Lorin Scott, Rho Lisa, Wisnivesky Juan P, Nierman David M
Critical Care Education Center, Division of Pulmonary, Critical Care, and Sleep Medicine, Mount Sinai School of Medicine, New York, NY 10029, USA.
Crit Care Med. 2006 Sep;34(9):2386-91. doi: 10.1097/01.CCM.0000230239.04781.BD.
To determine whether intensive care unit (ICU) communication skills of fourth-year medical students could be improved by an educational intervention using a standardized family member.
Prospective study conducted from August 2003 to May 2004.
Tertiary care university teaching hospital.
All fourth-year students were eligible to participate during their mandatory four-week critical care medicine clerkship.
The educational intervention focused on the initial meeting with the family member of an ICU patient and included formal teaching of a communication framework followed by a practice session with an actor playing the role of a standardized family member of a fictional patient. At the beginning of the critical care medicine rotation, the intervention group received the educational session, whereas students in the control group did not.
At the end of each critical care medicine rotation, all students interacted with a different standardized family member portraying a different fictional scenario. Sessions were videotaped and were scored by an investigator blinded to treatment assignment using a standardized grading tool across four domains: a) introduction; b) gathering information; c) imparting information; and d) setting goals and expectations. A total of 106 (97% of eligible) medical students agreed to participate in the study. The total mean score as well as the scores for the gathering information, imparting information, setting goals, and expectations domains for the intervention group were significantly higher than for the control group (p < .01).
The communication skills of fourth-year medical students can be improved by teaching and then practicing a framework for an initial ICU communication episode with a standardized family member.
确定使用标准化家庭成员进行教育干预是否能提高四年级医学生在重症监护病房（ICU）的沟通技巧。
2003年8月至2004年5月进行的前瞻性研究。
三级医疗大学教学医院。
所有四年级学生在其为期四周的重症医学必修实习期间均有资格参与。
教育干预聚焦于与ICU患者家属的初次会面，包括正式教授沟通框架，随后与一名扮演虚构患者标准化家属角色的演员进行练习环节。在重症医学轮转开始时，干预组接受教育课程，而对照组学生未接受。
在每次重症医学轮转结束时，所有学生与一名描绘不同虚构场景的不同标准化家属进行互动。课程进行录像，并由一名对治疗分配不知情的研究者使用标准化评分工具在四个领域进行评分：a）介绍；b）收集信息；c）传达信息；d）设定目标和期望。共有106名（97%符合条件）医学生同意参与该研究。干预组的总平均分以及在收集信息、传达信息、设定目标和期望领域的得分显著高于对照组（p < 0.01）。
通过教授并练习与标准化家属进行初次ICU沟通环节的框架，可以提高四年级医学生的沟通技巧。
