CAJ | 학술논문

目的通过巴林特小组案例分析,解析目前医学生在临床实习过程中的负性体验,探索医学生医患沟通培训的新方法.方法在复旦大学附属中山医院院组织10次有医学生参加的巴林特小组活动,共呈现10个临床案例,采用扎根理论的方法对讨论记录进行质性分析.结果案例发生的情境主要包括医患互动、团体协作,职业发展规划和个人生活的冲突；案例呈现的触发事件包括医患冲突、价值观冲突、面对“无法治愈的患者”的困惑、职业角色模糊、本人或患者遭受不公正待遇；小组讨论的主题包括与患者相关的情感体验、职业发展定位、医疗团队的合作、医学生临床教学.结论巴林特小组可以帮助临床医学生识别和处理医患沟通中复杂的情绪反应(自己的和患者的),澄清职业角色的要求,提高团队合作效能、提升工作满意度.
목적 통과파림특소조안례분석,해석목전의학생재림상실습과정중적부성체험,탐색의학생의환구통배훈적신방법.방법 재복단대학부속중산의원원조직10차유의학생삼가적파림특소조활동,공정현10개림상안례,채용찰근이론적방법대토론기록진행질성분석.결과 안례발생적정경주요포괄의환호동、단체협작,직업발전규화화개인생활적충돌；안례정현적촉발사건포괄의환충돌、개치관충돌、면대“무법치유적환자”적곤혹、직업각색모호、본인혹환자조수불공정대우；소조토론적주제포괄여환자상관적정감체험、직업발전정위、의료단대적합작、의학생림상교학.결론 파림특소조가이방조림상의학생식별화처리의환구통중복잡적정서반응(자기적화환자적),징청직업각색적요구,제고단대합작효능、제승공작만의도.
Objective To analyze the negative experience from medical practice of medical students by Balint group case study,and to explore new approach for training doctor-patient communication skills.Methods 10 times of Balint group activities were held in Zhongshan Hospital of Fudan University,with one case each time.Grounded theory approach were applied for analyzing discussion record.Results The cases were occurred in doctor-patient interaction,teamwork,conflict between one's personal life and vocational development planning.Trigger events involved doctor-patient conflict,conflict of values,decision making problem while conffronted with incurable patients,role ambiguity,unfair treatment.Topics of discussion included emotional experience with patients,career development orientation,medical teamwork,clinical education of medical student.Conclusion Through practice of Balint group,medical students in teaching hospital can improve their awareness of complicating psycho-social problem of patients and themselves,as well as handling it.And it can improve the professional identity,professional growth and professional self-identity.