张雪峰说学医的天亮了

近日，张雪峰针对北京协和医学院争议提出“学医的天亮了”观点，引发热议。

今天你练听力了吗？

🤔️小作业：

1. What can be inferred about the doctors who did not receive the empathy training?

A. They felt more burnout than before

B. Their ability to empathize deteriorated over time

C. They performed equally well in empathy scores as their peers

D. They began to question the effectiveness of empathy training

无注释原文：

Can Doctors Learn Empathy?

From: The New York Times

Empathy has always been considered an essential component of compassionate care, and recent research has shown that its benefits go far beyond the exam room. Greater physician empathy has been associated with fewer medical errors, better patient outcomes and more satisfied patients. It also results in fewer malpractice claims and happier doctors.

A growing number of professional accrediting and licensing agencies have taken these findings to heart, developing requirements that make empathy a core value and an absolute "learning objective" for all doctors. But even for the most enthusiastic supporters of such initiatives, the vexing question remains: Can people learn to be empathetic?

A new study reveals that they can.

Building on research over the last decade that has shown that empathetic observers have brain activity, heart rate and skin electrical conductance that mirror those of the person undergoing the emotional experience -- observing a friend's hand getting slammed in a car door, for example, causes us to flinch because an image of the accident gets mapped onto the pain and threat sensors in our own brain -- Dr. Helen Riess, director of the Empathy and Relational Science Program in the department of psychiatry at the Massachusetts General Hospital in Boston, created a series of empathy "training modules" for doctors. The tools are designed to teach methods for recognizing key nonverbal cues and facial expressions in patients as well as strategies for dealing with one's own physiologic responses to highly emotional encounters.

In one lesson, for example, doctors watch a video of a tense exam room interaction while a striking graphic sidebar records the electrical skin conductance of both patient and doctor, the mismatched spikes peaking as each person's frustration with the other escalates. Another lesson walks doctors through a series of pictures of a patient whose face expresses anger, contempt, happiness, fear, surprise, disgust or sadness.

To test the effectiveness of the lessons, Dr. Riess and several of her colleagues enrolled about 100 doctors-in-training and asked their patients to evaluate their empathy, based on the doctor's ability to make them feel at ease, show care and compassion and fully understand patient concerns. Half of the doctors then took part in three one-hour empathy training sessions.

Two months later, the researchers asked a second group of patients to evaluate all the doctors again. They found that the doctors who had taken the empathy classes showed significant improvements in their empathetic behavior, while those who had not actually got worse at empathizing with patients.

"People tend to believe that you are either born with empathy or not," said Dr. Helen Riess, lead author of the study. "But empathy can be taught, and you can improve."

Compared with their peers, doctors who went through the empathy course interrupted their patients less, maintained better eye contact and were better able to maintain their equanimity if patients became angry, frustrated or upset. They also appeared to develop resistance to the notorious "dehumanizing effects" of medical training. After the empathy classes, one physician who had complained about being burned out said, "I feel as though like I like my job again."

Responses to this study have so far been enthusiastic, in part because it is one of the first to rely on patient evaluations of empathy rather than physician self-assessment. "The holy grail of this kind of research is whether patients think doctors are empathic, not whether the doctors think they are," Dr. Riess said.

- ◆ -

注：完整题目见本文开头；中文文本为纽约时报官方译文，仅供参考

含注释全文：

Can Doctors Learn Empathy?

From: The New York Times

Empathy has always been considered an essential component of compassionate care, and recent research has shown that its benefits go far beyond the exam room. Greater physician empathy has been associated with fewer medical errors, better patient outcomes and more satisfied patients. It also results in fewer malpractice claims and happier doctors.

与病人感同身受的同情心(empathy)一直被认为是人文关怀的精髓。最近的研究也显示，这种同情心带来的益处远远超出了诊室的范围。医师的同情心越强，医疗失误也就越少，患者恢复越好、满意度越高；同时也减少了医疗索赔事件，让医生的心情更好。

compassionate /kəmˈpæʃ.ən.ət/ 表示“富有同情心的”，英文解释为“feeling or showing sympathy and sadness for the suffering or bad luck of others, and wanting to help them”举个🌰：The public's response to the crisis appeal was generous and compassionate. 公众对危难时刻的呼吁表现得慷慨大方、富有同情心。

malpractice /ˌmælˈpræk.tɪs/ 表示“营私舞弊；玩忽职守，渎职”，英文解释为“failure to act correctly or legally when doing your job, often causing injury or loss”举个🌰：They are accused of medical/financial/electoral malpractice. 他们被控医疗事故/财务舞弊/选举舞弊。

A growing number of professional accrediting and licensing agencies have taken these findings to heart, developing requirements that make empathy a core value and an absolute "learning objective" for all doctors. But even for the most enthusiastic supporters of such initiatives, the vexing question remains: Can people learn to be empathetic?

这些研究结果引起越来越多职业认证和执照发放机构的重视，他们开始要求把同情心作为医疗的核心理念以及所有医生必须达到的学习目标。然而，即使是最热心于此创举的支持者也不免被一个疑问所困扰：同情心，能“学”得来么？

accredit /əˈkred.ɪt/ 表示“鉴定…为合格；认可；认为…属实；授权”，英文解释为“to officially recognize, accept, or approve of someone or something”举个🌰：The agency was not accredited by the Philippine Consulate to offer contracts to Filipinos abroad. 该代理处没有得到菲律宾领事馆的批准，无权向国外的菲律宾人提供承包合同。

licensing /ˈlaɪ.sən.sɪŋ/ 表示“许可；授权”，英文解释为“the act of giving people official permission to do, have, or sell something”举个🌰：In many countries, licensing is used as a method of deciding who should sell what. 在许多国家，授权被用作决定谁应该销售什么的方法。

vexing /ˈveks.ɪŋ/ 表示“引起烦恼的；令人恼火的；伤脑筋的”，英文解释为“annoying, worrying, or causing problems ”举个🌰：The shortage of qualified teachers remains a vexing problem. 有资质的老师数量短缺仍然是一个非常伤脑筋的问题。

A new study reveals that they can.

一项新的研究表明：能。

Building on research over the last decade that has shown that empathetic observers have brain activity, heart rate and skin electrical conductance that mirror those of the person undergoing the emotional experience -- observing a friend's hand getting slammed in a car door, for example, causes us to flinch because an image of the accident gets mapped onto the pain and threat sensors in our own brain -- Dr. Helen Riess, director of the Empathy and Relational Science Program in the department of psychiatry at the Massachusetts General Hospital in Boston, created a series of empathy "training modules" for doctors. The tools are designed to teach methods for recognizing key nonverbal cues and facial expressions in patients as well as strategies for dealing with one's own physiologic responses to highly emotional encounters.

过去十年的研究结果显示：具有同情心的观察者跟亲历者之间的大脑活动、心率和皮肤电导率均相互合拍。比如，看到朋友关车门时夹到了手，我们会下意识地缩缩手，因为那画面直接映射到我们大脑内的疼痛与威胁感知系统。波士顿麻省总医院(Massachusetts General Hospital) 精神科“同情与关系学”项目主管海伦·里斯医生(Helen Riess)设计出了一套“医师同情心训练模块”，用来指导医生如何甄别病人的关键性非语言暗示和表情，以及如何处理高度情绪化事件中医生自身出现的生理反应。

slam /slæm/ 1）表示“（使）重重撞上，（使）砰地关上”，英文解释为“to (cause to) move against a hard surface with force and usually a loud noise”举个🌰：The wind made the door/window slam (shut). 风吹过来门/窗户砰地关上了。

2）表示“严厉批评；猛烈抨击”，英文解释为“To slam someone or something means to criticize them very severely.”举个🌰：The famed filmmaker slammed the claims as "an outrageous lie." 该享有盛名的电影制片人猛烈抨击这些说法，称其为“无耻谎言。”

📍类似的，还有condemn，blast，speak out against.

flinch /flɪntʃ/ 表示“（因疼痛或恐惧）猛地一颤；畏缩，退缩”，英文解释为“to make a sudden, small movement because of pain or fear”举个🌰：He didn't even flinch when the nurse cleaned the wound. 护士清洗伤口的时候，他都一点也没畏缩。

module /ˈmɒdʒ.uːl/ 1）表示“组件；模块”，英文解释为“one of a set of separate parts that, when combined, form a complete whole”举个🌰：The emergency building is transported in individual modules, such as bedrooms and a kitchen, which are put together on site. 应急住房以单独的组件运输，如卧室和厨房，它们可以当场进行组装。

2）module /ˈmɒdjuːl/ 表示“（航天器独立的）舱”，英文解释为“a part of a spacecraft that can operate independently of the other parts, especially when separate from them”

non-verbal /ˌnɒnˈvɜː.bəl/ 表示“非言语的”，英文解释为“not using words, or not relating to the use of words”举个🌰：Body language is a potent form of non-verbal communication. 肢体语言是一种有效的非言语交流方式。

physiological /ˌfɪz.i.əˈlɒdʒ.ɪ.kəl/ 表示“生理学的”，英文解释为“relating to the way in which the bodies of living things work”举个🌰：Touching causes a physiological reaction. 触摸引起生理反应。

In one lesson, for example, doctors watch a video of a tense exam room interaction while a striking graphic sidebar records the electrical skin conductance of both patient and doctor, the mismatched spikes peaking as each person's frustration with the other escalates. Another lesson walks doctors through a series of pictures of a patient whose face expresses anger, contempt, happiness, fear, surprise, disgust or sadness.

举例来说，有一节课是让医生们观看一段诊室的录像，其中医患间正进行着紧张的交流。视频侧栏用曲线图记录着两人皮肤电导率的变化。每当二者情绪不统一时（一人沮丧而另一人兴奋），图上就会出现脉冲尖峰。还有一节课是让医生们看一系列照片，上面拍下了一位病人生气、轻蔑、高兴、畏惧、惊讶、厌恶和难过时的表情。

sidebar /ˈsaɪd.bɑːr/ 1）表示“（主要新闻报道的）补充报道”，英文解释为“a box or narrow area on a newspaper or magazine page that contains a short news story or extra information relating to a longer main story”

2）表示“（网页上的）侧边栏”，英文解释为“a narrow area at the side of a page on a website, giving extra information or links”

spike /spaɪk/ 在年度词汇盘点文章中基本都会出现这个词，1）作名词，可以理解为“峰值”或者“激增；猛增；急升”，英文解释为“a sharp increase in the magnitude or concentration of something”如：a spike in oil prices 油价的急剧上涨。

2）也可以作动词，同样表示“激增”，英文解释为“if the number or rate of something spikes, it increases quickly and by a large amount ”举个🌰：New orders have spiked in the last two years. 新订单在过去两年里激增。

3）作名词，表示“尖头，尖刺；（尤指金属的）尖状物”，英文解释为“a narrow, thin shape with a sharp point at one end, or something, especially a piece of metal, with this shape”

4）spikes表示“（某些运动鞋上的）防滑鞋钉；钉鞋”，英文解释为“a set of short, pointed pieces of metal or plastic, attached to the bottom of shoes worn for particular sports, that stop the person wearing the shoes from sliding on the ground, or shoes with these pointed pieces”

contempt /kənˈtempt/ 表示“蔑视；鄙视；轻视；轻蔑”，英文解释为“a strong feeling of disliking and having no respect for someone or something”举个🌰：At school she had complete contempt for all her teachers. 在学校读书时她对所有老师都不屑一顾。

To test the effectiveness of the lessons, Dr. Riess and several of her colleagues enrolled about 100 doctors-in-training and asked their patients to evaluate their empathy, based on the doctor's ability to make them feel at ease, show care and compassion and fully understand patient concerns. Half of the doctors then took part in three one-hour empathy training sessions.

为检验课程的效果，里斯和同事们招募了100名实习医生进行实验。首先，她们让患者对这些医生的同情心进行评估，标准包括：医生是否能让病人感到自在、不拘束；是否显示出了关怀、怜悯之情；是否可以完全理解患者的担忧。然后，让其中一半医生参加同情心培训，每次1小时，共3次。

表示“（使）加入；注册；招（生）；吸收”，英文解释为“If you enrol or are enrolled at an institution or in a class, you officially join it.”举个🌰：I was enrolled at the University in 2016. 我是2016年上大学的。

Two months later, the researchers asked a second group of patients to evaluate all the doctors again. They found that the doctors who had taken the empathy classes showed significant improvements in their empathetic behavior, while those who had not actually got worse at empathizing with patients.

两个月后，另一批患者对这100名实习医生的同情心重新进行了测评。结果发现，培训过的医生其同情心及相关行为有明显进步，而未经培训的医生则表现得还不如两个月前。

"People tend to believe that you are either born with empathy or not," said Dr. Helen Riess, lead author of the study. "But empathy can be taught, and you can improve."

 “人们倾向于认为同情心是天生的。”研究的第一作者里斯医生说：“其实不然，同情心是可以被教会的，（通过学习）是能够进步的。”

Compared with their peers, doctors who went through the empathy course interrupted their patients less, maintained better eye contact and were better able to maintain their equanimity if patients became angry, frustrated or upset. They also appeared to develop resistance to the notorious "dehumanizing effects" of medical training. After the empathy classes, one physician who had complained about being burned out said, "I feel as though like I like my job again."

相比之下，上过同情心课程的医生更少会打断患者的话，与患者有更好的眼神交流，当患者发怒、沮丧或烦躁不安时更能保持镇定。同时，他们似乎也开始对医疗训练所导致的臭名昭著的“去人性化结果(dehumanizing effects)”心生抵触。参加过同情心培训后，一位曾抱怨被工作搞得精疲力竭的医生说：“我好像又重新喜欢上我的工作了。”

peer /pɪər/ 作动词，表示“仔细看，端详；费力地看”，英文解释为“to look carefully or with difficulty”举个🌰：When no one answered the door, she peered through the window to see if anyone was there. 没有人开门，她就费力地透过窗户朝里望去，看是否有人在。

作名词，表示“同龄人；同辈；同等社会地位（或能力）的人”，英文解释为“a person who is the same age or has the same social position or the same abilities as other people in a group”举个🌰：Do you think it's true that teenage girls are less self-confident than their male peers? 你是否认为十几岁的女孩子不如同年龄的男孩子自信？

equanimity /ˌek.wəˈnɪm.ə.ti/ 表示“（尤指处于震惊、失望或困境时的）镇静，沉着，冷静”，英文解释为“a calm mental state, especially after a shock or disappointment or in a difficult situation”举个🌰：He received the news of his mother's death with remarkable equanimity. 他接到母亲去世的噩耗时表现出惊人的自制力。

notorious /nəʊˈtɔː.ri.əs/ 表示“臭名昭著的，声名狼藉的”，英文解释为“famous for something bad”如：one of Mexico's most notorious criminals 墨西哥最臭名昭著的罪犯之一。

Responses to this study have so far been enthusiastic, in part because it is one of the first to rely on patient evaluations of empathy rather than physician self-assessment. "The holy grail of this kind of research is whether patients think doctors are empathic, not whether the doctors think they are," Dr. Riess said.

迄今为止，这项研究一直得到了热情的回馈，部分原因在于这是第一次由病人对医生进行同情心评价，而非医生自测。“我们的研究妙就妙在裁判是患者，不是医生自己。”里斯说。

the holy grail /ˌhəʊ.li ˈɡreɪl/ 1）表示“圣杯（传说耶稣在最后的晚餐上使用过）”，英文解释为“a cup believed to have been used by Jesus Christ at the meal before his death”

2）表示“极难找到（或得到）之物”，英文解释为“something that is extremely difficult to find or get”举个🌰：Sustained nuclear fusion is the holy grail of the power industry. 能持久反应的核聚变是电力工业梦寐以求的“圣杯”。

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