Tacoma Family Medicine, Tacoma, WA 98407-5920, USA.
Patient Educ Couns. 2010 May;79(2):199-206. doi: 10.1016/j.pec.2009.08.012. Epub 2009 Sep 11.
To explore student and faculty perceptions of how students are learning doctor-patient relationship skills in their clinical medical education.
Exploratory qualitative study involving data from interviews and focus groups with students and interviews with teaching faculty.
Respondents reported that pre-clinical relationship skills curricula were not well-coordinated with clinical curricula. Within the clinical curriculum, respondents perceived a disparity between general practice and hospital-based attachments. Teaching of relationship skills on the wards was highly variable, rarely explicit, and primarily dependent on role-modelling. In contrast, general practice runs included explicit teaching with feedback that reinforced skills taught in the pre-clinical curriculum. Respondents recommended increased focus on and assessment of students' interpersonal skills within clinical settings.
Pre-clinical and clinical relationship skills curricula were not coordinated. The tension between service commitments and student teaching in hospital-based attachments contributed to an insufficient focus on communication and relationship skills acquisition and did not reinforce teaching in pre-clinical and ambulatory clinical settings.
The teaching of doctor-patient relationship skills can be augmented by coordinating pre-clinical and clinical curricula and by requiring observation and structured feedback related to explicit criteria of student skills acquisition across all clinical learning experiences.
探讨学生和教师对临床医学教育中学生学习医患关系技能的看法。
采用学生访谈和焦点小组、教师访谈的探索性定性研究。
受访者报告称，临床前关系技能课程与临床课程没有很好地协调。在临床课程中，受访者认为普通科和医院实习之间存在差异。病房中的关系技能教学变化很大，很少有明确的教学，主要依赖于榜样作用。相比之下，普通科实习包括明确的教学和反馈，强化了临床前课程中教授的技能。受访者建议在临床环境中更加关注和评估学生的人际交往能力。
临床前和临床关系技能课程没有协调。服务承诺与医院实习中学生教学之间的紧张关系导致沟通和关系技能的获取不够重视，也没有加强临床前和门诊临床环境中的教学。
通过协调临床前和临床课程，以及要求在所有临床学习经历中观察和结构化反馈与学生技能获取的明确标准相关联，可以增强医患关系技能的教学。
