Berger Jeffrey S, Blatt Benjamin, McGrath Brian, Greenberg Larrie, Berrigan Michael J
J Grad Med Educ. 2010 Dec;2(4):600-3. doi: 10.4300/JGME-D-10-00012.1.
The Accreditation Council for Graduate Medical Education requires residency programs to teach 6 core competencies and to provide evidence of effective standardized training through objective measures. George Washington University's Department of Anesthesiology and Critical Care Medicine implemented a pilot program to address the interpersonal and communication skill competency. In this program, we aimed to pilot the Relationship Express model, a series of exercises in experiential learning to teach anesthesiology residents to build effective relationships with patients in time-limited circumstances. The purpose of this paper is to describe the application of this model for anesthesiology training.
A total of 7 first-year clinical anesthesiology residents participated in this pilot study, and 4 residents completed the entire program for analysis purposes. Relationship Express was presented in three 1.5-hour sessions: (1) introduction followed by 2-case, standardized patient pretest with feedback to residents from faculty observers; (2) interpersonal and communication skills didactic workshop with video behavior modeling; and (3) review discussion followed by 2-case, standardized patient posttest and evaluation.
MODIFIED BROOKFIELD COMMENTS REVEALED THE FOLLOWING THEMES: (1) time constraints were realistic compared with clinical practice; (2) admitting errors with patients was difficult; (3) patients were more aware of body language than anticipated; (4) residents liked the group discussions and the video interview; (5) standardized patients were convincing; and (6) residents found the feedback from faculty and standardized patients helpful.
Resident retrospective self-assessment and learning comments confirm the potential value of the Relationship Express model. This program will require further assessment and refinement with a larger number of residents.
毕业后医学教育认证委员会要求住院医师培训项目教授6项核心能力,并通过客观指标提供有效标准化培训的证据。乔治华盛顿大学麻醉学与重症医学系实施了一个试点项目,以解决人际沟通技能方面的能力问题。在这个项目中,我们旨在试点“关系表达”模式,这是一系列体验式学习练习,旨在教导麻醉科住院医师在时间有限的情况下与患者建立有效的关系。本文的目的是描述该模式在麻醉学培训中的应用。
共有7名临床麻醉学一年级住院医师参与了这项试点研究,4名住院医师完成了整个项目以进行分析。“关系表达”分三个1.5小时的课程进行:(1)介绍,随后是2个病例的标准化患者预测试,并由教员观察员向住院医师提供反馈;(2)人际沟通技能理论研讨会,伴有视频行为示范;(3)回顾讨论,随后是2个病例的标准化患者后测试和评估。
经修改的布鲁克菲尔德评论揭示了以下主题:(1)与临床实践相比,时间限制是现实的;(2)向患者承认错误很困难;(3)患者对肢体语言的感知比预期更强;(4)住院医师喜欢小组讨论和视频访谈;(5)标准化患者很有说服力;(6)住院医师发现教员和标准化患者的反馈很有帮助。
住院医师的回顾性自我评估和学习评论证实了“关系表达”模式的潜在价值。该项目需要对更多住院医师进行进一步评估和完善。