叙事医学在妇产科教学中的应用效果——以妊娠期高血压疾病为例

    Application of narrative medicine in obstetrics and gynecology teaching: a randomized controlled trial in hypertensive disorders of pregnancy

      摘要
    • 摘要:
      目的 分析叙事医学在妇产科教学中的应用效果。
      方法 选取在空军军医大学西京医院妇产科见习的五年制本科生86人，采用随机数字表法分为对照组（n=43）和试验组（n=43）。对照组采用传统教学法（理论课和见习课均以教员讲授为主）；试验组在理论课阶段与对照组授课方式一致，仅在见习阶段增加了多层次叙事医学教学，包括：叙事理论学习、叙事分享、叙事访谈、书写平行病历、反思环节及临床实施等。授课结束后比较两组学员的理论考核成绩，并通过问卷调查评估两组学员见习前后叙事能力的变化及对教学模式的满意度。
      结果 见习结束后，试验组理论成绩（92.7 ± 1.2）显著高于对照组（90.1 ± 1.1）（P<0.01）,两组内见习前后比较，理论成绩均有提高，差异有统计学意义（P<0.01）。叙事能力方面：① 组间比较：试验组评分（152 ± 6）较对照组（120.1 ± 2.8）显著提升（P<0.01）；②组内比较：对照组干预前后评分无显著差异（117 ± 7） vs. （120.1 ± 2.8）；而试验组评分从（124 ±8）提升至（152 ± 6）（P<0.01）。此外，试验组学员对教学模式的满意度显著优于对照组（P<0.01）。
      结论  将叙事医学融入妇产科临床教学可有效提高学员的理论成绩及叙事能力，教学满意度显著提高，具有临床推广价值。

       

      Abstract:
      AIM  To analyze the effectiveness of narrative medicine in obstetrics and gynecology (OB/GYN) teaching.
      METHODS  A randomized controlled trial was conducted with 86 fifth-year undergraduate medical students during their OB/GYN clerkship at Xijing Hospital, Air Force Medical University. Participants were randomly assigned to either the control group (n=43), which received traditional instructor-led teaching, or the experimental group (n=43). The control group adopted the traditional teaching method (both theoretical courses and internship courses were mainly taught by teachers); The teaching method of the experimental group was the same as that of the control group in the theoretical course stage, and only in the internship stage, multi-level narrative medicine teaching was added, including narrative theory learning, narrative sharing, narrative interview, writing parallel medical records, reflection and clinical implementation. After the teaching, the theoretical examination results of the two groups of students before and after the internship were compared, and the changes of narrative ability and satisfaction with the teaching mode of the two groups of students before and after the internship were evaluated by questionnaire.
      RESULTS After the internship, the theoretical score of the experimental group (92.7 ± 1.2) was significantly higher than that of the control group (90.1 ± 1.1) (P<0.01), The theoretical scores of the two groups were improved before and after the internship, and the difference was statistically significant (P<0.01). Narrative ability: ① Comparison between groups: the score of the experimental group (152 ± 6) was significantly higher than that of the control group (120.1 ± 2.8) (P<0.01); ② Intra group comparison: there was no significant difference in the scores of the control group before and after the intervention (117 ± 7) vs. (120.1 ± 2.8); The score of the experimental group increased from (124 ± 8) to (152 ± 6) (P<0.01). In addition, the satisfaction of the experimental group was significantly better than that of the control group (P<0.01).
      CONCLUSION  Integrating narrative medicine into OB/GYN clinical education enhances theoretical performance, cultivates narrative skills, and improves learner satisfaction, supporting its broader adoption in medical training.

       

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