Roach R R, Pichert J W, Stetson B A, Lorenz R A, Boswell E J, Schlundt D G
Department of Home Economics, Memphis State University, TN 38152.
J Am Diet Assoc. 1992 Dec;92(12):1466-70, 1473.
Many health professionals lack important teaching skills, perhaps adding to patient difficulties in understanding and adopting therapeutic diets. Research suggests that teaching skills improved after dietitians took a continuing education course entitled "Effective Patient Teaching." Our study tested whether dietitians' new skills would persist in the field and whether selected patient outcomes would differ as a result. Thirty staff dietitians from six urban hospitals were videotaped teaching patients, then randomly assigned to take the Effective Patient Teaching course or not (control group). Follow-up videotapes were made after 1 week, 1 month, and 3 months. After each teaching session, patient satisfaction and recall were assessed. Two judges rated 20 teaching skills, which were divided into four subsets for analysis. Repeated measures analyses of variance showed overall gains only for the group that took the Effective Patient Teaching course, which scored higher than the control group at 1 week and 1 month, but not at baseline or 3 months. Gains occurred in presentation skills and essential teaching functions. Throughout the study, interpersonal skills were high and adherence promotion skills were low for dietitians in both groups. Groups did not differ on patient satisfaction or recall. Improvements in dietitians' teaching skills translated to the field immediately after they completed the continuing education program, but not all gains were sustained after 3 months. We recommend that dietitians assess their teaching and adherence promotion skills, obtain training where warranted, and periodically reassess the application of those skills during patient teaching sessions.
许多医疗专业人员缺乏重要的教学技能，这可能增加了患者理解和采用治疗性饮食的难度。研究表明，营养师参加了名为“有效的患者教学”的继续教育课程后，教学技能有所提高。我们的研究测试了营养师的新技能在实际工作中能否持续，以及选定的患者结果是否会因此而有所不同。来自六家城市医院的30名在职营养师在为患者进行教学时被录像，然后随机分为参加“有效的患者教学”课程组（实验组）和不参加的组（对照组）。在1周、1个月和3个月后进行随访录像。每次教学课程结束后，评估患者的满意度和记忆情况。两名评判员对20项教学技能进行评分，这些技能被分为四个子集进行分析。重复测量方差分析显示，只有参加“有效的患者教学”课程的组有总体提升，该组在1周和1个月时的得分高于对照组，但在基线时和3个月时没有差异。提升体现在演示技能和基本教学功能方面。在整个研究过程中，两组营养师的人际技能得分都很高，而依从性促进技能得分都很低。两组在患者满意度或记忆方面没有差异。营养师完成继续教育项目后，其教学技能的提升立即在实际工作中得到体现，但3个月后并非所有提升都能持续。我们建议营养师评估自己的教学和依从性促进技能，在必要时接受培训，并在患者教学课程中定期重新评估这些技能的应用情况。
