Bute Medical School, University of St Andrews, Westburn Lane, St Andrews, Fife, UK.
BMC Med Educ. 2009 Jul 20;9:47. doi: 10.1186/1472-6920-9-47.
Patients provide emotional cues during consultations which may be verbal or non-verbal. Many studies focus on patient verbal cues as predictors of physicians' ability to recognize and address patient needs but this project focused on non-verbal cues in the form of facial micro-expressions. This pilot study investigated first year medical students' (n = 75) identified as being either good or poor communicators abilities to detect emotional micro-expressions before and after training using the Micro Expression Training Tool (METT) http://www.mettonline.com.
The sample consisted of 24 first year medical students, 9 were from the lowest performance quartile in a communication skills OSCE (Objective Structured Clinical Exam) station and 15 were from the highest performance quartile. These students completed the METT individually, recording pre- and post-assessment scores. Students were also invited to provide their views on the training.
No difference in pre-assessment scores was found between the lowest and highest quartile groups (P = 0.797). After training, students in the high quartile showed significant improvement in the recognition of facial micro-expressions (P = 0.014). The lowest quartile students showed no improvement (P = 0.799).
In conclusion, this pilot study showed there was no difference between the ability of medical undergraduate students assessed as being good communicators and those assessed as poor communicators to identify facial micro-expressions. But, the study did highlight that those students demonstrating good general clinical communication benefited from the training aspect of the METT, whereas low performing students did not gain. Why this should be the case is not clear and further investigation should be carried out to determine why lowest quartile students did not benefit.
患者在就诊过程中会提供情感线索，这些线索可以是言语的，也可以是非言语的。许多研究都集中在患者的言语线索作为医生识别和满足患者需求的能力预测指标上，但本项目侧重于以面部微表情形式表现出来的非言语线索。这项初步研究调查了一年级医学生（n=75），他们被确定为沟通能力较好或较差的学生，使用微表情训练工具（METT）http://www.mettonline.com，在培训前后识别情绪微表情的能力。
该样本包括 24 名一年级医学生，其中 9 名来自沟通技能 OSCE（客观结构化临床考试）站表现最低的四分位数，15 名来自表现最高的四分位数。这些学生单独完成 METT，记录评估前和评估后的分数。学生还被邀请提供他们对培训的看法。
在最低和最高四分位数组之间，评估前的分数没有差异（P=0.797）。经过培训，高四分位数组的学生在识别面部微表情方面有显著提高（P=0.014）。低四分位数组的学生没有提高（P=0.799）。
总之，这项初步研究表明，评估为沟通能力较好的医学生和评估为沟通能力较差的医学生在识别面部微表情方面没有差异。但是，该研究确实强调，那些表现出良好一般临床沟通能力的学生从 METT 的培训方面受益，而表现不佳的学生则没有受益。为什么会这样还不清楚，应该进一步调查以确定为什么最低四分位数的学生没有受益。
