Kalet Adina L, Janicik Regina, Schwartz Mark, Roses Daniel, Hopkins Mary Ann, Riles Thomas
a Section of Primary Care, Division of General Internal Medicine, Department of Medicine.
b Department of Surgery New York University School of Medicine.
Med Educ Online. 2005 Dec;10(1):4382. doi: 10.3402/meo.v10i.4382.
Physician communication skills, linked to important patient outcomes, are rarely formally addressed after the pre-clinical years of medical school. We implemented a new communication skills curriculum during the third year Surgery Clerkship which was part of a larger curriculum revision found in a controlled trial to significantly improve students' overall communication competence.
In three 2 hour workshops students, learned to address common communication challenges in surgery: patient education, shared decision-making, and delivering bad news. Each 2 hour, surgeon facilitated session was comprised of a 30 minute introductory lecture, a 15 minute checklist driven video critique, a 15 minute group discussion, a 45 minute standardized patient (SP) exercise with feedback from the SP, peers, and faculty member, and a 15 minute closing summary. To date, over 25 surgery faculty have been trained to conduct these sessions. In an end-of-clerkship survey, students reported on skill changes and assessed the curriculum's educational effectiveness.
A survey was completed by 120 of the 160 (76%) third year students who participated in the curriculum. Fifty-five percent of students reported improvement in their communication skills and ability to address specific communication challenges. Students were satisfied with the amount and quality of teaching.
Communication skills teaching can be implemented in the surgery clerkship, and surgeons are particularly well suited to teach about patient education, discussing informed consent and shared decision making, and delivering bad news. Structured case-based sessions are acceptable to, and improve the self-assessed skills of, surgery clerkship students. Faculty development geared toward such sessions has added benefits to educational activities in a clinical department overall.
与重要患者结局相关的医生沟通技巧，在医学院校临床前阶段之后很少得到正式关注。我们在三年级外科实习期间实施了一项新的沟通技巧课程，这是一项更大规模课程修订的一部分，该修订在一项对照试验中被发现能显著提高学生的整体沟通能力。
在三个两小时的工作坊中，学生们学习应对外科手术中常见的沟通挑战：患者教育、共同决策以及传达坏消息。每个两小时由外科医生主持的课程包括30分钟的 introductory lecture、15分钟基于清单的视频点评、15分钟的小组讨论、45分钟与标准化患者（SP）互动并接收来自SP、同伴和教员反馈的练习，以及15分钟的总结。迄今为止，已有超过25名外科教员接受培训以开展这些课程。在实习结束时的一项调查中，学生报告了技能变化并评估了课程的教育效果。
160名参与该课程的三年级学生中有120名（76%）完成了一项调查。55%的学生报告称他们的沟通技巧以及应对特定沟通挑战的能力有所提高。学生们对教学的数量和质量感到满意。
沟通技巧教学可在外科实习中实施，并且外科医生特别适合教授患者教育、讨论知情同意和共同决策以及传达坏消息。基于案例的结构化课程为外科实习学生所接受，并提高了他们的自我评估技能。针对此类课程的教员发展对临床科室的整体教育活动有额外益处。
