临床医学实习生叙事能力现状及影响因素分析  

Analysis of Narrative Competence and Influcing Factors of Clinical Medical Interns

作　　者：和珂 刘刃 吴庆[3] 赵珍赢 张业妍 杨德梅 HE Ke;LIU Ren;WU Qing;ZHAO Zhenying;ZHANG Yeyan;YANG Demei(Department of Healthcare-associated Infection Control,the Fifth Affiliated Hospital,Sun Yat-sen University,Zhuhai 519000,China;Department of Medical Affairs,the Fifth Affiliated Hospital,Sun Yat-sen University,Zhuhai 519000,China;Department of Teaching Affairs,the Fifth Affiliated Hospital,Sun Yat-sen University,Zhuhai 519000,China;Department of Cardiology,the Fifth Affiliated Hospital,Sun Yat-sen University,Zhuhai 519000,China)

机构地区：[1]中山大学附属第五医院医院感染管理科,广东珠海519000 [2]中山大学附属第五医院医务科,广东珠海519000 [3]中山大学附属第五医院教学科,广东珠海519000 [4]中山大学附属第五医院心血管内科,广东珠海519000

出　　处：《医学教育研究与实践》2025年第2期225-231,共7页Medical Education Research and Practice

基　　金：2023年度广东省临床教学基地教学改革项目(19);广东省“新医科”教指委2023年教学改革项目(73)。

摘　　要：目的 了解临床医学专业本科生实习阶段医学叙事能力现状,并分析其影响因素,为医疗机构教学管理者制定医学生叙事能力培训策略提供参考。方法 2024年5—2024年6月,采用整群抽样方法,选取广东省某三级甲等教学医院2024年参加临床实习的194名临床专业本科生为研究对象,采用一般资料调查问卷、医学叙事能力量表进行横断面调查。采用独立样本t检验和方差分析比较组间差异,采用多元线性回归分析叙事能力的影响因素。结果 共回收163份有效问卷,有效回收率为84%。临床医学专业本科生叙事能力总分为(144.89±19.53)分,平均得分为(5.07±0.55)分,反思再现维度条目均分高于理解回应和关注倾听。同学关怀程度、参加社会活动次数、人文素养自评、是否自主选择专业是临床医学专业本科生医学叙事能力的影响因素。结论 临床医学专业本科生实习阶段的医学叙事能力处于较低水平,临床教学管理者应在教学方案中增加叙事医学相关内容,提供更多的临床实践机会,进而提升临床医学本科实习生的医学叙事能力。Objective To investigate the narrative competence of undergraduate Clinical Medical interns and explore the influencing factors,aiming to offer valuable insights for teaching administrators of medical agencies to set narrative-based medical education.Methods From May to June 2024,a cluster sampling method was employed to select 194 Clinical Medical undergraduates who participated in the clinical internship in a grade-A tertiary teaching hospital in Guangdong Province in 2024 as the research objects.General questionnaire and medical narrative ability scale were used to conduct cross-sectional study.Independent-sample t-tests and analysis of variance were applied to compare difference between groups,and multiple linear regression was used to analyze the influencing factors of narrative competence.Results A total of 163 valid questionnaires were included in the final analysis,with the valid recovery rate of 84%.The total score of Clinical Medical undergraduates’narrative competence was(144.89±19.53),the mean score was(5.07±0.55),and the mean item score of reflection and representation was higher than that of understanding and listening.Caring degree of peers,frequency of participating social activities,self-assessment of humanistic quality,and the willingness to choose major were significant influencing factors of Clinical Medical undergraduates’narra‐tive competence.Conclusion The medical narrative competence of Clinical Medical undergraduates in internship is at a relatively low level.Clinical teaching administrators should add narrative medicine related knowledge in the teaching design and provide more opportunities of clinical practice,so as to improve the medical narrative competence of Clinical Medical undergraduate interns.

关 键 词：临床医学 实习生 教学管理 叙事能力 影响因素 

分 类 号：G642[文化科学—高等教育学]