Rosenbaum Marcy E, Ferguson Kristi J, Lobas Jeffrey G
University of Iowa College of Medicine, Iowa City, IA 52245, USA.
Acad Med. 2004 Feb;79(2):107-17. doi: 10.1097/00001888-200402000-00002.
Although delivering bad news is something that occurs daily in most medical practices, the majority of clinicians have not received formal training in this essential and important communication task. A variety of models are currently being used in medical education to teach skills for delivering bad news. The goals of this article are (1) to describe these available models, including their advantages and disadvantages and evaluations of their effectiveness; and (2) to serve as a guide to medical educators who are initiating or refining curriculum for medical students and residents. Based on a review of the literature and the authors' own experiences, they conclude that curricular efforts to teach these skills should include multiple sessions and opportunities for demonstration, reflection, discussion, practice, and feedback.
尽管传递坏消息在大多数医疗实践中每天都会发生，但大多数临床医生并未接受过关于这项重要沟通任务的正规培训。目前在医学教育中使用了多种模型来教授传递坏消息的技巧。本文的目的是：（1）描述这些可用模型，包括它们的优缺点以及对其有效性的评估；（2）为正在为医学生和住院医师启动或完善课程的医学教育工作者提供指导。基于对文献的回顾和作者自身的经验，他们得出结论，教授这些技巧的课程努力应包括多个环节以及示范、反思、讨论、实践和反馈的机会。
