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教研室：医学英语教研室 教师名称：
| 课程名称 | 医学英语 | 授课专业和班级 | 05级 | ||
| 授课内容 | Unit eleven Narrative and Medicine | 授课学时 | 4 | ||
| 教学目的 | The teacher will lead the Chinese students to get close to a method of interviewing a patient招生简章—listen to the patient and conclude from his expressions. | ||||
| 教学重点 | Some new concepts related to narrative medicine and cultivate the awareness of the students in curing a patient. | ||||
| 教学难点 | Literary skills are used in the treatment of the patient and the concept is new and the cultures are quite different, so Chinese students have to get to know to it and associate the methods with the Chinese way of curing a patient. | ||||
| 教具和媒体使用 | Traditional method and PPT | ||||
| 教学方法 | Analyzing the text and discussion | ||||
| 教 学 过 程 | I. Lead in activities (10 min.) How would you cure a patient when he comes to see you? Will you spare enough time to make the patient tell without interruption? Have you ever though about some literary ways of interviewing a patient? II. Background knowledge (10 min.) Mark Twain was the pseudonym of Samuel Langhorne Clemens, who grew up in Hannibal, Missouri. III. Analysis of the text (50 min.) 1. A concrete case mentioned in the text. 2. Language points. 3. Analysis of difficult sentences. 4. Different cultural background and different interviewing skills. IV. Discussion (10 min.) V. Summary (10 min.) 1. You will probably a doctor working in China. Will you make use of the method in your medical career? 2. Is that really feasible to use narrative skills? How can you overcome the difficulties? How can you be a qualified doctor? VI. Assignment (10 min.) Translate the Chinese phrases into English on P76 | ||||
| 讲授 新内容 | A new concept “narrative medicine” and its popularity in the western countries. The essence of narrative medicine is introduced in the class. | ||||
| 课后总结 | Students get to know the full meaning of narrative of medicine and they begin to realize that being a doctor is hard and listening to the patient is so important and there are some listening skills in interviewing a patient. | ||||
I．Background knowledge
1. Author:
Dr. Rita Charonis a pioneer and national authority in the field of literature and medicine,and has written and lectured extensively on literature’s salience to medicalpractice as well as on the doctor-patient relationship, narrative competence, medicalethics.
Her research has focused on communicationbetween doctors and patients, seeking ways to improve the ability of doctors tounderstand what their patients tell them.
Columbia University is the only medical school with a programin narrative competence, in which medical students learn how to better"read" their patients" stories through literary studies.
2. Something about“Narrative Medicine”
Narrative medicine “goes deeper” than aphysical diagnosis .Narratives, Rita Charon said,have what medicine lacks, namely characters, plots and storylines. “Only intelling a story that I can live in the face of time, that I can see somethingsingular,” and referring to an individual person and that person’s story,rather than a name on a chart. “It makes it not just a technical puzzle but alived experience,” Charon said.
I listen not onlyfor the content of his narratives, but for its form—its temporal course, itsimages, its associated subplots, its silences, where he chooses to begin intelling of himself, how he sequences symptoms with other life events.
Such fields as medical interviewing,primary care, literature and medicine, and relation-centered orpatient-centered care have revolved around these “tellings”.
In turn, doctors have learned abouttherapeutic listening from practitioners of oral history, trauma studies,autobiography, and psychoanalysis.
II. Analysis ofthe text
1. 3 aspects of“Narrative Competence”
1st. Textual Skills (文字能力)
2nd. CreativeSkills (创造能力)
3rd. Affective Skills （情感表达能力)
When a doctorpractices medicine with narrative competence, he or she can quickly hear andinterpret what a patient tries to say.
Narrative skills that are important to medical practicehave been identified, and methods of teaching them have been developed.
2. Words andexpressions
1. narrative: n. (1) spoken or written account of events; story
a gripping ~ about the war 扣人心弦的战况报道
a. (2) of, or in the form of , story-telling
~ literature, ~ poems
Narrate: tell (a story)
~ one’s adventures
2. sequence: (1)succession
a ~ of bumper harvests 连续的大丰收
(2) 把什么按顺序排好
~ the major eventsin his life
Sequential: following in order
Consequence: (1) resulwww.lindalemus.com/job/t
Her investment had a disastrous ~: she losteverything she owed. 她的投资结果很掺：她血本无归。
(2) importance
It is of no ~.
Consequent: following as a result of sth
His resignation and the ~ public uproar
Consequential: (1) consequent (2) of far-reaching importance
3. literature: (1)文学，文学作品
(2) writing on a particular subject: 文献，著述
I’ve read all the ~ available. (资料)
(3) pamphlets,leaflets
Please send me any ~ you have on travelingin Sichuan.
4. lay: (1) not having expert knowledge of a subject
~ opinion 外行的意见
（2) not professionally qualified
Layman
A book written for professionals and laymenalike
5. render: (1) cause sb/sth to be ina certain condition
Your action has ~edour contract invalid.
(2) translate;express sth in another language
~ing poetry into another language is rather difficult.
6. transcendent: extremely great, supreme
A writer of ~ genius 杰出的天才作家
transcend: (1) go beyond the range of (humanexperience, belief, powers of description)
Such matters ~ humanknowledge.
(2)surpass
She far ~s others inbeauty and intelligence.她才貌出众。
7. Endow: (1) give money,property, etc to provide a regular income for (a school, a college)
Endow one primary school
(2) provide sb. naturally with (any good quality or ability)
She’s ~ed withbeauty and intelligence. 她生来聪明貌美。
Endowment: acting of endowing; money, propertygiven to provide income; natural talent
Not everyone is born with such ~s as you.
8. characteristic:a. typical
Such bluntness is ~ of him. 他就是这么迟钝。
n. distinguishing feature
Arrogance is one of his less attractive ~s.骄傲自大是他的一个缺点。
9. Attend: Vi (1)give careful thought 专心，仔细考虑
~ to your work;stop talking.
Vi (2) give practical consideration to sb/sth
Could you ~ to this matter immediately? 立刻处理
Vt. (3) take care of
Smith ~ed her inhospital.
(4) be present at
~ one’s wedding, ameeting, a birthday party
Structure of thetext
Part I (1):Patients need narratives.
Part II (2-3):Doctors have learned that narrative helps them practice medicine.
Part III (4-7): Narrativecompetence is important for practicing medicine.
Part IV (8-9):Methods to teach people to acquire narrative skills have been developed and theprocesses of benefiting doctors are being looked into.
Part V (10):Narrative studies can honor patients and nourish doctors.
What was once considered a civilizingveneer for the gentleman physician – reading literature, studying humanities,writing in literary ways about practice – is now being recognized as central tomedical training for empathy and reflection.
Narrative studies, many physicians are beginning to believe, canprovide the “basic science” of a story-based medicine that can honor thepatients who endure illness and nourish the physicians who care for them.
Summary
Narrativeskills is necessary inone’s career and this is the respect to the patient and doctors can benefitfrom listening to the patient.
assignment
Try to find outsome practical methods to make yourself a qualifieddoctor.
III．Discussion:
Many previous efforts have been made, fromFrancis Peabody on, to listen to patients and to care about what happens tothem. My patient with back pain — actually a composite of several new patientsI saw recently — revealed to me the connections among his symptoms, hisilliteracy, his failures as a breadwinner, his familial losses, and his life inan alien culture. Armed with such knowledge, available to me most expedientlythrough his personal narrative, I confirmed the gravity of all he told me andshared my optimism that things could improve for him. Together, we made a planto investigate his educational needs and to evaluate his musculoskeletalsymptoms. The more medicine understands the complexities of illness, the betterclinicians can formulate their roles with respect to patients, both intechnical dimensions and in dimensions of meaning. Narrative studies, manyphysicians are beginning to believe, can provide the "basic science"of a story-based medicine that can honor the patients who endure illness andnourish the physicians who care for them.
IV．Assignment
Try to find out some practical methods to make you aqualified doctor.
