叙事医学在口腔黏膜病学临床实习带教中的应用研究  

Application of narrative medicine in the clinical teaching of oral mucosal diseases

作　　者：杜观环[1] 邓一文[1] 刘丽骏[1] 沈雪敏[1] Du Guanhuan;Deng Yiwen;Liu Lijun;Shen Xuemin(Department of Oral Medicine,Shanghai Ninth People's Hospital,College of Stomatology,Shanghai Jiao Tong University School of Medicine,National Center for Stomatology,National Clinical Research Center for Oral Diseases,Shanghai Key Laboratory of Stomatology,Shanghai Research Institute of Stomatology,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院口腔黏膜病科,上海交通大学口腔医学院,国家口腔医学中心,国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室,上海市口腔医学研究所,上海200011

出　　处：《中华医学教育探索杂志》2023年第12期1792-1796,共5页Chinese Journal of Medical Education Research

基　　金：上海交通大学医学院附属第九人民医院医院管理研究项目-教学类(YGB202115)。

摘　　要：目的探讨叙事医学理念下的带教实践对提高口腔黏膜病科实习生共情水平的影响。方法将上海交通大学口腔医学院2018级口腔医学专业实习生分为两组,分别为加入叙事医学教学组(即在实习前和实习过程中均加入叙事医学的相关理念和方法)(27人)和传统教学组(即无叙事医学相关理念和方法的加入,在带教教师常规指导下学生直接接诊患者)(21人)。利用问卷收集学生一般情况,采用中文版杰弗逊同理心量表(Jefferson scale of physician empathy,JSPE)(医学生版)测量学生共情水平,实习结束后统计分析2组学生的实习成绩,以及问卷调查叙事医学教学组学生对叙事医学指导下的实习认可度。利用GraphPad Prism 9.3.0进行t检验和秩和检验。结果传统教学组学生的同理心量表得分为(92.26±8.23),而叙事医学教学组学生得分为(104.20±15.65),差异有统计学意义(t=2.70,P=0.005)。此外,88.89%(24/27)的学生对参与叙事医学指导下的实习有兴趣。但是,叙事医学教学组学生的实习成绩为(87.28±2.77),传统教学组学生的实习成绩为(85.47±4.31),两者差异无统计学意义(t=1.68,P=0.100)。结论在口腔黏膜病学实习带教过程中融入叙事医学理念和方法能提高实习生的共情能力,让学生树立同理心与科学素养同样重要的意识。Objective To investigate the effect of teaching practice under the concept of narrative medicine on improving the empathy level of interns in oral mucosal diseases.Methods The interns of stomatology in the class of 2018 in School of Stomatology,Shanghai Jiao Tong University,were divided into narrative medicine teaching group(27 interns receiving narrative medicine concepts and methods before and during internship)and traditional teaching group(21 interns received patients directly under the guidance of teachers without the addition of narrative medicine concepts and methods).A questionnaire was used to collect the general information of students,and the Chinese version of Jefferson Scale of Physician Empathy(JSPE)(the version for medical students)was used to measure the empathy level of students.After the end of internship,a statistical analysis was performed for the scores of both groups,and a questionnaire survey was conducted to investigate the acceptance of internship under the guidance of narrative medicine among the students in the narrative medicine teaching group.GraphPad Prism 9.3.0 was used to perform the t-test and the rank sum test.Results There was a significant difference in JSPE score between the traditional teaching group and the narrative medicine teaching group(92.26±8.23 vs.104.20±15.65,t=2.70,P=0.005),and in addition,88.89%(24/27)of the students in the narrative medicine teaching group were interested in participating in internship under the guidance of narrative medicine.However,there was no significant difference in the score of internship between the narrative medicine teaching group and the traditional teaching group(87.28±2.77 vs.85.47±4.31,t=1.68,P=0.100).Conclusions Incorporating the concepts and methods of narrative medicine into clinical teaching of oral mucosal diseases can significantly improve the empathy ability of interns and raise the awareness that empathy is as important as scientific literacy among students.

关 键 词：叙事医学 口腔黏膜病学 实习带教 共情水平 

分 类 号：R-05[医药卫生]