Han Paul K J, Joekes Katherine, Elwyn Glyn, Mazor Kathleen M, Thomson Richard, Sedgwick Philip, Ibison Judith, Wong John B
Center for Outcomes Research and Evaluation, Maine Medical Center, Portland, USA; Tufts University School of Medicine, Boston, USA.
Centre for Medical and Healthcare Education, St George's, University of London, London, UK.
Patient Educ Couns. 2014 Jan;94(1):43-9. doi: 10.1016/j.pec.2013.09.009. Epub 2013 Sep 19.
To develop, pilot, and evaluate a curriculum for teaching clinical risk communication skills to medical students.
A new experience-based curriculum, "Risk Talk," was developed and piloted over a 1-year period among students at Tufts University School of Medicine. An experimental study of 2nd-year students exposed vs. unexposed to the curriculum was conducted to evaluate the curriculum's efficacy. Primary outcome measures were students' objective (observed) and subjective (self-reported) risk communication competence; the latter was assessed using an Observed Structured Clinical Examination (OSCE) employing new measures.
Twenty-eight 2nd-year students completed the curriculum, and exhibited significantly greater (p<.001) objective and subjective risk communication competence than a convenience sample of 24 unexposed students. New observational measures of objective competence in risk communication showed promising evidence of reliability and validity. The curriculum was resource-intensive.
The new experience-based clinical risk communication curriculum was efficacious, although resource-intensive. More work is needed to develop the feasibility of curriculum delivery, and to improve the measurement of competence in clinical risk communication.
Risk communication is an important advanced communication skill, and the Risk Talk curriculum provides a model educational intervention and new assessment tools to guide future efforts to teach and evaluate this skill.
开发、试行并评估一门向医学生传授临床风险沟通技能的课程。
开发了一门基于新体验的课程“风险沟通”，并在塔夫茨大学医学院的学生中进行了为期一年的试行。对二年级学生进行了一项实验研究，比较接触该课程与未接触该课程的学生，以评估课程的效果。主要结局指标是学生的客观（观察到的）和主观（自我报告的）风险沟通能力；后者使用采用新指标的客观结构化临床考试（OSCE）进行评估。
28名二年级学生完成了该课程，与24名未接触该课程的便利样本学生相比，表示出显著更高（p<.001）的客观和主观风险沟通能力。风险沟通客观能力的新观察指标显示出可靠性和有效性的良好证据。该课程资源密集。
新的基于体验的临床风险沟通课程是有效的，尽管资源密集。需要开展更多工作来提高课程实施的可行性，并改进临床风险沟通能力的测量。
风险沟通是一项重要的高级沟通技能，“风险沟通”课程提供了一个示范性教育干预措施和新的评估工具，以指导未来教授和评估这项技能的工作。
