叙事医学联合案例教学法在精神科住院医师教学中的实践研究

A Practical Research on the Application of Narrative Medicine Combined with Case-Based Teaching Method in the Training of Psychiatric Residents

摘要: 目的：探讨叙事医学联合案例教学法(case-based learning, CBL)模式在精神科住院医师教学中的应用效果及教学意义，为该模式在临床教学中运用提供理论基础。方法：选取2022年8月至2024年8月内蒙古自治区精神卫生中心参加住院医师规范化培训的68名精神科住院医师为研究对象，随机数字表法分为对照组及观察组，对照组按传统临床教学内容进行，观察组在传统临床带教的基础上进行叙事医学联合CBL教学法的临床实践训练，并进行教学评价。结果：问卷结果显示，观察组在提高共情能力、有效采集病史、清楚表达诊断意见、提出合理建议、妥善应对问题5个方面均高于对照组，差异有统计学意义(P < 0.05)。结论：在本研究单中心样本背景下，叙事医学联合案例教学法能提升沟通能力及人文素养，为同级别精神住培基地精神科医师实践教学提供新思路。

Abstract: Objective: To explore the application effect and teaching significance of the narrative medicine combined with case-based learning (CBL) model in the training of psychiatric residents, and to provide a theoretical basis for the application of this model in clinical teaching. Methods: A total of 68 psychiatric residents participating in the standardized training at the Inner Mongolia Autonomous Region Mental Health Center from August 2022 to August 2024 were selected as the research subjects and randomly divided into the control group and the observation group by the random number table method. The control group was taught with traditional clinical teaching content, while the observation group received clinical practice training based on traditional clinical teaching combined with narrative medicine and CBL, followed by teaching evaluation. Results: The questionnaire results showed that the observation group performed better than the control group in five aspects: enhancing empathy, effectively collecting medical history, clearly expressing diagnostic opinions, providing reasonable suggestions, and properly handling problems, with statistically significant differences (P < 0.05). Conclusion: In the context of a single-center sample in this study, narrative medicine combined with the case teaching method can enhance communication skills and humanistic qualities, providing new ideas for the practical teaching of psychiatrists in the same-level mental health residency training base.