面向哈佛-麻省理工学院医学院二年级学生的创新课程：与提供即时反馈的志愿者患者练习沟通技巧。
Innovative curriculum for second-year Harvard-MIT medical students: practicing communication skills with volunteer patients giving immediate feedback.
作者信息
Ali Nadaa B, Pelletier Stephen R, Shields Helen M
机构信息
Department of Medicine, Brigham and Women's Hospital.
Center for Evaluation, Harvard Medical School, Boston, MA, USA.
出版信息
Adv Med Educ Pract. 2017 May 19;8:337-345. doi: 10.2147/AMEP.S135172. eCollection 2017.
PURPOSE
Medical students are expected to develop excellent communication skills. The purpose of our study was to create an innovative communication skills exercise using real volunteer patients and physician co-teachers for students to practice communication skills while receiving immediate feedback.
METHOD
This is a mixed methods study where second-year medical students participated in the communication skills exercise with real patients and physician co-teachers giving immediate feedback. Clinical scenarios reflected the patients' actual experiences. Students acted out roles as physicians. Physicians co-taught with the patients and gave immediate feedback to students. Students completed an anonymous written survey at the end of the exercise. Qualitative and quantitative responses were recorded. Student feedback from the 2014 surveys was used to modify the teaching designs to increase active role play opportunities by having only two students in each group and doubling the number of stations with real patients.
RESULTS
Students rated the overall exercise and the utility of patient volunteers in learning how to communicate on a Likert scale of 1-5, where in this medical school traditionally 1 is excellent and 5 is poor. In 2014, the exercises were rated with a mean score of 1.47 (SD 0.621). In 2015, the exercises were rated with a mean score of 1.03 (SD 0.62). In 2016, the exercises were rated with a mean score of 1.27 (SD 0.52). ANOVA analysis (=0.002) and Bonferroni corrections indicate a statistically significant difference between combined mean scores of the exercise in 2014 and 2015 (=0.001). No difference was shown between 2014 and 2016 or 2015 and 2016.
CONCLUSIONS
Medical students rated practicing communication skills with real patient volunteers and physician co-teachers giving immediate feedback in their preclinical years very highly. Student feedback indicated that they preferred active roles and increased opportunities to practice their communication skills.
目的
医学生需要培养出色的沟通技巧。我们研究的目的是创建一种创新的沟通技巧练习，利用真实的志愿者患者和医生共同教师，让学生在练习沟通技巧的同时能获得即时反馈。
方法
这是一项混合方法研究，二年级医学生参与了与真实患者及能提供即时反馈的医生共同教师进行的沟通技巧练习。临床场景反映了患者的实际经历。学生扮演医生角色。医生与患者共同教学，并即时向学生提供反馈。练习结束时，学生完成一份匿名书面调查。记录定性和定量回复。2014年调查中的学生反馈被用于修改教学设计，通过每组仅两名学生并将有真实患者的站点数量翻倍来增加积极角色扮演的机会。
结果
学生对整体练习以及患者志愿者在学习沟通方面的效用进行评分，采用1至5的李克特量表，在这所医学院校中，传统上1表示优秀，5表示差。2014年，练习的平均得分为1.47（标准差0.621）。2015年，练习的平均得分为1.03（标准差0.62）。2016年，练习的平均得分为1.27（标准差0.52）。方差分析（P = 0.002）和邦费罗尼校正表明，2014年和2015年练习的综合平均得分之间存在统计学显著差异（P = 0.001）。2014年和2016年之间或2015年和2016年之间未显示出差异。
结论
医学生对在临床前阶段与真实患者志愿者及能提供即时反馈的医生共同教师一起练习沟通技巧给予了高度评价。学生反馈表明他们更喜欢积极参与角色并增加练习沟通技巧的机会。
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