多源反馈对住院医师沟通技能和职业素养的影响：一项随机对照试验。

Effect of multisource feedback on resident communication skills and professionalism: a randomized controlled trial.

作者信息

Brinkman William B, Geraghty Sheela R, Lanphear Bruce P, Khoury Jane C, Gonzalez del Rey Javier A, Dewitt Thomas G, Britto Maria T

机构信息

Department of Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA.

出版信息

Arch Pediatr Adolesc Med. 2007 Jan;161(1):44-9. doi: 10.1001/archpedi.161.1.44.

DOI:10.1001/archpedi.161.1.44

PMID:17199066

Abstract

OBJECTIVE

To determine whether augmenting standard feedback on resident performance with a multisource feedback intervention improved pediatric resident communication skills and professionalism.

DESIGN

Randomized controlled trial.

SETTING

Children's Hospital Medical Center, Cincinnati, Ohio, from June 21, 2004, to July 7, 2005.

PARTICIPANTS

Thirty-six first-year pediatric residents.

INTERVENTIONS

Residents assigned to the multisource feedback group (n = 18) completed a self-assessment, received a feedback report about baseline parent and nurse evaluations, and participated in a tailored coaching session in addition to receiving standard feedback. Residents in the control group (n = 18) received standard feedback only. The control group and their residency directors were blinded to parent and nurse evaluations until the end of the study.

MAIN OUTCOME MEASURES

Residents' specific communication skills and professional behaviors were rated by parents and nurses of pediatric patients. Both groups were evaluated at baseline and after 5 months. Scores were calculated on each item as percentage in the highest response category.

RESULTS

Both groups had comparable baseline characteristics and ratings. Parent ratings increased for both groups. While parent ratings increased more for the multisource feedback group, differences between groups were not statistically significant. In contrast, nurse ratings increased for the multisource feedback group and decreased for the control group. The difference in change between groups was statistically significant for communicating effectively with the patient and family (35%; 95% confidence interval, 11.0%-58.0%), timeliness of completing tasks (30%; 95% confidence interval, 7.9%-53.0%), and demonstrating responsibility and accountability (26%; 95% confidence interval, 2.9%-49.0%).

CONCLUSION

A multisource feedback intervention positively affected communication skills and professional behavior among pediatric residents.

摘要

目的

确定通过多源反馈干预增强对住院医师表现的标准反馈是否能提高儿科住院医师的沟通技巧和职业素养。

设计

随机对照试验。

地点

俄亥俄州辛辛那提市儿童医院医疗中心，2004年6月21日至2005年7月7日。

参与者

36名一年级儿科住院医师。

干预措施

分配到多源反馈组（n = 18）的住院医师完成自我评估，收到关于基线家长和护士评估的反馈报告，并除了接受标准反馈外还参加了一次量身定制的辅导课程。对照组（n = 18）的住院医师仅接受标准反馈。直到研究结束，对照组及其住院医师主任对家长和护士的评估均不知情。

主要结局指标

儿科患者的家长和护士对住院医师的特定沟通技巧和职业行为进行评分。两组在基线时和5个月后进行评估。每个项目的得分按最高反应类别中的百分比计算。

结果

两组具有可比的基线特征和评分。两组的家长评分均有所提高。虽然多源反馈组的家长评分提高得更多，但两组之间的差异无统计学意义。相比之下，多源反馈组的护士评分提高，而对照组的护士评分降低。两组之间在与患者及家属有效沟通（35%；95%置信区间，11.0%-58.0%）、完成任务的及时性（30%；95%置信区间，7.9%-53.0%）以及表现出责任感和问责制（26%；95%置信区间，2.9%-49.0%）方面的变化差异具有统计学意义。