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教授自我意识有助于增强以患者为中心的问诊学习。

Teaching self-awareness enhances learning about patient-centered interviewing.

作者信息

Smith R C, Dorsey A M, Lyles J S, Frankel R M

机构信息

Department of Medicine, Michigan State University, East Lansing 48824, USA.

出版信息

Acad Med. 1999 Nov;74(11):1242-8. doi: 10.1097/00001888-199911000-00020.

Abstract

PURPOSE

To evaluate the effect of intensive attitudinal training on residents' learning the patient-centered interviewing skills required to establish a healthy provider-patient relationship and to communicate effectively.

METHOD

While teaching 53 residents patient-centered interviewing skills, the authors also trained them to recognize previously unrecognized, negative attitudes that interfered with learning the skills. The authors, using an iterative, consensus-building process based on the residents' performances and personality data, identified a spectrum of responses to the educational intervention. Barriers to and facilitators of mastery of skills were analyzed and this information was used to help residents overcome skill deficits.

RESULTS

To varying degrees, 44 residents became aware of previously unrecognized attitudes to the extent that they improved their patient-centered interviewing skills. Six residents failed to develop awareness of negative attitudes and showed little learning and clinical use of the interviewing skills being taught. Three residents who rapidly developed superb interviewing skills showed no negative attitude towards using them.

CONCLUSIONS

Pending a confirmatory hypothesis-testing study, the authors believe that, as residents learn how to conduct patient-centered interviews, training in awareness of interfering attitudes should accompany training in skills.

摘要

目的

评估强化态度训练对住院医师学习建立健康医患关系及有效沟通所需的以患者为中心的问诊技巧的效果。

方法

在教授53名住院医师以患者为中心的问诊技巧时,作者还训练他们识别之前未被认识到的、妨碍技巧学习的消极态度。作者基于住院医师的表现和性格数据,采用反复的、建立共识的过程,确定了对教育干预的一系列反应。分析了掌握技巧的障碍和促进因素,并利用这些信息帮助住院医师克服技巧缺陷。

结果

44名住院医师不同程度地意识到了之前未被认识到的态度,从而提高了以患者为中心的问诊技巧。6名住院医师未意识到消极态度,在所学的问诊技巧方面几乎没有学习和临床应用。3名迅速掌握高超问诊技巧的住院医师对运用这些技巧没有消极态度。

结论

在进行验证性假设检验研究之前,作者认为,随着住院医师学习如何进行以患者为中心的问诊,在技巧训练的同时应进行妨碍态度的意识训练。

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