课程思政视域下叙事医学案例教学法在“内科学”教学中的应用研究

Research on the Application of Narrative Medicine Case Teaching Method in “Internal Medicine” Teaching from the Perspective of Curriculum Ideology and Politics

摘要: 目的：探索课程思政视域下叙事医学案例教学法在“内科学”本科教学中的应用效果，为医学教育中“立德树人”与专业能力培养的融合提供实践参考。方法：选取北京中医药大学第六临床医学院房山医院6名内科学教师(男1名、女5名，年龄41~45岁)及76名中医专业医学生为研究对象。教师组通过“名医大讲堂”接受叙事医学系统培训，并编写涵盖患者病情、医患互动、心理活动的动态叙事案例；学生组采用叙事医学案例教学模式。于培训前、结课后采用叙事能力量表、关怀能力量表、杰弗逊共情能力量表对师生进行问卷调查，通过SPSS 26.0进行配对样本t检验分析。结果：学生组结课后JSE-HP评分、CAI评分、叙事能力评分均显著高于开学初，差异均有统计学意义(P < 0.05)；教师组结课后各项评分虽有波动，但差异无统计学意义(P > 0.05)。结论：课程思政视域下的叙事医学案例教学法可显著提升医学生的共情能力、关怀能力与叙事能力，有效实现“知识传授”与“价值引领”的协同，是“内科学”课程思政建设的有效路径。

Abstract: Objective: To explore the application effect of narrative medicine case teaching method in undergraduate teaching of “Internal Medicine” from the perspective of curriculum ideological and political education, and to provide practical reference for the integration of “fostering virtue through education” and professional competence training in medical education. Methods: Six internal medicine teachers (1 male, 5 females, aged 41 to 45 years) and 76 undergraduate students majoring in Traditional Chinese Medicine from Fangshan Hospital, the Sixth Clinical Medical College of Beijing University of Chinese Medicine were selected as research subjects. The teacher group received systematic training in narrative medicine through the “Famous Doctor Lecture Hall” and compiled dynamic narrative cases covering patients’ conditions, doctor-patient interaction, and psychological activities. The student group adopted the narrative medicine case teaching model. Before training and after the course, the Narrative Competence Scale, Caring Ability Inventory, and Jefferson Scale of Empathy-Health Professions were used to conduct questionnaires among teachers and students, and paired sample t-test was performed with SPSS 26.0. Results: After the course, the JSE-HP score, CAI score, and narrative competence score of the student group were significantly higher than those at the beginning of the semester, with statistically significant differences (P < 0.05). For the teacher group, although there were fluctuations in various scores after the course, the differences were not statistically significant (P > 0.05). Conclusion: The narrative medicine case teaching method from the perspective of curriculum ideological and political education can significantly improve medical students’ empathy ability, caring ability, and narrative competence, and effectively realize the coordination of “knowledge impartment” and “value guidance”. It is an effective path for the construction of curriculum ideological and political education in “Internal Medicine”.