对医学生进行医师职业精神培养是医学教育的重要组成部分。本文基于文献阅读,将医学院校教育阶段医师职业精神培养的实践模式总结为人文课程中的医师职业精神培养、医学基础课程和医学专业课程(理论部分)中的医师职业精神培养、针对医师职业精神培养建设的特定课程、社会实践活动中的医师职业精神培养以及临床见习和实习中的医师职业精神培养。同时,指出我国医学院校在医师职业精神培养方面存在院校间发展不平衡以及教师和学生重视程度不够等问题,对医学院校结合自身特点做好医师职业精神培养的顶层设计提出了建议。
Professionalism cultivation is a key component of medical education. Based on literature review, this paper summarizes college medical professionalism cultivation into five different models, including the training of medical professionalism through humanity courses, the training of medical professionalism through basic medical courses and clinical theory courses, the development of specific medical professionalism courses, the cultivation of medical professionalism through social practices, and the cultivation of medical professionalism during internship and clerkship. It also points out that there are problems exist in China's medical professionalism training, such as the unbalanced development between different schools, and the neglect from teachers and students. Thus suggest that different colleges should make their own top-level design with the consideration of their respective characteristics.
[1]Cruess RL, Cruess SR, Boudreau JD, et al. Reframing medical education to support professional identity formation[J]. Acad Med, 2014,89(11):1446-1451. DOI: 10.1097/ACM.0000000000000427.
[2]Irby DM, Hamstra SJ. Parting the clouds: three professionalism frameworks in medical education[J]. Acad Med, 2016,91(12):1606-1611. DOI: 10.1097/ACM.0000000000001190.
[3]连婕, 燕娟, 王洪奇. 哈佛医学院医学人文课程体系设置探析[J].医学与哲学,2013,34(15):26-29.
Jie L, Juan Y, Hong-qi W.Exploration of the curriculum system in medical humanity at harvard medical school[J].Medicine & Philosophy,2013,34(15):26-29.
[4]人文医学教育教学改革纲要[J]. 医学与哲学, 2015,36(7A):1-7.
[5]秦岭, 周诣, 石晓兰. 医学生职业精神研究进展[J]. 中国高等医学教育, 2018(7):23-24.DOI:10,3969/j.issn.1002-1701.2008.07.012.
[6]Margetts JK. Learning the law: practical proposals for UK medical education[J]. J Med Ethics, 2016,42(2):138-140. DOI: 10.1136/medethics-2012-101013.
[7]Shapiro J, Nixon LL, Wear SE, et al. Medical professionalism: what the study of literature can contribute to the conversation[J]. Philos Ethics Humanit Med, 2015,10:10. DOI: 10.1186/s13010-015-0030-0.
[8]Macpherson CC. Teaching professionalism in science courses: anatomy to zoology[J]. Kaohsiung J Med Sci, 2012,28(2 Suppl):S8-S12. DOI: 10.1016/j.kjms.2011.08.003.
[9]Jones TW. Creating a longitudinal environment of awareness: teaching professionalism outside the anatomy laboratory[J]. Acad Med, 2013,88(3):304-308. DOI: 10.1097/ACM.0b013e318280f075.
[10]Kumar GS, Kumar A. Building professionalism in human dissection room as a component of hidden curriculum delivery: a systematic review of good practices[J]. Anat Sci Educ, 2019,12(2):210-221. DOI: 10.1002/ase.1836.
[11]McKenna J, Rosen HD. Competency-based professionalism in anesthesiology: continuing professional development[J]. Can J Anaesth, 2012,59(9):889-908. DOI: 10.1007/s12630-012-9747-z.
[12]Deptula P, Chun MB. A literature review of professionalism in surgical education: suggested components for development of a curriculum[J]. J Surg Educ, 2013,70(3):408-422. DOI: 10.1016/j.jsurg.2012.11.007.
[13]Findyartini A, Sudarsono NC. Remediating lapses in professionalism among undergraduate pre-clinical medical students in an Asian Institution: a multimodal approach[J]. BMC Med Educ, 2018,18(1):88-97. DOI: 10.1186/s12909-018-1206-2.
[14]Flickinger TE, O'Hagan T, Chisolm MS. Developing a curriculum to promote professionalism for medical students using social media: pilot of a workshop and blog-based intervention[J]. JMIR Med Educ, 2015,17(12):1-11. DOI: 10.2196/mededu.4886.
[15]Hultman CS, Connolly A, Halvorson EG, et al. Get on your boots: preparing fourth-year medical students for a career in surgery, using a focused curriculum to teach the competency of professionalism[J]. J Surg Res, 2012,177(2):217-223. DOI: 10.1016/j.jss.2012.06.019.
[16]Beck J, Chretien K, Kind T. Professional Identity development through service learning: a qualitative study of first-year medical students volunteering at a medical specialty camp[J]. Clin Pediatr (Phila), 2015,54(13):1276-1282. DOI: 10.1177/0009922815571108.
[17]王天秀, 黄娉婷, 黄妹. 医师职业精神培养机制研究——志愿者行动[J]. 中国医学伦理学, 2013,26(4):439-441. DOI: 10.3969/j.issn.1001-8565.2013.04.008.
[18]王建敏, 王香平, 樊洁, 等. 医学生临床阶段职业精神培养实践探索与思考[J]. 中国医院, 2015(2):71-73. DOI: 10.3969/j.issn.1671-0592.2015.02.035.
[19]Zink T, Halaas GW, Brooks KD. Learning professionalism during the third year of medical school in a 9-month-clinical rotation in rural Minnesota[J]. Med Teach, 2009,31(11):1001-1006. DOI: 10.3109/01421590802572759.
[20]王雪. 医学生职业精神教育途径初探——北京大学医学部培育医学生职业精神的做法[J]. 中国医学伦理学, 2016,29(6):956-958.
[21]吴雪松, 张雪, 王彧, 等. 追寻医学人文教育的生命力——哈尔滨医科大学医学人文课程改革与实践[J]. 医学与哲学, 2015,36(6A):12-15.
[22]聂政, 苏炳银. 解剖学教学环境的医学人文素质教育基地建设[J]. 解剖学杂志, 2019,42(1):104-105. DOI: 10.3969/j.issn.1001.1633.2019.01.032.
[23]唐华, 王甦平, 周栋, 等. 令人忧虑的问题——对一次医学生职业精神认同调研的反思[J]. 医学与哲学, 2018,39(8 A):51-54. DOI: 10.12014/J.issn.1002-0772.2018.08a.12.
[24]于晨, 李红. 医学职业精神教育及其研究现状[J]. 中国医学伦理学, 2015,28(2):240-243.