健康中國背景下敘事醫學在醫學人文教育的應用研究

Research on the Application of Narrative Medicine in Medical Humanities Education under the Background of Healthy China

目的：了解健康中國背景下敘事醫學在醫學人文教育的應用研究現況與問題。方法：文獻分析法。結果：目前醫學人文教育存在的問題較多，涉及受教育者自身、教育者、社會影響等多個方面，其中有人文教育師資力量薄弱或投入不足、人文課程設置不合理、教學模式單一、缺乏創新性以及教學效果欠佳，學員對人文知識的重視不夠或認識不足、學員自身人文精神缺失或人文素質薄弱、醫院或學校對人文教育重視不夠、理論和實踐不能有機結合等。醫學院校作為開展醫學教育主體的機構主體，還沒有普遍給予敘事醫學教育足夠重視。結論：敘事醫學通過傾聽患者敘述、關注曾被忽視的情感因素、再現患者所講，以達到與患者共情、建立關聯和歸屬關係，從而建立醫患間的互信，使患者得到良好的就醫體驗、醫生得到職業滿足感，實現醫學人文關懷的真正落地。醫學人文教育中要加入以細讀文學作品和寫作為手段的敘事醫學內容，建議應儘早培養醫學生的敘事能力。

Objective: To understand the current situation and problems of applying narrative medicine to medical humanities education in the context of healthy China. Methods: Literature analysis. Results: At present, there are many problems in medical humanistic education, involving the learners themselves, educators, social influences and other aspects. These problems include weak teachers or insufficient investment in humanistic education, unreasonable humanistic curriculum, one-way teaching model, lack of innovation, and poor teaching effect, students’ not paying enough attention to humanistic knowledge, students’ lack of humanistic spirit or humanistic quality, hospitals or schools not paying enough attention to humanistic education, and theory and practice not being organically integrated. As the main body of medical education, medical colleges have not paid enough attention to narrative medical education. Conclusion: Narrative medicine through listening to patients was ignored. The emotional factors should be paid attention to, and the patients’ narrative content should be reproduced, so that the association with patients’ empathy and the belonging relationship can be established. Hence, the mutual trust between patients and doctors can be established, patients can get good medical treatment, doctors can get experience career satisfaction, and finally the real landing of medical humanities concern can be achieved. In medical humanities education, narrative medicine content should be added by means of careful reading of literary works and writing. It is suggested that the narrative ability of medical students should be cultivated as soon as possible.