Makoul Gregory
Program in Communication & Medicine, Division of General Internal Medicine, Northwestern University Feinberg School of Medicine, 676 North St. Clair Street, Suite 200, Chicago, IL 60611, USA.
Patient Educ Couns. 2003 May;50(1):79-84. doi: 10.1016/s0738-3991(03)00085-5.
Attention to providers' communication skills is likely to increase, given the confluence of forces that have highlighted the importance of communication in healthcare. In the United States, interpersonal and communication skills have been explicitly identified as a priority throughout the continuum of medical education and practice. Ideally, theory and research inform teaching and assessment efforts by suggesting how communication behavior affects outcomes and by providing a conceptual framework for learning skills. This article illustrates the interplay between education and research by discussing examples of useful concepts (models of communication, issues of perceived control, and patterns of non-verbal communication) and understudied topics (physician verbalizations during patients' initial narratives, the mundane aspects of communication in healthcare, conceptual and operational definitions of empathy, and the effect of patient narratives on both patients and providers). Given the breadth and depth of experience, from screening and prevention to treatment and support, the context of cancer offers a promising laboratory for enhancing both education and research about provider-patient communication.
鉴于各种力量的汇聚凸显了沟通在医疗保健中的重要性，对医疗服务提供者沟通技巧的关注可能会增加。在美国，人际沟通技巧在整个医学教育和实践过程中都被明确列为优先事项。理想情况下，理论和研究通过表明沟通行为如何影响结果以及提供学习技能的概念框架，为教学和评估工作提供信息。本文通过讨论有用概念（沟通模型、感知控制问题和非语言沟通模式）以及研究不足的主题（患者初次叙述时医生的言语表达、医疗保健中沟通的日常方面、同理心的概念和操作定义以及患者叙述对患者和医疗服务提供者的影响）的例子，阐述了教育与研究之间的相互作用。鉴于从筛查和预防到治疗和支持的经验广度和深度，癌症背景为加强关于医患沟通的教育和研究提供了一个有前景的实验室。
