Yassi A, Hassard T H, Kopelow M M, Schnabl G
Department of Community Health Sciences and Medicine, University of Manitoba, Winnipeg, Canada.
J Occup Med. 1990 Jul;32(7):582-5. doi: 10.1097/00043764-199007000-00007.
Primary care physicians must identify and manage work-related disease, yet it is unclear whether training is adequate to accomplish this. This study examines the performance of 110 candidates, including 93 4th-year medical students, in the diagnosis and treatment of a standardized patient with occupational illness. Results indicated that the students did substantially better than the medical practitioners who had not received recent training. Although a strong correlation existed between candidates performance on the occupational health (OH) case and overall score on 19 non-occupational health cases, the competency measure that most determined performance on the OH case was interpersonal skills. A correlation also existed between working knowledge, data collection and data interpretation skills overall, and performance on the OH case; diagnostic skills, test selection, test interpretation, and case management skills overall showed no such correlation. The findings highlighted the importance of emphasizing interpersonal skills in training physicians to appropriately manage occupational medical cases, and illustrated the usefulness of standardized patients in teaching and evaluating occupational medical skills.
初级保健医生必须识别和管理与工作相关的疾病，但目前尚不清楚培训是否足以实现这一目标。本研究考察了110名应试者（包括93名四年级医学生）对一名患有职业病的标准化病人的诊断和治疗能力。结果表明，这些学生的表现明显优于近期未接受培训的执业医生。虽然应试者在职业健康（OH）病例上的表现与19个非职业健康病例的总体得分之间存在很强的相关性，但最能决定OH病例表现的能力指标是人际沟通技巧。工作知识、数据收集和整体数据解读技能与OH病例的表现之间也存在相关性；而诊断技能、检查选择、检查解读和整体病例管理技能则不存在这种相关性。这些发现凸显了在培训医生以妥善管理职业医疗病例时强调人际沟通技巧的重要性，并说明了标准化病人在职业医疗技能教学和评估中的作用。
