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愿望与现实——德语区欧洲本科医学教育中沟通能力的教学与评估——一项调查

Desire and reality--teaching and assessing communicative competencies in undergraduate medical education in German-speaking Europe--a survey.

作者信息

Härtl Anja, Bachmann Cadja, Blum Katharina, Höfer Stefan, Peters Tim, Preusche Ingrid, Raski Bianca, Rüttermann Stefan, Wagner-Menghin Michaela, Wünsch Alexander, Kiessling Claudia

机构信息

Klinikum der Universität München, Institut für Didaktik und Ausbildungsforschung in der Medizin, München, Deutschland.

Universitätsklinikum Hamburg-Eppendorf, Institut für Allgemeinmedizin, Hamburg, Deutschland.

出版信息

GMS Z Med Ausbild. 2015 Nov 16;32(5):Doc56. doi: 10.3205/zma000998. eCollection 2015.

Abstract

OBJECTIVES

Increasingly, communicative competencies are becoming a permanent feature of training and assessment in German-speaking medical schools (n=43; Germany, Austria, Switzerland - "D-A-CH"). In support of further curricular development of communicative competencies, the survey by the "Communicative and Social Competencies" (KusK) committee of the German Society for Medical Education (GMA) systematically appraises the scope of and form in which teaching and assessment take place.

METHODS

The iterative online questionnaire, developed in cooperation with KusK, comprises 70 questions regarding instruction (n=14), assessment (n=48), local conditions (n=5), with three fields for further remarks. Per location, two to three individuals who were familiar with the respective institute's curriculum were invited to take part in the survey.

RESULTS

Thirty-nine medical schools (40 degree programmes) took part in the survey. Communicative competencies are taught in all of the programmes. Ten degree programmes have a longitudinal curriculum for communicative competencies; 25 programmes offer this in part. Sixteen of the 40 programmes use the Basler Consensus Statement for orientation. In over 80% of the degree programmes, communicative competencies are taught in the second and third year of studies. Almost all of the programmes work with simulated patients (n=38) and feedback (n=37). Exams are exclusively summative (n=11), exclusively formative (n=3), or both summative and formative (n=16) and usually take place in the fifth or sixth year of studies (n=22 and n=20). Apart from written examinations (n=15) and presentations (n=9), practical examinations are primarily administered (OSCE, n=31); WPA (n=8), usually with self-developed scales (OSCE, n=19). With regards to the examiners' training and the manner of results-reporting to the students, there is a high variance.

CONCLUSIONS

Instruction in communicative competencies has been implemented at all 39 of the participating medical schools. For the most part, communicative competencies instruction in the D-A-C-H region takes place in small groups and is tested using the OSCE. The challenges for further curricular development lie in the expansion of feedback, the critical evaluation of appropriate assessment strategies, and in the quality assurance of exams.

摘要

目标

在德语区医学院校(共43所,分布于德国、奥地利、瑞士——“D-A-CH”地区),沟通能力日益成为培训与评估的一项长期内容。为支持沟通能力课程的进一步发展,德国医学教育学会(GMA)的“沟通与社会能力”(KusK)委员会开展了一项调查,系统评估教学与评估的范围及形式。

方法

与KusK合作开发的迭代式在线问卷包含70个问题,涉及教学(14个问题)、评估(48个问题)、当地情况(5个问题),还有三个可作进一步说明的栏目。每个院校邀请两到三名熟悉本校课程的人员参与调查。

结果

39所医学院校(40个学位项目)参与了此次调查。所有项目均开设了沟通能力课程。10个学位项目设有沟通能力纵向课程;25个项目部分开设了此类课程。40个项目中有16个以《巴塞尔共识声明》为指导。超过80%的学位项目在学习的第二和第三年教授沟通能力。几乎所有项目都采用标准化病人(38个项目)和反馈(37个项目)。考试形式全部为终结性(11个项目)、全部为形成性(3个项目),或终结性与形成性兼具(16个项目),且通常在学习的第五或第六年进行(分别为22个和20个项目)。除笔试(15个项目)和展示(9个项目)外,实践考试主要采用客观结构化临床考试(OSCE,31个项目);工作场所评估(WPA,8个项目),通常使用自行制定的量表(OSCE,19个项目)。在考官培训以及向学生反馈考试结果的方式方面,差异较大。

结论

参与调查的39所医学院校均已开展沟通能力教学。在D-A-CH地区,沟通能力教学大多以小组形式进行,并通过客观结构化临床考试进行测试。课程进一步发展面临的挑战在于扩大反馈范围、对适当评估策略进行批判性评估以及保证考试质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41e6/4647163/919da6d02beb/ZMA-32-56-t-001.jpg

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