Hulsman Robert L, Ros Wynand J G, Winnubst Jacques A M, Bensing Jozien M
Academic Medical Centre, Department Medical Psychology, Amsterdam, The Netherlands.
Med Educ. 2002 Feb;36(2):125-34. doi: 10.1046/j.1365-2923.2002.01074.x.
Although doctor--patient communication is important in health care, medical specialists are generally not well trained in communication skills. Conventional training programmes are generally time consuming and hard to fit into busy working schedules of medical specialists. A computer-assisted instruction (CAI) programme was developed -- 'Interact-Cancer' -- which is a time-efficient learning method and easily accessible at the workplace.
To investigate the effect of the CAI training, 'Interact-Cancer', on the communication behaviour of medical specialists, and on satisfaction of patients about their physician interaction.
Consultations of medical specialists with cancer outpatients were videotaped at 4 specific stages, 2 before and 2 after Interact-Cancer, with intervals of 4 weeks.
PATIENTS/PARTICIPANTS: Participants were 21 medical specialists, mainly internists, working in 7 hospitals, and 385 cancer outpatients.
Communication behaviour was assessed on 23 observation categories derived from the course content. Frequencies were rated as well as judgements about the quality of the performance of each target skill. Satisfaction was measured by the Medical Interview Satisfaction Scale. Data were analyzed by means of multilevel statistical methods.
The behavioural assessment showed course effects on ratings of the physicians' quality of performance. No course effects were found on the frequencies of physicians' behaviours and on the patient satisfaction ratings.
CAI is a promising method to supply medical specialists with postgraduate training of communication skills. The application of judgement ratings of communication behaviour proved to be valuable to evaluate course effects in real-life patient encounters.
尽管医患沟通在医疗保健中很重要,但医学专家通常在沟通技巧方面未得到良好培训。传统的培训项目通常耗时且难以纳入医学专家繁忙的工作安排中。开发了一种计算机辅助教学(CAI)项目——“Interact-Cancer”,这是一种省时的学习方法,且在工作场所易于获取。
研究CAI培训“Interact-Cancer”对医学专家沟通行为以及患者对与医生互动满意度的影响。
在4个特定阶段对医学专家与癌症门诊患者的会诊进行录像,在“Interact-Cancer”之前和之后各2个阶段,间隔4周。
患者/参与者:参与者为21名医学专家,主要是内科医生,在7家医院工作,以及385名癌症门诊患者。
根据课程内容从23个观察类别评估沟通行为。对频率以及每个目标技能表现质量的判断进行评分。通过医学访谈满意度量表测量满意度。采用多级统计方法分析数据。
行为评估显示课程对医生表现质量评分有影响。在医生行为频率和患者满意度评分方面未发现课程影响。
CAI是为医学专家提供沟通技能研究生培训的一种有前景的方法。事实证明,沟通行为判断评分的应用对于评估现实生活中患者会诊的课程效果很有价值。