Baumal Reuben, Benbassat Jochanan
Department of Laboratory Medicine and Pathobiology, Toronto Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
Isr Med Assoc J. 2008 Jul;10(7):552-5.
Research in the acquisition of patient interviewing skills by medical students has dealt mostly with the evaluation of the effectiveness of various teaching programs and techniques. The educational approaches (i.e., the tutor-learner relationship and learning atmosphere) have rarely been discussed. These approaches may be grouped into: a) "teacher-centered" (didactic), in which the students are passive recipients of instruction; b) "learner-centered," in which the tutor functions as a facilitator of small group learning, whose task is not to teach but rather to ensure that all students participate in the discussions and share knowledge with other students; and c) "integrated learner-and teacher-centered" or "experiential learning," which consists of an ongoing dialogue between the tutor and the students. In this paper, we review the strengths and weaknesses of these educational approaches and attempt to identify the current trends in their use in the teaching of interviewing skills. It would appear that until the 1960s, medical students acquired interviewing skills without any expert guidance. On the other hand, since the 1970s, there has been a tendency to offer and upgrade undergraduate programs aimed at imparting communication skills to medical students. Initially, these programs were didactic; however, during the last decade, there has been an increasing shift to teaching interviewing skills by promoting experiential learning.
医学生获取患者访谈技巧的研究主要集中在评估各种教学计划和技术的有效性上。教育方法(即师生关系和学习氛围)很少被讨论。这些方法可分为:a)“以教师为中心”(讲授式),学生是教学的被动接受者;b)“以学习者为中心”,教师作为小组学习的促进者,其任务不是教学,而是确保所有学生参与讨论并与其他学生分享知识;c)“学习者和教师综合为中心”或“体验式学习”,包括教师与学生之间持续的对话。在本文中,我们回顾了这些教育方法的优缺点,并试图确定它们在访谈技巧教学中的当前使用趋势。直到20世纪60年代,医学生在没有任何专家指导的情况下获得访谈技巧。另一方面,自20世纪70年代以来,有一种趋势是提供和升级旨在向医学生传授沟通技巧的本科课程。最初,这些课程是讲授式的;然而,在过去十年中,越来越倾向于通过促进体验式学习来教授访谈技巧。