Department of Medicine, CLASS Clinical Skills Center, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Acad Med. 2010 Sep;85(9):1445-52. doi: 10.1097/ACM.0b013e3181eae5ec.
To assess whether perspective-taking, which researchers in other fields have shown to induce empathy, improves patient satisfaction in encounters between student-clinicians and standardized patients (SPs).
In three studies, randomly assigned students (N = 608) received either a perspective-taking instruction or a neutral instruction prior to a clinical skills examination in 2006-2007. SP satisfaction was the main outcome in all three studies. Study 1 involved 245 third-year medical students from two universities. Studies 2 and 3 extended Study 1 to examine generalizability across student and SP subpopulations. Study 2 (105 physician assistant students, one university) explored the effect of perspective-taking on African American SPs' satisfaction. Study 3 (258 third-year medical students, two universities) examined the intervention's effect on students with high and low baseline perspective-taking tendencies.
Intervention students outscored controls in patient satisfaction in all studies: Study 1: P = .01, standardized effect size = 0.16; Study 2: P = .001, standardized effect size = 0.31; Study 3: P = .009, standardized effect size = 0.13. In Study 2, perspective-taking improved African American SPs' satisfaction. In Study 3, intervention students with high baseline perspective-taking tendencies outscored controls (P = .0004, standardized effect size = 0.25), whereas those with low perspective-taking tendencies did not (P = .72, standardized effect size = 0.00).
Perspective-taking increased patient satisfaction in all three studies, across medical schools, clinical disciplines, and racially diverse students and SPs. Perspective-taking as a means for improving patient satisfaction deserves further exploration in clinical training and practice.
评估换位思考——其他领域的研究人员已证实其能引发同理心——是否能提高学生临床医生与标准化患者(SP)之间互动中的患者满意度。
在三项研究中,2006-2007 年,在临床技能考试前,随机分配的学生(N=608)接受换位思考指导或中性指导。所有三项研究的主要结果都是 SP 的满意度。研究 1 涉及来自两所大学的 245 名三年级医学生。研究 2 和研究 3 将研究 1 扩展到检验学生和 SP 亚群中的可推广性。研究 2(105 名医师助理学生,一所大学)探讨了换位思考对非裔美国 SP 满意度的影响。研究 3(258 名三年级医学生,两所大学)检验了该干预措施对基线换位思考倾向高和低的学生的影响。
在所有研究中,干预组学生的患者满意度均高于对照组:研究 1:P=0.01,标准化效应大小=0.16;研究 2:P=0.001,标准化效应大小=0.31;研究 3:P=0.009,标准化效应大小=0.13。在研究 2 中,换位思考提高了非裔美国 SP 的满意度。在研究 3 中,基线换位思考倾向高的干预组学生的得分高于对照组(P=0.0004,标准化效应大小=0.25),而倾向低的学生则没有(P=0.72,标准化效应大小=0.00)。
在所有三项研究中,换位思考都提高了患者的满意度,涵盖了医学院、临床学科和不同种族的学生和 SP。作为提高患者满意度的一种手段,换位思考值得在临床培训和实践中进一步探索。