Laidlaw Toni Suzuki, Kaufman David M, Sargeant Joan, MacLeod Heather, Blake Kim, Simpson David
Division of Medical Education, Dalhousie University, Canada.
Patient Educ Couns. 2007 Oct;68(2):153-60. doi: 10.1016/j.pec.2007.05.017. Epub 2007 Jul 12.
A pilot study was conducted to examine the characteristics, capacities (beliefs, values and intentions) and skills that distinguish exemplary communicators from less exemplary communicators in patient-physician encounters.
Forty physicians participated in a four-station videotaped OSCE focusing on a variety of adolescent sexual health issues and assessed using seven quantitative measures. Results determined the top 15%, and the bottom 15%. An interviewer reviewed and discussed two of the videotaped scenarios with physicians in both groups. Interviews were analyzed to determine differences between groups.
Results consistently identified the top 15% (6) and bottom 15% (6) physicians. The t-tests showed statistically significant differences on all skills and capacity measures. "Notable" differences (25% or higher) were found on two quantitative instruments assessing skills. There were no notable differences in capacities. The qualitative inquiry confirmed notable differences in skills and identified capacities of empathy, non-judgement and self-reflection as restricted to the exemplary group.
Using quantitative and qualitative measures, it is possible to determine skills and capacities that distinguish exemplary communicators from less exemplary communicators.
In addition to effective skills, physician empathy, non-judgement and self-reflection appear to be necessary components for exemplary physician communication with adolescents.
开展一项试点研究，以考察在医患交流中，能将模范沟通者与非模范沟通者区分开来的特征、能力（信念、价值观和意图）及技能。
40名医生参与了一场四站式视频客观结构化临床考试（OSCE），该考试聚焦于各种青少年性健康问题，并使用七种定量测量方法进行评估。结果确定了前15%和后15%的医生。一名面试官与两组医生一起回顾并讨论了其中两个视频场景。对访谈进行分析以确定两组之间的差异。
结果一致确定了前15%（6名）和后15%（6名）的医生。t检验显示，在所有技能和能力测量方面均存在统计学上的显著差异。在两项评估技能的定量工具上发现了“显著”差异（25%或更高）。在能力方面没有显著差异。定性调查证实了技能方面的显著差异，并确定同理心、无评判和自我反思能力仅限于模范组。
使用定量和定性测量方法，可以确定能将模范沟通者与非模范沟通者区分开来的技能和能力。
除有效的技能外，医生的同理心、无评判和自我反思似乎是与青少年进行模范沟通的必要组成部分。
