Kraan H F, Crijnen A A, de Vries M W, Zuidweg J, Imbos T, Van der Vleuten C P
Rijksuniversiteit, Limburg, The Netherlands.
Med Teach. 1990;12(3-4):315-28. doi: 10.3109/01421599009006637.
Growth patterns of medical interviewing skills during a 6-year undergraduate curriculum are assessed by studying 563 medical students taken from five year-groups, interviewing simulated patients. In a cross-sectional, quasi-experimental design their skills are rated by means of the Maastricht History-taking and Advice Checklist (MAAS), an observation instrument which measures five categories of interviewing skills pertaining to initial medical consultations. The findings suggest that the skills for 'history-taking', 'presenting solutions' and 'structuring of the interview' are effectively learned. These learning effects result from a continuous small group teaching program with expert and peer review of videotaped encounters with simulated patients. The teaching effects of this program seem less for the skills pertinent to the phase of 'exploring the reasons for encounter' and to the 'basic interviewing skills', because the students' growing medical knowledge and the increasing ability to solve medical problems exert a counteracting influence on the acquisition of these easily deteriorating skills. The results might be helpful to curriculum planners in order to make their programs for medical interviewing skills more effective.
通过对来自五个年级的563名医学生进行研究，让他们与模拟患者进行访谈，评估了6年本科课程中医务访谈技能的成长模式。在一项横断面准实验设计中，他们的技能通过马斯特里赫特病史采集与建议清单（MAAS）进行评分，这是一种观察工具，用于衡量与初次医疗咨询相关的五类访谈技能。研究结果表明，“病史采集”“提出解决方案”和“访谈结构安排”等技能得到了有效学习。这些学习效果源于一个持续的小组教学计划，该计划包括专家和同伴对与模拟患者的录像访谈进行评审。对于与“探究就诊原因阶段”和“基本访谈技能”相关的技能，该计划的教学效果似乎较差，因为学生不断增长的医学知识和解决医疗问题能力的提高，对这些容易退化的技能的习得产生了抵消作用。这些结果可能有助于课程规划者，使他们的医疗访谈技能课程更有效。
