Gulbrandsen Pål, Jensen Bård Fossli, Finset Arnstein
Helse Sør-Øst kompetansesenter for helsetjenesteforskning, Akershus universitetssykehus og Fakultetsdivisjon Akershus universitetssykehus, Universitetet i Oslo, Norway.
Tidsskr Nor Laegeforen. 2009 Nov 19;129(22):2343-6. doi: 10.4045/tidsskr.09.0261.
There is a paucity of research on clinical communication in hospitals. A large Norwegian hospital has tried out a course (developed in the USA) in clinical communication. In this substudy, we investigated the association between doctors' self-efficacy and participation in this course.
Doctors under 60 years of age, working in clinical somatic departments in Akershus University Hospital, were eligible for inclusion. The participants completed a validated questionnaire before and after the course. Self-efficacy was assessed (on a 10-point scale) through nine important communication skills.
103 doctors (randomly selected) were asked to participate in the study; 62 of them completed the 20-hour course. After completion of the course, the participants were more confident that communication skills could be learnt in this way than they were before it started. Their self-efficacy only improved moderately, on average 0.6 on the 10-point scale, but the change was statistically significant for seven of the nine skills. After completion of the course, self-efficacy had improved for 41 doctors and deteriorated for ten. Nevertheless, the latter were still positive regarding the learning effect of the course. The effects were independent of the doctors' sex, age, position (resident or consultant), self-efficacy before the course, and specialty. Of the skills taught, demonstration of empathy was the one that fewest doctors wanted to practice after the course.
A short course in clinical communication skills led to a moderate improvement in the participating doctors' self-efficacy. Whether this change implies improved communication is currently under investigation.
关于医院临床沟通的研究较少。挪威一家大型医院试用了一门(在美国开发的)临床沟通课程。在这项子研究中,我们调查了医生的自我效能感与参与该课程之间的关联。
在阿克什胡斯大学医院临床躯体科室工作的60岁以下医生符合纳入条件。参与者在课程前后完成了一份经过验证的问卷。通过九项重要沟通技能评估自我效能感(采用10分制)。
103名医生(随机选取)被要求参与研究;其中62人完成了为期20小时的课程。课程结束后,参与者比课程开始前更有信心通过这种方式学习沟通技能。他们的自我效能感仅适度提高,平均在10分制上提高了0.6分,但九项技能中有七项的变化具有统计学意义。课程结束后,41名医生的自我效能感有所提高,10名医生的自我效能感有所下降。然而,后者对课程的学习效果仍持积极态度。这些效果与医生的性别、年龄、职位(住院医师或顾问医生)、课程开始前的自我效能感以及专业无关。在所学技能中,课程结束后很少有医生想要练习同理心表达。
临床沟通技能短期课程使参与医生的自我效能感适度提高。这种变化是否意味着沟通得到改善目前正在研究中。