Mares J, Tvorogova N D, Chrobák L
Department of Social Sciences Medical Faculty Charles University, Hradec Králové.
Sb Ved Pr Lek Fak Karlovy Univerzity Hradci Kralove. 1992;35(2):169-211.
The work is based on the following concepts: communication with patients ceases being a matter of experience learning only (the trial and error method) and should become a part of systematic training; it should not be included only into continuous education of graduated physicians but must be gradually introduced into undergraduate education as well; it is not an optional activity which may but may not be performed by physicians, but it is a specific component of their clinical competence. Today attempts to instruct medical students in communication with patients and their relatives are being made at many medical schools all over the world. Reports on such instruction are, however, scattered in various journals or in internal publications published by universities, faculties and clinics. Thus they are not available very easily. If there exist some survey works, they are mostly conceived on the national level. The objective of the study presented here is to show a comparatively comprehensive survey dealing with the medical student instruction on the international level, analyze trends in development and identify problems that have not been solved so far. The work consists of five chapters. The first one gives a short survey of current concepts in communication with patients reaching beyond the traditional training in taking medical history. Among others, the following factors are included here: explanation of both diagnostical and therapeutical methods to the patient, informing the patient about results obtained from the examination, telling him or her general conclusions and recommendations, informing patients of social associations of the disease, developing in the patients those attitudes which support their cooperation with physicians and the patient's will to live, ability to treat serious and terminal patients properly, ability to treat patients' relatives and communicate with other members of a medical team. The second chapter shows current attempts to train the medical student-patient communication in Czechoslovakia, especially at Charles University. Third chapter describes how medical students in the former USSR were instructed, especially at medical schools in Moscow. This kind of information is still difficult to be had for people from abroad. The fourth chapter is the most important. Current attempts to train medical students in communication with patients in Europe, North and South America, Asia, Africa and Australia are described there. Reference frames in which the instruction takes place (medical, educational, psychological frames) are studied.(ABSTRACT TRUNCATED AT 400 WORDS)
与患者的沟通不再仅仅是经验学习（试错法）的问题，而应成为系统培训的一部分；它不应仅纳入毕业医生的继续教育，还必须逐步引入本科教育；它不是医生可做可不做的一项选择性活动，而是其临床能力的一个特定组成部分。如今，世界各地许多医学院都在尝试指导医学生与患者及其亲属进行沟通。然而，关于此类指导的报告分散在各种期刊或大学、学院和诊所出版的内部刊物中。因此，获取这些报告并不容易。如果存在一些调查研究，它们大多是在国家层面进行构思的。本文所呈现研究的目的是展示一项在国际层面上关于医学生指导的相对全面的调查，分析发展趋势并找出迄今尚未解决的问题。这项工作由五章组成。第一章简要概述了与患者沟通方面的当前理念，这些理念超越了传统的病史采集培训。其中包括以下因素：向患者解释诊断和治疗方法、告知患者检查结果、告诉他或她总体结论和建议、告知患者疾病的社会关联、培养患者支持其与医生合作的态度以及患者的求生意愿、妥善治疗重症和晚期患者的能力、治疗患者亲属以及与医疗团队其他成员沟通的能力。第二章展示了捷克斯洛伐克，特别是查理大学在培训医学生与患者沟通方面的当前尝试。第三章描述了前苏联的医学生是如何接受指导的，尤其是在莫斯科的医学院。对于外国人来说，这类信息仍然很难获取。第四章是最重要的。该章描述了欧洲、南北美洲、亚洲、非洲和澳大利亚在培训医学生与患者沟通方面的当前尝试。研究了进行指导的参考框架（医学、教育、心理框架）。（摘要截选至400字）
