叙事医学教学法在标准化病人规范化培训中的应用及效果初探  

Preliminary Exploratim of Application and Effect of Narrative-medicinebased Teaching in Standardized Patient Training

作　　者：杨虹 帅小龙 罗晓红 李雨璘 刘霞 Yang Hong;Shuai Xiao-long;Luo Xiao-hong;Li Yu-lin;Liu Xia

机构地区：[1]成都中医药大学医学与生命科学学院

出　　处：《中国医学人文》2025年第2期21-27,共7页Chinese Medical Humanities

基　　金：中国医药教育协会标准化病人实践教学应用研究课题项目编号:T-2025034;成都中医药大学教育教学改革项目项目编号:JGYB202407;成都中医药大学教育教学改革项目项目编号:JGYB202439;四川省高等教育人才培养质量和教学改革项目项目编号:JG2024-0642;四川省教育厅一流本科课程项目编号:YLKC01509。

摘　　要：背景标准化病人(standardized patient,SP)因符合现代医疗伦理标准、临床情境模拟效果好、评价客观,在医学教育和评估中广受认可。虽然SP已经建立了规范的培训体系,但表演技巧和反馈能力仍有待提高。目的探索叙事医学教学法(narrative-medicine-based teaching,NMBT)融入规范化SP培训体系的实践路径,促进临床医学专业人才的培养。方法实验组:NMBT培训的SP应用于2019级临床医学生问诊教学。对照组:常规培训的SP应用于2018级临床医学生问诊教学。NMBT教学法融入规范化SP培训具体实施步骤包括:观医患故事,深化SP同理心;写故事感悟,内化叙事能力;讲故事讨论交流,增强SP的共情能力,提升其职业认同。比较两组本科水平测试问诊成绩与学生满意度。结果实验组测试问诊成绩(89.42±8.52)分高于对照组(85.76±7.89)分,P<0.001。NMBT培训的SP教学满意度在表演真实性、教学有吸引力、教学促进沟通能力、教学培养临床思维四个方面的满意度高于对照组,P<0.05。结论本研究着眼于SP应用的不足,改革传统培训模式,融入NMBT提升SP的教学效能,旨在提高临床医学生实践技能水平,构建和谐的医患关系。Background Standardized patient(SP)is widely recognized in medical education and assessment due to their compliance with modern medical ethical standards,effective simulation of clinical scenarios,and objective evaluation.Currently,although a standardized training system for SP has been established,there is still room for improvement in their performance skills and feedback abilities.Objective To explore the implementation pathways of integrating narrative-medicine-based teaching(NMBT)into the standardized SP training system,in order to promote the cultivation of professional clinical medical talents.Methods The experimental group:SP trained with NMBT for students from the 2019 class of Clinical Medicine,in consultaion teaching;the control group:SP trained with conventional methods for students from the 2018 class of Clinical Medicine,in consultaion teaching.The specific implementation steps of integrating NMBT into standardized SP training include:watching medical stories to deepen the empathy of SP;writing reflections on stories to internalize narrative skills;discussing and sharing stories to enhance the empathy and professional identity of SP.The clinical interview scores of the two groups of students in the undergraduate level test were compared,as well as the students'satisfaction.Results The experimental group scored higher(89.42±8.52)than the control group(85.76±7.89),with P<0.001.The satisfaction level of SP teaching in NMBT training was significantly higher than that of the control group in terms of performance authenticity,teaching attractiveness,promotion of communication skills,and cultivation of clinical thinking.Conclusion This study focuses on the deficiencies in the application of SP,reforms the traditional training model by integrating NMBT to enhance the teaching effectiveness of SP,and aims to improve the practical skills of clinical medical professionals and build a harmonious doctor-patient relationship.

关 键 词：叙事医学 标准化病人 临床医学生 医学人文教育 教学反馈 

分 类 号：G642[文化科学—高等教育学]