Langewitz W
Psychosomatik - Innere Medizin, Universitätsspital Basel, Hebelstr. 2, 4031, Basel, Schweiz.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2012 Sep;55(9):1176-82. doi: 10.1007/s00103-012-1533-0.
Based on a review of recent key articles, this paper demonstrates that many elements of physician-patient communication can be learned successfully during medical education. Methods of assessment and definition of success depend largely on the definition of teaching goals, which are usually based on the principles of a more egalitarian and non-paternalistic physician-patient communication. In this article another approach is suggested. Teaching objectives in patient-physician communication can also be deduced from the needs of clinical medicine, resulting in the following goals: students are able to gather relevant data from patients' history, they explicitly structure the consultation and the way they give information, they know how to respond to patients' emotions. The Objective Standardised Clinical Examination (OSCE) is discussed with its strengths and weaknesses. The inclusion of video-based feedback is presented as a teaching tool to improve students' self-reflection. Workplace-based assessment and Mini-CEX are promising educational tools that require a well-trained faculty, not only in the teaching and practice of communication but also in the art of giving constructive and yet honest feedback.
基于对近期关键文章的回顾，本文表明医患沟通的许多要素能够在医学教育期间成功习得。评估方法和成功的定义很大程度上取决于教学目标的定义，而教学目标通常基于更平等和非家长式医患沟通的原则。本文提出了另一种方法。医患沟通中的教学目标也可以从临床医学的需求中推导出来，从而产生以下目标：学生能够从患者病史中收集相关数据，他们明确地组织会诊以及提供信息的方式，他们知道如何回应患者的情绪。讨论了客观结构化临床考试（OSCE）的优缺点。基于视频的反馈作为一种教学工具被提出，以提高学生的自我反思能力。基于工作场所的评估和迷你临床评估练习（Mini-CEX）是很有前景的教育工具，但需要一支训练有素的教师队伍，不仅要在沟通教学和实践方面，还要在给予建设性且诚实反馈的技巧方面。
