Reisner E, Dunnington G, Beard J, Witzke D, Fulginiti J, Rappaport W
Department of Surgery, University of Arizona, Tucson.
Am J Surg. 1991 Sep;162(3):271-3. doi: 10.1016/0002-9610(91)90086-s.
Physician-patient interaction skills are predominantly taught by successful role modeling but are rarely evaluated formally and systematically. This study describes a new model for the assessment of student physician-patient interaction skills and reports results of use in 78 third-year medical students on clerkships at two institutions. A single nurse instructor at each institution evaluated these skills using an 18-item checklist during student performance of wound care and dressing changes. Students were focused on the evaluation of their technical skills and were unaware of the evaluation of their interaction skills. Immediate feedback on performance was provided. The mean percentage score for the interaction skills was 35%, and no improvement was noted with greater clinical experience (later rotations). We conclude that there is a striking deficiency in physician-patient interaction skills among third-year students. The model described is effective for both evaluation and feedback.
医患互动技能主要通过成功的榜样示范来传授，但很少进行正式和系统的评估。本研究描述了一种评估医学生医患互动技能的新模式，并报告了在两所机构实习的78名三年级医学生使用该模式的结果。每个机构的一名护士教员在学生进行伤口护理和换药操作时，使用一份包含18项内容的清单对这些技能进行评估。学生们专注于对其技术技能的评估，并未意识到对其互动技能的评估。会提供关于表现的即时反馈。互动技能的平均百分比得分为35%，且随着临床经验的增加（后期轮转）未发现有改善。我们得出结论，三年级学生在医患互动技能方面存在明显不足。所描述的模式对于评估和反馈均有效。
