Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
Postgrad Med J. 2015 Jun;91(1076):303-8. doi: 10.1136/postgradmedj-2014-132983. Epub 2015 Mar 26.
Written and verbal communication skills are important skills for all physicians. While verbal skills are taught and assessed in medical school, medical students report limited instruction in written communication skills. This study examined the impact of a curriculum delivered during a 6-week clinical rotation in Internal Medicine on the objective assessment of medical students' written communication skills.
The curriculum consisted of two educational programmes: a medical student communication tutorial and a resident feedback workshop. The study was conducted from March 2012 to January 2013 at McMaster University in Hamilton, Ontario, Canada. The study featured three arms: (1) control, (2) medical student communication tutorial alone and (3) student tutorial and resident feedback workshop. Data were collected on 126 students during 6-week Internal Medicine clerkship rotations. Students' written consultation notes were collected prior to the educational programmes and at 6 weeks. Blinded faculty assessors used an independently validated Assessment Checklist to evaluate consultation notes.
Consultation note scores improved from week 1 to week 6 across all study arms. However, the change was statistically significant only in arm 3, featuring both the medical student tutorial and the resident feedback workshop, with mean scores improving from 4.75 (SD=1.496) to 5.56 (SD=0.984) out of 7. The mean difference between week 1 and week 6 was significantly different (0.806, p=0.002, 95% CI 0.306 to 1.058).
The combination of a resident feedback workshop with medical student written communication tutorial improves objective evaluations of consultation note scores over student tutorial alone.
书面和口头沟通技巧对于所有医生来说都是重要的技能。尽管口头技能在医学院得到了教授和评估,但医学生报告说,他们在书面沟通技能方面的指导有限。本研究考察了在内科临床轮转期间实施的课程对医学生书面沟通技能的客观评估的影响。
该课程包括两个教育项目:医学生沟通教程和住院医师反馈研讨会。该研究于 2012 年 3 月至 2013 年 1 月在加拿大安大略省汉密尔顿的麦克马斯特大学进行。该研究有三个部分:(1)对照组,(2)仅医学生沟通教程,和(3)学生教程和住院医师反馈研讨会。在为期 6 周的内科实习轮转期间,共收集了 126 名学生的数据。学生的书面咨询记录在教育项目之前和 6 周时收集。盲法教师评估员使用独立验证的评估检查表评估咨询记录。
在所有研究组中,咨询记录评分从第 1 周到第 6 周均有所提高。然而,只有在第 3 组(同时进行医学生教程和住院医师反馈研讨会)中,这种变化具有统计学意义,平均评分从 7 分制的 4.75(SD=1.496)提高到 5.56(SD=0.984)。第 1 周和第 6 周之间的平均差异显著不同(0.806,p=0.002,95%CI 0.306 至 1.058)。
住院医师反馈研讨会与医学生书面沟通教程相结合,可提高咨询记录评分的客观评估,优于仅学生教程。