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跨文化医学教育:以患者为中心的文化能力培训在非西方国家能有效吗?

Cross-cultural medical education: can patient-centered cultural competency training be effective in non-Western countries?

作者信息

Ho Ming-Jung, Yao Grace, Lee Keng-Lin, Beach Mary Catherine, Green Alexander R

机构信息

National Taiwan University, Taipei City, Taiwan.

出版信息

Med Teach. 2008;30(7):719-21. doi: 10.1080/01421590802232842.

Abstract

BACKGROUND

No evidence addresses the effectiveness of patient-centered cultural competence training in non-Western settings.

AIMS

To examine whether a patient-centered cultural competency curriculum improves medical students' skills in eliciting the patients' perspective and exploring illness-related social factors.

METHOD

Fifty-seven medical students in Taiwan were randomly assigned to either the control (n = 27) or one of two intervention groups: basic (n = 15) and extensive (n = 15). Both intervention groups received two 2-hour patient-centered cultural competency workshops. In addition, the extensive intervention group received a 2-hour practice session. The control group received no training.

RESULTS

At the end of the clerkship, all students were evaluated with an objective structured clinical examination (OSCE). Students in the extensive intervention group scored significantly higher than the basic intervention and control groups in eliciting the patient's perspective (F = 18.38, p < 0.001, eta(2) = 0.40). Scores of both intervention groups were significantly higher than the control group in the exploring social factors (F = 6.66, p = 0.003, eta(2) = 0.20).

CONCLUSION

Patient-centered cultural competency training can produce improvement in medical students' cross-cultural communication skills in non-Western settings, especially when adequate practice is provided.

摘要

背景

尚无证据表明以患者为中心的文化能力培训在非西方环境中的有效性。

目的

探讨以患者为中心的文化能力课程是否能提高医学生了解患者观点及探究疾病相关社会因素的技能。

方法

台湾的57名医学生被随机分配到对照组(n = 27)或两个干预组之一:基础组(n = 15)和强化组(n = 15)。两个干预组均参加了两次为时2小时的以患者为中心的文化能力工作坊。此外,强化干预组还参加了一次为时2小时的实践课程。对照组未接受培训。

结果

在临床实习结束时,所有学生均通过客观结构化临床考试(OSCE)进行评估。在了解患者观点方面,强化干预组的学生得分显著高于基础干预组和对照组(F = 18.38,p < 0.001,η² = 0.40)。在探究社会因素方面,两个干预组的得分均显著高于对照组(F = 6.66,p = 0.003,η² = 0.20)。

结论

以患者为中心的文化能力培训能够提高医学生在非西方环境中的跨文化沟通技能,尤其是在提供充分实践的情况下。

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