of Narrative Medical Education on Empathy Ability and Academic Achievement of Clinical Medical Students:A Randomized Controlled Trial

作　　者：杨柠溪 李小燕[1] 燕虹 李十月 耿庆山 YANG Ning-xi;LI Xiao-yan;YAN Hong;LI Shi-yue;GENG Qing-shan(School of Health Sciences, Wuhan University, Wuhan 430071, China;Institute of Medical Humanities, Peking University, Beijing 100191, China;Guangdong General Hospital, Guangdong Academy of Medical Science, Guangzhou 510080, China)

机构地区：[1]武汉大学健康学院,武汉430071 [2]北京大学医学人文研究院,北京100191 [3]广东省人民医院,广州510080

出　　处：《中国临床心理学杂志》2018年第3期557-560,556,共5页Chinese Journal of Clinical Psychology

基　　金：广东省哲学社会科学规划项目(NO:GD14CGL04)

摘　　要：目的:探索叙事医学教育干预对临床医学专业学生共情能力和学业成绩的影响。方法:以6个班级的242名临床医学专业学生为研究对象。6个班级被随机分成三组,每组两个班级。在测量基线资料后,第一组学习常规医学课程,第二组接受一学期的叙事医学理论教育,第三组接受共两学期的理论与实践相结合的叙事医学教育。运用杰斐逊共情量表测量六个时间点上的共情能力,在毕业前收集学生的学业成绩。运用单因素方差分析和LSD检验,比较3组的共情能力和学业成绩。重复测量方差分析用于测量共情能力随时间的变化。结果:共有234名学生参与研究,参加率为96.7%。第三组学生的共情能力高于第二组和第一组学生(P<0.05),学业成绩高于第一组学生(P<0.05)。第二组学生的共情能力高于第一组学生(P<0.05)。各组学生的共情能力在六个时间点上有所不同。结论:理论与实践相结合的叙事医学教育干预是一种有效的提高临床医学学生的共情能力与学业成绩的策略。Objective To determine the effectiveness of a narrative medicine educational intervention on the empathy abilities and academic achievement of clinical medical students. Methods： A cluster randomized controlled trial was conducted in 242 clinical medical students from 6 classes. The 6 classes were randomly divided into three groups with two classes in each group. After baseline measurements, Group 1 took regular medical education courses, Group 2 received a theoretical narrative medicine education for 1 term, and Group 3 received a narrative medicine education that integrated theory with practice for 2 terms. Empathy ability was measured by the Jefferson Scale of Empathy at 6 different times, and academic achievement was collected before graduation. A one-way ANOVA and LSD test was performed to compare the empathy abilities and academic achievements among the 3 groups. Repeated measures ANOVA was used to measure changes in empathy abilities over time. Results： A total of 234 students participated in the study, resulting in a 96.7% response rate. Students in Group 3 showed higher empathy abilities than students in Group 1 and Group 2（P〈0.05）, and higher academic achievement than Group 1（P〈0.05）. Students in Group 2 showed higher empathy abilities than students in Group 1（P〈 0.05）. The empathy ability of each group was different at the six time points. Conclusion： Narrative medicine educational intervention that combines theory with practice is an effective strategy to improve clinical medical students＇ empathy abilities and academic achievement.

关 键 词：叙事医学 教育干预 共情 学业成绩 临床医学学生 

分 类 号：R395.6[哲学宗教—心理学]