Kalish R, Dawiskiba M, Sung Y-C, Blanco M
Tufts Medica Center, Boston, Massachusetts, USA.
Educ Health (Abingdon). 2011 Dec;24(3):490. Epub 2011 Dec 2.
With medical training focused on medical knowledge and skills, the nurturing of humanistic care can suffer.
We designed and conducted an outpatient rheumatology patient-partner exercise that integrates the assessment of student compassionate care into an outpatient clinical skills training exercise.
Eleven third-year medical students were videotaped performing a medical history on a patient volunteer. Students, the preceptor and a fourth-year medical student independently observed the videotape, tagged segments demonstrating observed or missed compassionate care opportunities and completed a compassionate care questionnaire. Students also participated in a focus group. Ten patients completed a comparable questionnaire and provided feedback on student encounters.
Students recognized and reflected on opportunities for compassionate care. The preceptor's feedback was reinforced. Students' ratings of their demonstrations of compassionate care were lower after reviewing videotapes, and were also lower than preceptor ratings. Patients were satisfied with the exercise and highlighted student professionalism.
The exercise proved to be an effective format for promoting student reflection on and self-assessment of compassionate care. It demonstrated that nurturing compassionate care can be integrated into an outpatient clinical skills exercise.
由于医学培训侧重于医学知识和技能,人文关怀的培养可能会受到影响。
我们设计并开展了一项门诊风湿病患者参与的活动,将对学生同情关怀的评估纳入门诊临床技能培训活动中。
对11名三年级医学生为一名患者志愿者进行病史采集的过程进行录像。学生、带教老师和一名四年级医学生分别观看录像,标记出展示观察到或遗漏的同情关怀机会的片段,并完成一份同情关怀问卷。学生们还参加了一个焦点小组。10名患者完成了一份类似的问卷,并对与学生的接触提供了反馈。
学生们认识到并反思了同情关怀的机会。带教老师的反馈得到了强化。学生们在观看录像后对自己同情关怀表现的评分降低了,且低于带教老师的评分。患者对该活动感到满意,并强调了学生的专业素养。
该活动被证明是促进学生对同情关怀进行反思和自我评估的有效形式。它表明,同情关怀的培养可以融入门诊临床技能活动中。