课程思政视域下临床医学本科生耳科理论教学人文精神培育的探索

Cultivating Humanistic Values in Otology Theory Teaching for Clinical Medicine Undergraduates through Curriculum-Based Ideological and Political Education

摘要: 目的：探讨将课程思政理念融入耳科学理论教学的实施路径，评价其对临床医学本科生人文关怀能力、共情能力及职业素养等相关表现的影响，为耳鼻咽喉头颈外科学课程思政教学改革提供参考。方法：选取本科临床医学专业两个自然教学班学生为研究对象，在授课教师、教材、教学大纲和学时安排一致的前提下，对照组实施常规耳科学理论教学；实验组在常规教学基础上开展课程思政教学。教学前后采用关怀能力评价量表(CAI)和杰弗逊共情量表医学生版(JSE-S)进行测评；教学结束后采用师生互评教学满意度问卷、课程思政认知度问卷和反思报告主题分析进行多维度评价。结果：教学结束后，实验组CAI总分为(203.33 ± 13.50)，高于对照组的(193.35 ± 12.93)分；实验组JSE-S总分为(115.66 ± 9.90)，亦高于对照组(98.77 ± 7.91)；差异均有统计学意义(P < 0.001)。实验组学生对教师的满意度评分为(4.43 ± 0.44)，显著高于对照组(3.27 ± 0.67) (P < 0.001)；教师对实验组学生学习态度和课堂参与度的评分分别为(4.09 ± 0.44)分和(4.07 ± 0.49)分，均高于对照组(均P < 0.001)。课程思政认知度问卷显示，实验组在耳科学发展史中的家国情怀认同、防聋治聋事业的社会责任感和医患共情重要性认知3个维度的认同率均高于对照组(均P < 0.05)。反思报告主题分析显示，实验组学生较多关注“技术之外的人文温度”“听力障碍群体的社会处境”和“医者的多重责任”等主题。结论：在耳科学理论教学情境中，系统融入学科史教育、公共卫生政策案例、叙事医学讨论和反思性写作，与学生较高的人文关怀能力、共情能力及教学过程评价相关。受单中心、非随机分组及短期观察等因素限制，尚不能据此作出明确的因果推断。该教学设计可为临床医学理论课开展医学人文与价值引领融合教学提供参考，其效果仍需在不同院校、不同专业及更长随访周期中进一步验证。

Abstract: Objective: To explore the implementation of curriculum-based ideological and political education in otology theory teaching and evaluate its effects on humanistic caring ability, empathy, and related professional attributes among undergraduate clinical medicine students, thereby providing a reference for curriculum reform in otorhinolaryngology-head and neck surgery. Methods: Two intact classes of undergraduate clinical medicine students were enrolled. Under identical conditions regarding instructors, textbooks, syllabus, and teaching hours, the control group received routine otology theory teaching, whereas the intervention group received routine teaching integrated with curriculum-based ideological and political education. Humanistic caring ability and empathy were assessed before and after the intervention using the Caring Ability Inventory (CAI) and the Jefferson Scale of Empathy-Medical Student Version (JSE-S), respectively. After the intervention, multidimensional evaluation was conducted using a student-teacher reciprocal teaching satisfaction questionnaire, a curriculum-based ideological and political education awareness questionnaire, and thematic analysis of reflective reports. Results: After the intervention, the CAI total score was significantly higher in the intervention group than in the control group (203.33 ± 13.50 vs. 193.35 ± 12.93 points), as was the JSE-S total score (115.66 ± 9.90 vs. 98.77 ± 7.91 points; both P < 0.001). Students’ overall ratings of teaching were significantly higher in the intervention group than in the control group (4.43 ± 0.44 vs. 3.27 ± 0.67, P < 0.001). Instructor ratings of students’ learning attitude and classroom engagement in the intervention group were 4.09 ± 0.44 and 4.07 ± 0.49, respectively, both higher than those in the control group (both P < 0.001). Recognition rates in the three domains of patriotic commitment reflected in the history of otology, social responsibility for hearing-loss prevention and treatment, and the importance of physician-patient empathy were all higher in the intervention group (all P < 0.05). Thematic analysis of reflective reports identified frequent attention to “humanistic warmth beyond technology,” “the social circumstances of people with hearing impairment,” and “the multiple responsibilities of physicians.” Conclusion: In the context of otology theory teaching, the systematic integration of disciplinary history education, public health policy cases, narrative medicine discussions, and reflective writing was associated with higher levels of humanistic caring ability, empathy, and favorable teaching-process evaluations among students. Owing to the single-center, nonrandomized design and short observation period, no definitive causal inference can be drawn. This teaching approach may provide a reference for integrating medical humanities and value-based education into theoretical courses in clinical medicine; its effectiveness should be further validated across different institutions, disciplines, and longer follow-up periods.