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在具有挑战性的门诊会诊中,上级医生和住院医生的患者教育能力。

Supervisors' and residents' patient-education competency in challenging outpatient consultations.

作者信息

Wouda Jan C, van de Wiel Harry B M

机构信息

University of Groningen, University Medical Center Groningen, The Netherlands.

University of Groningen, University Medical Center Groningen, The Netherlands.

出版信息

Patient Educ Couns. 2015 Sep;98(9):1084-91. doi: 10.1016/j.pec.2015.05.010. Epub 2015 May 30.

Abstract

OBJECTIVES

We compared supervisors' and residents' patient-education competency in challenging consultations in order to establish whether supervisors demonstrate sufficient patient-education competency to act credibly as role models and coaches for residents.

METHODS

All consultations conducted at one, two, or three of the outpatient clinics of each of the participating physicians were videoed. Each participant selected two challenging consultations from each clinic for assessment. We assessed their patient-education competency using the CELI instrument, we calculated net consultation length for all videoed consultations and we measured patient opinion about the patient education received using a questionnaire.

RESULTS

Forty-four residents and fourteen supervisors participated in the study. They selected 230 consultations for assessment. On average, supervisors and residents demonstrated similar patient-education competency. Net consultation length was longer for supervisors. Patient opinion did not differ between supervisors and residents.

CONCLUSIONS

Supervising consultants generally do not possess sufficient patient-education competency to fulfill their teaching roles in workplace-based learning that is aimed at improving residents' patient-education competency.

PRACTICE IMPLICATIONS

Not only residents but also supervising consultants should improve their patient-education competency. Workplace-based learning consisting of self-assessment of and feedback on videoed consultations could be useful in attaining this goal.

摘要

目的

我们比较了上级医生和住院医师在具有挑战性的会诊中的患者教育能力,以确定上级医生是否具备足够的患者教育能力,从而能够作为住院医师的可信榜样和指导者。

方法

对每位参与医生在其一家、两家或三家门诊诊所进行的所有会诊进行录像。每位参与者从每家诊所中挑选两次具有挑战性的会诊进行评估。我们使用CELI工具评估他们的患者教育能力,计算所有录像会诊的净会诊时长,并通过问卷调查衡量患者对所接受患者教育的看法。

结果

44名住院医师和14名上级医生参与了该研究。他们挑选了230次会诊进行评估。平均而言,上级医生和住院医师表现出相似的患者教育能力。上级医生的净会诊时长更长。上级医生和住院医师在患者看法方面没有差异。

结论

在旨在提高住院医师患者教育能力的基于工作场所的学习中,指导顾问通常不具备足够的患者教育能力来履行其教学职责。

实践意义

不仅住院医师,指导顾问也应提高其患者教育能力。由对录像会诊的自我评估和反馈组成的基于工作场所的学习可能有助于实现这一目标。

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