Department of Primary and Interdisciplinary Care, University of Antwerp, Campus Drie Eiken, R3.11, Universiteitsplein 1, B-2610 Wilrijk, Belgium.
Med Teach. 2012;34(5):e338-48. doi: 10.3109/0142159X.2012.670320. Epub 2012 Mar 28.
Although communication skills training (CST) enhances patient-centred skills and attitudes, the literature indicates a problematic transfer of these from education into practice.
We explored 'lived' experiences of medical students and doctors to gain a better understanding of the impact of CST on patient-centredness in the transition to real practice.
From a phenomenological perspective, we conducted 15 interviews and 11 focus groups with 4-9 participants/group (n = 67) at two universities and carried out constant comparative analysis.
The gap between education and practice is the central phenomenon. Although CST raises students' communication awareness and self-efficacy in an 'ideal' context, this paradoxically seems to jeopardize their ability to bridge the gulf. In addition, CST does not come to grips with students' attitudes. However, CST appears to be successful in equipping students with long-lasting 'handles'. Yet students need more support to mould the provided 'ideal' models into their own unique style of context-specific patient-centred behaviour. This implies: raising students' awareness of own attitudes and communication styles, offering a more realistic training ground, integrating CST with clinical experience and translating the primary-care-rooted concept of patient-centredness into various specialization contexts.
CST could raise its impact by supporting students' recycling processes towards a personal style of context-sensitive patient-centredness.
尽管沟通技巧培训（CST）增强了以患者为中心的技能和态度，但文献表明，这些技能和态度在从教育向实践的转移过程中存在问题。
我们探讨了医学生和医生的“真实”体验，以更好地了解 CST 对向实际实践过渡中的以患者为中心的影响。
从现象学的角度出发，我们在两所大学进行了 15 次访谈和 11 次焦点小组讨论，每组有 4-9 名参与者（n=67），并进行了恒定性比较分析。
教育与实践之间的差距是核心现象。尽管 CST 在“理想”环境中提高了学生的沟通意识和自我效能感，但这似乎反而危及了他们弥合差距的能力。此外，CST 并没有解决学生的态度问题。然而，CST 似乎成功地为学生提供了持久的“应对策略”。然而，学生需要更多的支持来将提供的“理想”模式塑造成自己独特的、针对具体情境的以患者为中心的行为方式。这意味着：提高学生对自己的态度和沟通方式的认识，提供更现实的培训场地，将 CST 与临床经验相结合，并将以初级保健为基础的以患者为中心的概念转化为各种专业背景。
CST 可以通过支持学生向个性化、情境敏感的以患者为中心的风格进行循环过程，从而提高其影响力。
