Engerer Cosima, Berberat Pascal O, Dinkel Andreas, Rudolph Baerbel, Sattel Heribert, Wuensch Alexander
TUM Medical Education Center, TUM School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany.
Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, Langerstrasse 3, 81675, Munich, Germany.
BMC Med Educ. 2016 Oct 18;16(1):271. doi: 10.1186/s12909-016-0792-0.
Feedback is considered a key didactic element in medical education, especially for teaching of communication skills. This study investigates the impact of a best evidence-based practice feedback concept within the context of communication skills training (CST). We evaluate this concept for acceptance and changes in students self-ratings of communication competence.
Our CST integrating feedback process comprises a short theoretical introduction presenting standards for good communication and a constructive 360° feedback from three perspectives: feedback from peers, from standardized patients (SPs), and from a trainer. Feed-forward process was facilitated for documenting suggestions for improvements based on observable behaviors to maximize learning benefits. Our CST was applied to four groups of eight or nine students. We assessed the data on students' acceptance using a 6-point scale ranging from very good (1) to poor (6), applied a forced choice question to rank didactic items, and assessed changes in student' self-ratings of their communication competence on a 10-cm visual analogue scale (VAS).
Thirty-four medical undergraduates (82 % female, 18 % male) in their first clinical year, with an average age of 21.4 years (SD = 1.0), participated in the new training. The concept achieved high acceptance from good to very good: overall impression (M = 1.56), sufficient interaction for discussion (M = 1.15), and constructive learning atmosphere (M = 1.18). Specific elements, such as practical training with SPs (M = 1.18) and feedback by SPs (M = 1.12), showed highest acceptance. The forced choice ranking placed all feedback elements at the top of the list (feedback (FB) by SPs, rank 2; FB by trainer, rank 3; FB by colleagues, rank 4), whereas theoretical elements were at the bottom (theoretical introduction, rank 7; memory card, rank 9). Overall, student self-ratings of communication competence significantly improved in nine of the ten communication items assessed by VAS and showed a pre-post effect size of ES = 0.74 on a global rating.
This study demonstrates that the training concept based on 360° behavioral feedback was well accepted and generated significant changes in student self-ratings of their communication competence. Further research is needed to determine the effects on objective communication performance.
反馈被认为是医学教育中的一个关键教学要素，尤其是在沟通技能教学方面。本研究调查了基于最佳证据的实践反馈概念在沟通技能培训（CST）背景下的影响。我们评估了这一概念在学生对沟通能力的自我评估中的接受度和变化情况。
我们整合反馈过程的CST包括一个简短的理论介绍，阐述良好沟通的标准，以及从三个角度进行的建设性360°反馈：同伴反馈、标准化病人（SPs）反馈和培训师反馈。通过促进前馈过程，根据可观察到的行为记录改进建议，以最大化学习收益。我们的CST应用于四组每组八或九名学生。我们使用从非常好（1）到差（6）的6分制评估学生的接受度数据，应用强制选择问题对教学项目进行排名，并使用10厘米视觉模拟量表（VAS）评估学生对其沟通能力的自我评估变化。
34名医学本科一年级学生（82%为女性，18%为男性）参与了新培训，平均年龄21.4岁（标准差=1.0）。该概念获得了从好到非常好的高度接受：总体印象（M=1.56）、足够的讨论互动（M=1.15）和建设性的学习氛围（M=1.18）。具体要素，如与标准化病人的实践培训（M=1.18）和标准化病人的反馈（M=1.12），显示出最高的接受度。强制选择排名将所有反馈要素排在前列（标准化病人的反馈（FB），排名第2；培训师的反馈，排名第3；同事的反馈，排名第4），而理论要素则排在末尾（理论介绍，排名第7；记忆卡，排名第9）。总体而言，在VAS评估的十个沟通项目中，有九个项目学生对沟通能力的自我评估显著提高，在整体评分上显示出前后效应量ES=0.74。
本研究表明，基于360°行为反馈的培训概念得到了很好的接受，并在学生对其沟通能力的自我评估中产生了显著变化。需要进一步研究以确定对客观沟通表现的影响。
