Simmenroth-Nayda Anne, Weiss Cora, Fischer Thomas, Himmel Wolfgang
Department of General Practice / Family Medicine University of Göttingen, Humboldtalle 38, 37077, Göttingen, Germany.
BMC Res Notes. 2012 Sep 5;5:486. doi: 10.1186/1756-0500-5-486.
Although it is taken for granted that history-taking and communication skills are learnable, this learning process should be confirmed by rigorous studies, such as randomized pre- and post-comparisons. The purpose of this paper is to analyse whether a communication course measurably improves the communicative competence of third-year medical students at a German medical school and whether technical or emotional aspects of communication changed differently.
A sample of 32 randomly selected students performed an interview with a simulated patient before the communication course (pre-intervention) and a second interview after the course (post-intervention), using the Calgary-Cambridge Observation Guide (CCOG) to assess history taking ability.
On average, the students improved in all of the 28 items of the CCOG. The 6 more technically-orientated communication items improved on average from 3.4 for the first interview to 2.6 in the second interview (p < 0.0001), the 6 emotional items from 2.7 to 2.3 (p = 0.023). The overall score for women improved from 3.2 to 2.5 (p = 0.0019); male students improved from 3.0 to 2.7 (n.s.). The mean interview time significantly increased from the first to the second interview, but the increase in the interview duration and the change of the overall score for the students' communication skills were not correlated (Pearson's r = 0.03; n.s.).
Our communication course measurably improved communication skills, especially for female students. These improvements did not depend predominantly on an extension of the interview time. Obviously, "technical" aspects of communication can be taught better than "emotional" communication skills.
尽管人们认为病史采集和沟通技巧是可以习得的，但这一学习过程应通过严格的研究来证实，比如随机的前后对比研究。本文旨在分析一门沟通课程是否能显著提高德国一所医学院校三年级医学生的沟通能力，以及沟通的技术或情感方面是否有不同程度的变化。
随机选取32名学生，在沟通课程前（干预前）对一名模拟患者进行访谈，并在课程结束后（干预后）进行第二次访谈，使用卡尔加里-剑桥观察指南（CCOG）评估病史采集能力。
平均而言，学生在CCOG的所有28项内容上都有进步。6项更侧重于技术的沟通项目平均得分从第一次访谈的3.4分提高到第二次访谈的2.6分（p < 0.0001），6项情感项目从2.7分提高到2.3分（p = 0.023）。女生的总体得分从3.2分提高到2.5分（p = 0.0019）；男生从3.0分提高到2.7分（无显著差异）。第一次访谈到第二次访谈的平均访谈时间显著增加，但访谈时长的增加与学生沟通技能总体得分的变化不相关（皮尔逊相关系数r = 0.03；无显著差异）。
我们的沟通课程显著提高了沟通技能，尤其是对女生。这些提高并不主要依赖于访谈时间的延长。显然，沟通的“技术”方面比“情感”沟通技能更容易教授。
