题名

醫學專業素養創新課程經驗分享-「療癒者藝術(Healer's Art)課程」

并列篇名

Innovations in Medical Professional Education-The Healer's Art Course

DOI

10.6145/jme.201103_15(1).0006

作者

楊志偉(Chih-Wei Yang);黃亭睿(Ting-Jui Huang);黃琮芸(Chung-Yun Huang);陳克華(Ko-Hua Chen);何明蓉(Ming-Jung Ho)

关键词

療癒者藝術課程 ; 醫學教育 ; 醫學人文課程 ; 專業素養 ; healer's art course ; medical education ; medical humanistic curriculum ; professionalism

期刊名称

Journal of Medical Education

卷期/出版年月

15卷1期(2011 / 03 / 01)

页次

51 - 59

内容语文

繁體中文

中文摘要

人道主義與專業素養是醫師養成過程中重要的核心價值,除了知識與技能的學習之外,認同感與價值觀的培養佔有重要的角色,必須應用不同於知識與技能的教育方法,包括群體的互動、自我省思的體驗。「療癒者藝術(Healer's Art)課程」是一門由Rachel Naomi Remen醫師發展有關醫師專業素養養成的選修課,包括大堂課的講授及團體省思的活動,另外還有小組的互動,採用“探索模式(Discovery Model)”的教育方法,讓學生省思過去的經驗並在安全的環境下分享,探索人性的各個面向,從中體驗在醫病關係與療癒(Healing)過程中的許多要素。近年來台灣的醫學教育越來越重視專業素養的教育與培養,透過瞭解Healer's Art課程的教育精神與經驗,相信對於醫學人文與專業素養的養成教育會有深遠的影響與助益。

英文摘要

Humanism and professionalism are core values of the physician-educating process. In addition to technical, intellectual and cognitive competencies, the development of values and identity is pivotal when cultivating professionalism. Education in meanings and values requires techniques that are different to those used when developing intellectual and technical competencies. Active participation, reflection and small-group strategies have been recommended in order to engage students with these elements of professional development. The Healer's Art, developed by Rachel Naomi Remen, M.D., is an elective course in professionalism. It consists of five 3-hour modules, each of which includes both large- and small-group work that centers on the students' reflections of their own experiences and on sharing the stories associated with these experiences in an environment that exhibits both mutual acceptance and respect. Through this ”Discovery Model”, students are enabled, which allows them to discover and strengthen their affiliation with the core values underlying the doctor-patient relationship and the healing process. These are specifically: authentic listening and presence; respect and trust; compassion and empathy; and community and commitment. The Healer's Art has been positively evaluated across medical schools in the US and has also been promoted internationally. By learning the principles and experiences of the Healer's Art, education processes that target humanity and professionalism in Taiwan should be augmented and further disseminated.

主题分类 醫藥衛生 > 醫藥總論
社會科學 > 教育學
参考文献
  1. Chou, N. K.、Wang, S. S.、Chou, L. L.(2004)。A preliminary study assessing the relationship between physician and patients in outpatients department-problem-based learning amongst junior medical students。J Med Educ,8,159-67。
    連結:
  2. Ho, S. T.、Hsu, C. P.、Wang, C. J. O.(2004)。Future direction of medical education reform in Taiwan。J Med Educ,8,18-30。
    連結:
  3. Kao, M. Y.、Lue, B. H.、Chuu, L. I.(2004)。The practices and dilemmas of medical humanities curriculum in Taiwan。Med Educ,8,392-403。
    連結:
  4. Liu, J. S.、Liu, K. M.(2004)。A preliminary study of discourses and practice on "medical humanities" in Taiwan's medical education reform。J Med Educ,8,371-84。
    連結:
  5. Pan, C. Y.,Lai, M. L.,Liu, H. W.(2004).The investigation of intention about humanity care in medical students.Med Educ,8,301-13.
    連結:
  6. Baernstein, A.,Fryer-Edwards, K.(2003).Promoting reflection on professionalism: a comparison trial of educational interventions for medical students.Acad Med,78,742-7.
  7. Branch, W. T., Jr(2000).Supporting the moral development of medical students.J Gen Intern Med,15,503-8.
  8. Branch, W. T., Jr(2001).Small-group teaching emphasizing reflection can positively influence medical students' values.Acad Med,76,1171-2.
  9. Branch, W. T., Jr,Kern, D.,Haidet, P.(2001).The patient-physician relationship. Teaching the human dimensions of care in clinical settings.JAMA,286,1067-74.
  10. Christakis, D. A.,Feudtner, C.(1997).Temporary matters. The ethical consequences of transient social relationships in medical training.JAMA,278,739-43.
  11. Coulehan, J.,Williams, P. C.(2001).Vanquishing virtue: the impact of medical education.Acad Med,76,598-605.
  12. Feudtner, C.,Christakis, D. A.,Christakis, N. A.(1994).Do clinical clerks suffer ethical erosion? Students' perceptions of their ethical environment and personal development.Acad Med,69,670-9.
  13. Forsythe, G. B.(2005).Identity development in professional education.Acad Med,80,S112-7.
  14. Geary, C.,McKee, J.,Sierpina, V. S.(2009).The art of healing: an adaptation of the healer's art course for fourth-year students.Explore: The Journal of Science and Healing,5,306-7.
  15. Guthrie, E.,Black, D.,Bagalkote, H.(1998).Psychological stress and burnout in medical students: a five-year prospective longitudinal study.J R Soe Med,91,237-43.
  16. Hafferty, F. W.(1998).Beyond curriculum reform: confronting medicine's hidden curriculum.Acad Med,73,403-7.
  17. Hojat, M.,Mangione, S.,Nasca, T. J.(2004).An empirical study of decline in empathy in medical school.Med Educ,38,934-41.
  18. Inui, T. S.(2003).A Flag in the Wind: Educating for Professionalism in Medicine.Washington DC:Association of American Medical Colleges.
  19. Kay, J.(1990).Traumatic deidealization and the future of medicine.JAMA,263,572-3.
  20. Kligler, B.,Maizes, V.,Schachter, S.(2004).Core competencies in integrative medicine for medical school curricula: a proposal.Acad Med,79,521-31.
  21. Peters, A. S.,Greenberger-Rosovsky, R.,Crowder, C.(2000).Long-term outcomes of the New Pathway Program at Harvard Medical School: a randomized controlled trial.Acad Med,75,470-9.
  22. Rabow, M. W.,Wrubel, J.,Remen, R. N.(2007).Authentic community as an educational strategy for advancing professionalism: a national evaluation of the Healer's Art Course.J Gen Intern Med,22,1422-8.
  23. Remen, R. N.,Rabow, M. W.(2005).The healer's art: professionalism, service and mission.Med Educ,39,1172.
  24. Stern, D. T.(1998).Practicing what we preach? An analysis of the curriculum of values in medical education.Am J Med,104,569-75.
  25. Suchman, A. L.,Williamson, P. R.,Litzelman, D. K.(2004).Toward an informal curriculum that teaches professionalism. Transforming the social environment of a medical school.J Gen Intern Med,19(5 Pt 2),501-4.
  26. Swanwick, T.(2005).Informal learning in postgraduate medical education: from cognitivism to 'culturism'.Med Educ,39,859-65.
  27. Swick, H. M.,Szenas, P.,Danoff, D.(1999).Teaching professionalism in undergraduate medical education.JAMA,282,830-2.
  28. Testerman, J. K.,Morton, K. R.,Loo, L. K.(1996).The natural history of cynicism in physicians.Acad Med,71,S43-5.
  29. Wenger, E.(1998).Communities of Practice: Learning, Meaning and Identity.New York:Cambridge University Press.
  30. Wolf, T. M.,Balson, P. M.,Faucett, J. M.(1989).A retrospective study of attitude change during medical education.Med Educ,23,19-23.
  31. Wu, C. H.、Hsu, H. H.、Ho, M. J.(2008)。The medical humanities curriculum in Taiwan: curriculum survey and student interviews。J Med Educ,12,107-17。
  32. Yang, M. J.、Tsai, J. H.(1997)。Social and educational aspects concerning the development of physicians in Taiwan。J Med Educ,1,21-8。