Kopecky-Wenzel Marie, Maier Esther M, Muntau Ania C, Reinhardt Dietrich, Frank Reiner
Klinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, Klinikum der Universität München.
Z Kinder Jugendpsychiatr Psychother. 2009 Mar;37(2):139-44. doi: 10.1024/1422-4917.37.2.139.
In 2002, the Medical Licensing Board prescribed fundamental changes in medical education. The reformed curriculum set its focus on bed-side teaching in small groups, problem-based courses, and training of communication skills. The previous curriculum did not include the teaching of communication skills to future physicians. Physicians thus felt unprepared for the doctor-patient communication.
Within the newly derived Medical Curriculum Munich (MeCuMLMU), the School of Medicine at the Ludwig-Maximilian-University of Munich implemented in 2005 a teaching unit named "Breaking Bad News" in order to train the students' communication skills. Its main elements are videotaped role-plays and the subsequent video-based analyses. In the role-plays, students experience the parts of a physician and a couple of parents. The task of the physician is to break the news of a severe condition to the parents of a child. The teaching units are held by members of the department of child psychiatry together with fifteen members of the department of paediatrics who had been instructed in analyzing videotaped role-plays. A manual was developed to facilitate a standardized approach.
The teaching units were evaluated by means of questionnaires filled in by students and tutors. The evaluation showed that "Breaking Bad News" was highly appreciated by both students and tutors. Our experience showed that this type of instruction is suitable to improve the communication skills of medical students, and it is feasible despite the relatively extensive technical and personnel resources needed.
2002年，医学许可委员会规定了医学教育的根本性变革。改革后的课程重点是小组床边教学、基于问题的课程以及沟通技能培训。以前的课程没有包括对未来医生进行沟通技能教学。因此，医生们觉得自己没有为医患沟通做好准备。
在新制定的慕尼黑医学课程（MeCuMLMU）中，慕尼黑路德维希 - 马克西米利安大学医学院于2005年实施了一个名为“告知坏消息”的教学单元，以培养学生的沟通技能。其主要内容是录像角色扮演及随后基于视频的分析。在角色扮演中，学生分别扮演医生和一对家长的角色。医生的任务是向一个孩子的家长告知严重病情。教学单元由儿童精神病学系的成员以及15名接受过录像角色扮演分析培训的儿科学系成员授课。还编写了一本手册以促进标准化教学方法。
通过学生和导师填写的问卷对教学单元进行了评估。评估表明，“告知坏消息”受到了学生和导师的高度评价。我们的经验表明，这种教学方式适合提高医学生的沟通技能，尽管需要相对大量的技术和人力资源，但它是可行的。
