Sugawara Akiko, Ishikawa Kazunobu, Motoya Ryo, Kobayashi Gen, Moroi Yoko, Fukushima Tetsuhito
Center for Medical Education and Career Development, Fukushima Medical University, Japan.
Department of Hygiene and Preventive Medicine, Fukushima Medical University School of Medicine, Japan.
Intern Med. 2017;56(12):1507-1513. doi: 10.2169/internalmedicine.56.8135. Epub 2017 Jun 15.
Objective To examine the characteristics of the communication skills of medical students, we observed their performance during introductory medical interview training with simulated patients (SPs). Methods The subjects of the present study included fifth-year medical students (male, n=180, female, n=99) who were undergoing clinical training in Japan from 2012 to 2014. Each student was assigned to one of four 10-minute clinical scenarios, which was conducted with an SP. Three or four teachers observed and assessed the performance of each of the students. The overall performance was rated on a 10-point scale, and nine basic communication skills that were common to each of the scenarios were rated using a four-point scale. The students also assessed their own performance on these items. The SPs assessed the students' performance from a patient's perspective on four items. Results There were significant correlations between the teacher and student scores. However, the students tended to score themselves significantly lower than the teachers. The female students were rated significantly higher by the teachers on the following four items; 'eye contact and appropriate attitude,' 'nodding and back-channeling,' 'giving empathic verbal responses,' and 'acquisition of patient's psychosocial information.' However, the self-assessments of the female students were only significantly higher than the male students in one item, 'acquisition of patient's psychosocial information.' In contrast, self-assessments of the male students were significantly higher in two items; none of their items was scored higher by the teachers. There was no significant gender difference in the assessments made by the SPs. Conclusion There were significant gender differences in the communication skills of the medical students during introductory training, suggesting the possibility that there were gender-specific traits and gender-based differences in the students' degrees of readiness.
目的 为研究医学生沟通技巧的特点，我们观察了他们在与模拟患者（SP）进行医学入门访谈培训期间的表现。方法 本研究的对象包括2012年至2014年在日本接受临床培训的五年级医学生（男性，n = 180；女性，n = 99）。每位学生被分配到四个10分钟临床场景中的一个，与一名SP进行。三到四位教师观察并评估每位学生的表现。整体表现以10分制评分，每个场景共有的九项基本沟通技巧以四分制评分。学生们也对自己在这些项目上的表现进行评估。SP从患者的角度对学生在四个项目上的表现进行评估。结果 教师评分与学生评分之间存在显著相关性。然而，学生给自己的评分往往明显低于教师。在以下四个项目上，女学生得到教师的评分显著更高：“眼神交流与恰当态度”“点头与反馈”“给予共情性言语回应”以及“获取患者的心理社会信息”。然而，女学生的自我评估仅在一个项目“获取患者的心理社会信息”上显著高于男学生。相比之下，男学生在两个项目上的自我评估显著更高；他们的这些项目没有一个得到教师更高的评分。SP的评估中没有显著的性别差异。结论 在入门培训期间，医学生的沟通技巧存在显著的性别差异，这表明学生在准备程度上可能存在特定性别特征和基于性别的差异。
