从课堂到临床：医学生专业身份的形成过程研究

From Classroom to Clinic: A Study on the Process of Professional Identity Formation among Medical Students

摘要: 医学生专业身份的形成不仅关乎知识技能的掌握，更关乎身份认同与价值观的塑造。本文基于华南某医学院一年的民族志田野调查，结合课堂观察、临床模拟记录和深度访谈，探讨医学生如何在被观看的环境中自我定位、在隐性课程中学习冷静与角色扮演，并在理想与现实的矛盾中重塑“医生”角色认同。研究表明，医学生的专业社会化是一种多层次的文化建构过程，包括外在规范的规训、情感管理的学习及职业理想的调适。同时，隐性课程和权力结构对职业理想与价值观产生深远影响。为此，本文强调医学人文教育在身份塑造中的核心作用，并提出在人文教学中通过优化隐性课程的文化生态、建立结构化情感反思机制以及完善人文与临床整合的评价体系，旨在破解职业异化困境，培养出既具备精湛专业素养又兼具人文温度的高素质医学人才。

Abstract: The formation of medical students’ professional identity involves not only the acquisition of knowledge and technical skills but also the shaping of identity and values. Based on one year of ethnographic fieldwork conducted at a medical school in South China, this study draws on classroom observations, records of clinical simulation training, and in-depth interviews to examine how medical students position themselves in environments of constant observation, learn emotional restraint and role performance through the hidden curriculum, and renegotiate their understanding of the “doctor” role amid tensions between idealism and reality. The findings indicate that professional socialization in medical education is a multilayered process of cultural construction, encompassing disciplinary regulation, the learning of emotional management, and the adjustment of professional ideals. At the same time, hidden curricula and power structures exert profound influences on students’ professional ideals and value orientations. The article underscores the crucial role of medical humanities education in professional identity formation and recommends improving the hidden curriculum environment while strengthening reflective practices and emotional support to cultivate physicians who are both professionally competent and humane.