Division of General Medicine, Geriatrics, and Bioethics, University of California Davis School of Medicine, Sacramento, CA 95817, USA.
Med Teach. 2013 May;35(5):395-403. doi: 10.3109/0142159X.2013.769677. Epub 2013 Feb 27.
Communicating with patients is arguably the most common and important activity in medical practice, but this activity receives relatively little emphasis in graduate medical education. We propose 12 evidence-based communication competencies that program directors can adopt as a framework for teaching and evaluating residents' communication skills. We review supporting evidence for these competencies and argue that communication should be treated like a procedural skill that must be taught and evaluated by observing real resident-patient interactions. We make practical suggestions for implementing these competencies by addressing three critical components of a competency-based approach to communication skills: patient safety, faculty development, and direct observation of residents. This approach to teaching and assessing communication skills provides a rationale for incorporating routine direct observation into graduate medical education programs and also for designing communication skills training that ensures graduating residents develop the skills needed to provide safe, effective patient care.
与患者沟通可以说是医疗实践中最常见和最重要的活动，但这种活动在研究生医学教育中相对不受重视。我们提出了 12 项基于证据的沟通能力，项目主管可以将其作为教学和评估住院医师沟通技巧的框架。我们回顾了这些能力的支持证据，并认为沟通应该像程序性技能一样对待，必须通过观察真实的医患互动来教授和评估。我们通过解决基于能力的沟通技巧方法的三个关键组成部分，即患者安全、教师发展和对住院医师的直接观察，为实施这些能力提出了切实可行的建议。这种教授和评估沟通技巧的方法为将常规直接观察纳入研究生医学教育项目以及设计确保毕业住院医师发展提供安全、有效患者护理所需技能的沟通技巧培训提供了依据。
