通讯作者: 杨卫霞, tjqhyll@163.com

DOI：10.12201/bmr.202607.00048

Cultivating Narrative Competence in Pediatric Residents: Current Status, Challenges, and Path Reconstruction

• 摘要：文章立足于生物-心理-社会医学模式转型的宏观背景,聚焦于儿科住院医师核心职业素养——叙事能力的系统化培养。旨在深入剖析当前儿科住院医师叙事能力薄弱的现状、成因,并构建提升路径。首先通过文献综述与现状调研,揭示了儿科住院医师在叙事认知、实践与共情层面存在的显著短板,并指出其与现行培养体系的结构性缺失相关,进而从医学教育体系、临床实践生态及深层次文化认知三个维度,深入剖析了制约叙事能力发展的障碍。基于此,文章提出一个涵盖理念重塑、课程重构、教学方法创新、综合评价与支持保障的系统化解决方案。方案核心在于将叙事能力培养整合入住院医师规范化培训的全过程,具体路径包括推行以平行病历与反思性写作为核心的叙事实践、开展基于真实案例的叙事医学工作坊、构建多元化的评价反馈体系,并着力于叙事医学导师队伍与数字化支持平台的建设。最后,文章针对实施中可能面临的挑战,提出应对策略,并展望了与人工智能技术融合、跨学科合作等未来方向,以期为我国儿科医学人文教育改革提供理论支撑与实践范本。

  关键词： 叙事医学; 叙事能力; 儿科住院医师; 医学教育

   

  Abstract: The article is grounded in the macro context of the transformation of the bio-psycho-social medical model and focuses on the systematic cultivation of a core professional competency of pediatric residents—narrative competence. It aims to deeply analyze the current weakness in pediatric residents’ narrative competence, its underlying causes, and to construct pathways for improvement. Through literature review and current situation surveys, it first reveals significant deficiencies in pediatric residents’ narrative cognition, practice, and empathy, and points out that these are associated with structural gaps in the existing training system. It then conducts an in-depth analysis of the barriers to narrative competence development from three dimensions: the medical education system, the clinical practice environment, and deep cultural cognition. Based on this, the article proposes a systematic solution encompassing concept reshaping, curriculum reconstruction, innovative teaching methods, comprehensive evaluation, and support measures. The core of the solution lies in integrating narrative competence training throughout the entire standardized residency training process. Specific pathways include implementing narrative practice centered on parallel medical records and reflective writing, conducting narrative medicine workshops based on real cases, establishing a diversified evaluation and feedback system, and focusing on the development of a narrative medicine mentor team and digital support platforms. Finally, the article proposes strategies to address potential challenges during implementation and envisions future directions such as integration with artificial intelligence technologies and interdisciplinary collaboration, aiming to provide theoretical support and practical models for the reform of humanistic education in pediatric medicine in China.

  Key words: Narrative Medicine; Narrative Competence; Pediatric Residents; Medical Education

  提交时间：2026-07-29

  版权声明：作者本人独立拥有该论文的版权，预印本系统仅拥有论文的永久保存权利。任何人未经允许不得重复使用。
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• 序号	提交日期	编号	操作
  1	2026-06-27	10.12201/bmr.202607.00048V1	下载

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