Laidlaw Toni Suzuki, Kaufman David M, MacLeod Heather, van Zanten Sander, Simpson David, Wrixon William
Division of Medical Education, Clinical Research Centre, Dalhousie University, 5849 University Avenue, Halifax, Nova Scotia, Canada B3H 4H9.
Med Educ. 2006 Jan;40(1):18-25. doi: 10.1111/j.1365-2929.2005.02345.x.
A substantial body of literature demonstrates that communication skills in medicine can be taught and retained through teaching and practice. Considerable evidence also reveals that characteristics such as gender, age, language and attitudes affect communication skills performance. Our study examined the characteristics, attitudes and prior communication skills training of residents to determine the relationship of each to patient-doctor communication. The relationship between communication skills proficiency and clinical knowledge application (biomedical and ethical) was also examined through the use of doctor-developed clinical content checklists, as very little research has been conducted in this area.
A total of 78 first- and second-year residents across all departments at Dalhousie Medical School participated in a videotaped 4-station objective structured clinical examination presenting a range of communication and clinical knowledge challenges. A variety of instruments were used to gather information and assess performance. Two expert raters evaluated the videotapes.
Significant relationships were observed between resident characteristics, prior communication skills training, clinical knowledge and communication skills performance. Females, younger residents and residents with English as first language scored significantly higher, as did residents with prior communication skills training. A significant positive relationship was found between the clinical content checklist and communication performance. Gender was the only characteristic related significantly to attitudes.
Gender, age, language and prior communication skills training are related to communication skills performance and have implications for resident education. The positive relationship between communication skills proficiency and clinical knowledge application is important and should be explored further.
大量文献表明,医学沟通技能可通过教学和实践来传授并保持。相当多的证据还显示,性别、年龄、语言和态度等特征会影响沟通技能表现。我们的研究考察了住院医师的特征、态度及先前的沟通技能培训情况,以确定它们各自与医患沟通之间的关系。通过使用医生制定的临床内容清单,还考察了沟通技能熟练程度与临床知识应用(生物医学和伦理学方面)之间的关系,因为该领域的相关研究极少。
达尔豪斯医学院所有科室的78名一年级和二年级住院医师参加了一场录像形式的4站式客观结构化临床考试,该考试呈现了一系列沟通和临床知识方面的挑战。使用了多种工具来收集信息并评估表现。两名专家评分员对录像进行了评估。
观察到住院医师特征、先前的沟通技能培训、临床知识与沟通技能表现之间存在显著关系。女性、年轻住院医师以及以英语为第一语言的住院医师得分显著更高,接受过先前沟通技能培训的住院医师也是如此。临床内容清单与沟通表现之间存在显著的正相关关系。性别是唯一与态度显著相关的特征。
性别、年龄、语言和先前的沟通技能培训与沟通技能表现相关,对住院医师教育具有启示意义。沟通技能熟练程度与临床知识应用之间的正相关关系很重要,应进一步探索。