Peterson Eleanor B, Boland Kimberly A, Bryant Kristina A, McKinley Tara F, Porter Melissa B, Potter Katherine E, Calhoun Aaron W
J Grad Med Educ. 2016 Dec;8(5):739-746. doi: 10.4300/JGME-D-15-00485.1.
Effective communication is an essential element of medical care and a priority of medical education. Specific interventions to teach communication skills are at the discretion of individual residency programs.
We developed the Resident Communication Skills Curriculum (RCSC), a formal curriculum designed to teach trainees the communication skills essential for high-quality practice.
A multidisciplinary working group contributed to the development of the RCSC, guided by an institutional needs assessment, literature review, and the Accreditation Council for Graduate Medical Education core competencies. The result was a cohesive curriculum that incorporates didactic, role play, and real-life experiences over the course of the entire training period. Methods to assess curricular outcomes included self-reporting, surveys, and periodic faculty evaluations of the residents.
Curricular components have been highly rated by residents (3.95-3.97 based on a 4-point Likert scale), and residents' self-reported communication skills demonstrated an improvement over the course of residency in the domains of requesting a consultation, providing effective handoffs, handling conflict, and having difficult conversations (intern median 3.0, graduate median 4.0 based on a 5-point Likert scale, ≤ .002). Faculty evaluations of residents have also demonstrated improvement over time (intern median 3.0, graduate median 4.5 based on a 5-point Likert scale, < .001).
A comprehensive, integrated communication skills curriculum for pediatrics residents was implemented, with a multistep evaluative process showing improvement in skills over the course of the residency program. Positive resident evaluations and informal comments from faculty support its general acceptance. The use of existing resources makes this curriculum feasible.
有效的沟通是医疗护理的基本要素，也是医学教育的重点。教授沟通技巧的具体干预措施由各个住院医师培训项目自行决定。
我们开发了住院医师沟通技能课程（RCSC），这是一门正式课程，旨在教授学员高质量医疗实践所需的沟通技能。
一个多学科工作小组在机构需求评估、文献综述以及毕业后医学教育认证委员会核心能力的指导下，参与了RCSC的开发。结果是形成了一门连贯的课程，在整个培训期间融入了理论教学、角色扮演和实际生活经验。评估课程成果的方法包括自我报告、调查以及教员对住院医师的定期评估。
住院医师对课程组成部分的评价很高（基于4分制李克特量表，评分为3.95 - 3.97），住院医师自我报告的沟通技能在住院期间的会诊请求、有效交接、处理冲突和进行困难对话等方面有了提高（基于5分制李克特量表，实习医生中位数为3.0，毕业生中位数为4.0，P≤0.002）。教员对住院医师的评估也随着时间的推移有所改善（基于5分制李克特量表，实习医生中位数为3.0，毕业生中位数为4.5，P<0.001）。
为儿科住院医师实施了一门全面、综合的沟通技能课程，多步骤评估过程显示在住院医师培训项目期间技能有所提高。住院医师的积极评价和教员的非正式评论支持了该课程的普遍接受度。利用现有资源使这门课程具有可行性。
