LoSasso Alisa Alfonsi, Lamberton Courtney E, Sammon Mary, Berg Katherine T, Caruso John W, Cass Jonathan, Hojat Mohammadreza
A.A. LoSasso is director, Pediatric Undergraduate Medical Education, and associate professor of clinical pediatrics, Department of Pediatrics, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania.C.E. Lamberton is a first-year resident, Departments of Medicine and Pediatrics, Duke University Medical Center, Durham, North Carolina.M. Sammon is assistant professor of clinical pediatrics, Department of Pediatrics, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania.K.T. Berg is director, University Clinical Skills and Simulation Center, medical director, Standardized Patient Program, and professor of medicine, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania.J.W. Caruso is senior associate dean, Graduate Medical Education and Affiliations, and professor of medicine, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania.J. Cass is senior technical analyst, Center for Research in Medical Education and Health Care, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania.M. Hojat is research professor of psychiatry and human behavior, Department of Psychiatry and Human Behavior, and director, Jefferson Longitudinal Study of Medical Education, Center for Research in Medical Education and Health Care, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania.
Acad Med. 2017 Jul;92(7):1022-1027. doi: 10.1097/ACM.0000000000001476.
To examine whether an intervention on proper use of electronic medical records (EMRs) in patient care could help improve medical students' empathic engagement, and to test the hypothesis that the training would reduce communication hurdles in clinical encounters.
Seventy third-year medical students from the Sidney Kimmel Medical College at Thomas Jefferson University were randomly divided into intervention and control groups during their six-week pediatric clerkship in 2012-2013. The intervention group received a one-hour training session on EMR-specific communication skills, including discussion of EMR use, the SALTED mnemonic and technique (Set-up, Ask, Listen, Type, Exceptions, Documentation), and role-plays. Both groups completed the Jefferson Scale of Empathy (JSE) at the clerkship's start and end. At clerkship's end, faculty and standardized patients (SPs) rated students' empathic engagement in SP encounters, using the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE), and their history-taking and communication skills.
Faculty mean ratings on the JSPPPE, history-taking skills, and communication skills were significantly higher for the intervention group than the control group. SP mean ratings on history-taking skills were significantly higher for the intervention group than the control group. Both groups' JSE mean scores increased pretest to posttest, but the changes were not significant. The intervention group's posttest JSE mean score was higher than the control group's, but the difference was not significant.
The findings suggest that a simple intervention providing specialized training in EMR-specific communication can improve medical students' empathic engagement in patient care, history-taking skills, and communication skills.
探讨针对电子病历（EMR）在患者护理中的正确使用进行干预是否有助于提高医学生的共情参与度，并检验该培训可减少临床诊疗中沟通障碍这一假设。
2012 - 2013年，托马斯·杰斐逊大学西德尼·金梅尔医学院的70名三年级医学生在为期六周的儿科实习期间被随机分为干预组和对照组。干预组接受了为期一小时的关于EMR特定沟通技巧的培训课程，包括EMR使用的讨论、SALTED助记法和技巧（设置、询问、倾听、录入、例外情况、记录）以及角色扮演。两组在实习开始和结束时均完成了杰斐逊共情量表（JSE）。实习结束时，教员和标准化患者（SP）使用杰斐逊患者对医生共情的感知量表（JSPPPE）对学生在与SP接触中的共情参与度、病史采集和沟通技巧进行评分。
干预组在JSPPPE、病史采集技巧和沟通技巧方面的教员平均评分显著高于对照组。干预组在病史采集技巧方面的SP平均评分显著高于对照组。两组的JSE平均得分从测试前到测试后均有所增加，但变化不显著。干预组测试后的JSE平均得分高于对照组，但差异不显著。
研究结果表明，一项提供EMR特定沟通专业培训的简单干预措施可提高医学生在患者护理中的共情参与度、病史采集技巧和沟通技巧。
