目的 开展基于共情体验的疼痛医学教学方式的实施与效果评价。方法 2020年1月至2021年8月,选择在北京大学人民医院疼痛医学科轮转的48名住院医师和进修医师(以下将两者简称为学员)为研究对象,采用随机对照表法将其分为试验组和对照组,每组24名学员。试验组学员采用共情体验教学方式,对照组学员采用传统教学方式。教学结束后,对两组学员进行理论考试,采用人际反应指针量表进行共情能力测试,并收集学员的教学满意度评价。采用t检验对评分结果进行统计学分析。结果 试验组学员理论考试成绩[(95.1±3.4)分]高于对照组学员[(89.0±4.1)分],其差异具有统计学意义(P<0.001)。试验组学员人际反应指针量表各维度评分均高于对照组学员[如观点采择(16.2±2.2)分比(14.3±2.8)分、想象力(20.5±2.3)分比(17.8±2.9)分],其差异均具有统计学意义(均P<0.05)。试验组学员的教学满意度评价各项目评分均高于对照组学员[如学习兴趣激发(94.8±4.1)分比(87.0±5.0)分、临床思维能力(93.3±3.6)分比(83.1±5.3)分],其差异均具有统计学意义(均P<0.001)。结论 基于共情体验的疼痛医学方法的应用效果优于传统教学方式,有助于提高学员对理论知识的掌握程度和教学满意度,增强学员共情能力。
Objective To implement and evaluate empathic experience-based learning in the pain medicine. Methods From January 2020 to August 2021, forty-eight resident trainees and visiting scholars (hereinafter referred to as trainees) were recruited from the Department of Pain Medicine of Peking University People's Hospital. Using the method of random control table, the trainees were divided into experimental group and control group with 24 in each. The experimental group was trained with empathy experience-based learning method, the control group adopted traditional teaching method. Evaluation of learning outcomes was carried out in the form of theoretical examination and Interpersonal Reactivity Index-C (IRI-C), and the teaching satisfaction evaluation was collected. The score results were statistically analyzed by t-test. Results The theoretical test scores of the trainees in the experimental group were higher than those in the control group [(95.1±3.4) vs. (89.0±4.1), P<0.001]. The scores of all dimensions of IRI-C of the trainees in the experimental group were higher than those in the control group [such as viewpoint selection (16.2±2.2) vs. (14.3±2.8), imagination (20.5±2.3) vs. (17.8±2.9), all P<0.05]. The teaching satisfaction evaluation scores of the trainees in the experimental group were higher than those in the control group [such as stimulating learning interest (94.8±4.1) vs. (87.0±5.0), clinical thinking capacity (93.3±3.6) vs. (83.1±5.3), all P<0.001]. Conclusions The effect of empathic experience-based learning in the pain medicine is better than traditional teaching method, which improves trainees' mastery of theoretical knowledge and teaching satisfaction, and so supports the building of trainees' empathic capacity.
[1] 丁远远, 姚鹏. 疼痛学教育中加强人文教育的重要性及方法[J].中国继续医学教育,2017,9(8):65-67. DOI: 10.3969/j.issn.1674-9308.2017.08.034.
[2] 王凤华,石统昆,谢宏,等.体验式教学法在医患沟通课程教学中的应用[J].浙江医学教育,2016,15(4):10-12.
[3] 闫琦, 戴天, 冯艺, 等. 体验式学习在八年制医学生麻醉学实习教学中的应用[J].中华医学教育杂志,2021,41(1):58-61. DOI: 10.3760/cma.j.cn115259-20200430-00670.
[4] 崔雪梅, 李鸿鹤, 宋鑫智, 等. 临床实习期医学生与患者互动对其职业精神培养的研究与启示[J].中华医学教育杂志,2021,41(7):622-626. DOI: 10.3760/cma.j.cn115259-20210113-00063.
[5] 张凤凤,董毅,汪凯,等.中文版人际反应指针量表(IRI-C)的信度及效度研究[J].中国临床心理学杂志,2010,18(2):155-157.DOI:10.16128/j.cnki.1005-3611.2010.02.019.
[6] Purdie F, Morley S. Compassion and chronic pain[J]. Pain, 2016,157(12):2625-2627. DOI: 10.1097/j.pain.0000000000000638.
[7] 王娟, 李莉, 林文娟, 等. 共情——改善医患沟通的新视野[J].医学与哲学(人文社会医学版),2011,32(11):25-26,29.
[8] Vogel D, Meyer M, Harendza S. Verbal and non-verbal communication skills including empathy during history taking of undergraduate medical students[J]. BMC Med Educ, 2018,18(1):157. DOI: 10.1186/s12909-018-1260-9.
[9] Boissy A, Windover AK, Bokar D, et al. Communication skills training for physicians improves patient satisfaction[J]. J Gen Intern Med, 2016,31(7):755-761. DOI: 10.1007/s11606-016-3597-2.
[10] 姜能志, 李长江, 孙琳, 等. 基于共情心理的医学生医患沟通教育模式的构建[J].中国高等医学教育,2018(7):17-18. DOI: 10.3969/j.issn.1002-1701.2018.07.009.
[11] 鲁琳, 李久辉. 美国医学共情探究及对医学人文教育的启示[J].医学与哲学,2017,38(11):41-44. DOI: 10.12014/j.issn.1002-0772.2017.06a.11.
[12] Wanigasekera V, Mezue M, Andersson J, et al. Disambiguating pharmacodynamic efficacy from behavior with neuroimaging: implications for analgesic drug development[J]. Anesthesiology, 2016,124(1):159-168. DOI: 10.1097/ALN.0000000000000924.
