Chan Annie, Purcell Alison, Power Emma
Speech Pathology, Faculty of Health Sciences, The University of Sydney, Lidcome, New South Wales, Australia.
Med Educ. 2016 Sep;50(9):898-911. doi: 10.1111/medu.13117.
Culturally and linguistically diverse (CALD) students often experience difficulties with the clinical communication skills that are essential for successful interactions in the workplace. However, there is little evidence on the effectiveness of assessment and intervention strategies for this population. The two aims of this study were: to evaluate the effectiveness of assessment tools in identifying and describing the clinical communication difficulties of CALD health care students; and to determine whether communication programmes improved their clinical communication skills.
Systematic review based on the Cochrane protocol. Articles were identified through a search of established databases using MeSH and key search terms. Studies published in English from 1990 to March 2015 were included if they described assessment strategies or a training programme for communication skills of CALD students. Studies were excluded if they did not describe implementation of a specific assessment or intervention programme. Data were extracted independently by the first author and verified by the second author. Quality was measured by the Best Evidence Medical Education guide and the Educational Interventions Critical Appraisal Tool. The Kirkpatrick hierarchy was used to measure impact. Meta-analysis was not conducted because of the heterogeneity of programme design and outcome measures.
One hundred and twenty-nine articles met the criteria for full text review. Eighty-six articles were excluded. Thirteen articles addressing assessment and 30 articles reporting on communication training programmes were included in this review. Assessment tools used rubrics and rating scales effectively. Intervention studies focused on speech and language skills (n = 20), interpersonal skills (n = 7) and faculty-level support (n = 5). Although 17 studies reported positive findings on student satisfaction, only eight reported improved skills post-training.
The development of effective assessment and intervention programmes should have an integrated design and include specific outcome measures to increase educational impact.
文化和语言背景多样(CALD)的学生在临床沟通技能方面常常面临困难,而这些技能对于职场中的成功互动至关重要。然而,关于针对这一群体的评估和干预策略的有效性,几乎没有证据。本研究的两个目的是:评估评估工具在识别和描述CALD医护专业学生临床沟通困难方面的有效性;确定沟通课程是否能提高他们的临床沟通技能。
基于Cochrane方案进行系统综述。通过使用医学主题词(MeSH)和关键检索词在既定数据库中进行检索来识别文章。纳入1990年至2015年3月发表的英文研究,条件是这些研究描述了针对CALD学生沟通技能的评估策略或培训课程。如果研究未描述特定评估或干预计划的实施情况,则将其排除。数据由第一作者独立提取,并由第二作者进行核实。质量通过最佳证据医学教育指南和教育干预批判性评估工具进行衡量。采用柯克帕特里克层次结构来衡量影响。由于方案设计和结果测量的异质性,未进行荟萃分析。
129篇文章符合全文审查标准。排除86篇文章。本综述纳入了13篇关于评估的文章和30篇关于沟通培训课程的报告。评估工具有效地使用了评分标准和量表。干预研究集中在言语和语言技能(n = 20)、人际技能(n = 7)和教师层面的支持(n = 5)。虽然17项研究报告了学生满意度方面的积极结果,但只有8项报告称培训后技能有所提高。
有效的评估和干预计划的制定应采用综合设计,并包括具体的结果测量指标,以提高教育影响。