Junod Perron Noelle, Sommer Johanna, Hudelson Patricia, Demaurex Florence, Luthy Christophe, Louis-Simonet Martine, Nendaz Mathieu, De Grave Willem, Dolmans Diana, Van der Vleuten Cees
Department of Community Medicine and Primary Care, Geneva University Hospitals, Switzerland.
Educ Health (Abingdon). 2009 May;22(1):280. Epub 2009 May 8.
Residents' perceived needs in communication skills training are important to identify before designing context-specific training programmes, since learrners' perceived needs can influence the effectiveness of training.
To explore residents' perceptions of their training needs and training experiences around communication skills, and whether these differ between residents training in inpatient and outpatient clinical settings.
Four focus groups (FG) and a self-administered questionnaire were conducted with residents working in in- and outpatient medical service settings at a Swiss University Hospital. Focus groups explored residents' perceptions of their communication needs, their past training experiences and suggestions for future training programmes in communication skills. Transcripts were analysed in a thematic way using qualitative analytic approaches. All residents from both settings were asked to complete a questionnaire that queried their sociodemographics and amount of prior training in communication skills.
In focus groups, outpatient residents felt that communication skills were especially useful in addressing chronic diseases and social issues. In contrast, inpatient residents emphasized the importance of good communication skills for dealing with family conflicts and end-of-life issues. Felt needs reflected residents' differing service priorities: outpatient residents saw the need for skills to structure the consultation and explore patients' perspectives in order to build therapeutic alliances, whereas inpatient residents wanted techniques to help them break bad news, provide information and increase their own well-being. The survey's overall response rate was 56%. Its data showed that outpatient residents received more training in communication skills and more of them than inpatient residents considered communication skills training to be useful (100% vs 74%).
Outpatient residents' perceived needs in communication skills were more patient-centered than the needs perceived by inpatient residents. Residents' perceived needs for communication skills may differ not only because of their differing service priorities but also because of differences in their previous experiences with communication skills training. These factors should be taken into account when designing a training programme in communication skills.
在设计针对特定情境的培训项目之前，明确住院医师在沟通技能培训方面的感知需求非常重要，因为学习者的感知需求会影响培训效果。
探讨住院医师对沟通技能培训需求及培训经历的看法，以及在住院和门诊临床环境中培训的住院医师之间是否存在差异。
在瑞士一家大学医院的住院和门诊医疗服务部门工作的住院医师中开展了四个焦点小组讨论（FG）和一项自填式问卷调查。焦点小组讨论探讨了住院医师对沟通需求的看法、他们过去的培训经历以及对未来沟通技能培训项目的建议。使用定性分析方法对访谈记录进行主题分析。要求两个环境中的所有住院医师完成一份问卷，询问他们的社会人口统计学信息和之前沟通技能培训的时长。
在焦点小组讨论中，门诊住院医师认为沟通技能在处理慢性病和社会问题方面特别有用。相比之下，住院住院医师强调良好的沟通技能对于处理家庭冲突和临终问题的重要性。感知需求反映了住院医师不同的服务重点：门诊住院医师认为需要具备构建会诊结构和探索患者观点以建立治疗联盟的技能，而住院住院医师希望掌握帮助他们传达坏消息、提供信息并提升自身幸福感的技巧。调查的总体回复率为56%。数据显示，门诊住院医师接受的沟通技能培训更多，并且比住院住院医师中更多人认为沟通技能培训有用（100%对74%）。
门诊住院医师在沟通技能方面的感知需求比住院住院医师的需求更以患者为中心。住院医师对沟通技能的感知需求可能不仅因其服务重点不同而有所差异，还因其之前沟通技能培训经历的不同而不同。在设计沟通技能培训项目时应考虑这些因素。
