Marteau T M, Humphrey C, Matoon G, Kidd J, Lloyd M, Horder J
Psychology Unit, Royal Free Hospital School of Medicine, London.
Med Educ. 1991 Mar;25(2):127-34. doi: 10.1111/j.1365-2923.1991.tb00038.x.
The aim of this study was to examine the factors influencing medical students' communication skills. The sample comprised all first-year clinical students. Thirty-two received teaching in communication skills during the year; the remaining 56 did not. Students' career preferences, attitudes towards communication skills and confidence in their ability to communicate with patients were assessed by questionnaire at the beginning and end of the year. At the end of the year each student was videotaped interviewing a simulated patient. Students' communication skills were assessed on the basis of this interview by raters using a standardized rating scale, and by patient questionnaires. While there was some evidence that brief communication skills training improved skills, sex of student was a more significant predictor of level of skill. Students who perceived communication skills as less relevant to medicine and those who were more confident about their own communication skills were more likely to prefer a career in hospital medicine. Students' judgements of their ability to communicate effectively were poor. In the main there was no relationship between confidence and level of skill: where they were related, the association was negative. The benefits from communication skills training might be enhanced by involving hospital doctors in the teaching, and providing students with detailed video feedback on their skills at the outset.
本研究的目的是探讨影响医学生沟通技巧的因素。样本包括所有一年级临床学生。当年有32名学生接受了沟通技巧教学；其余56名学生未接受。在年初和年末通过问卷调查评估学生的职业偏好、对沟通技巧的态度以及与患者沟通的能力信心。年末，对每名学生与一名模拟患者的访谈进行录像。评估人员使用标准化评分量表并通过患者问卷，根据此次访谈对学生的沟通技巧进行评估。虽然有证据表明简短的沟通技巧培训提高了技能，但学生性别是技能水平更重要的预测因素。那些认为沟通技巧与医学不太相关的学生以及对自己沟通技巧更有信心的学生更倾向于选择医院医学职业。学生对自己有效沟通能力的判断较差。总体而言，信心与技能水平之间没有关系：若二者相关，这种关联也是负面的。让医院医生参与教学，并在一开始就为学生提供关于其技能的详细视频反馈，可能会增强沟通技巧培训的效果。
