Sweeney Kieran, Baker Paul
Medical Education, Royal Bolton Hospital NHS Foundation Trust, Bolton, UK.
North West Deanery Foundation School, Manchester, UK.
Clin Teach. 2018 Aug;15(4):336-340. doi: 10.1111/tct.12693. Epub 2017 Aug 14.
Empathy is fundamental to patient-centred care. It has been shown to improve patient satisfaction and therapeutic outcomes. The success of educational interventions in enhancing students' empathy has been mixed, however, and a consensus on the most effective approach is lacking.
Patients were videoed discussing their hospital experiences and interactions with clinicians. These videos were shown to groups of medical students, who then took part in a facilitated discussion around themes of health care communication and patient experience. The session was delivered to 48 students over seven sessions and evaluated by way of serial attitude questionnaires (the Patient-Practitioner Orientation Scale, PPOS) and written feedback.
There was an improvement in PPOS scores amongst participants, with pre- and post-intervention means of 78.8 and 82.0, respectively, indicating an improvement in patient-centred attitudes. Written feedback highlighted the emotional impact of hearing patients' stories, and that the discussion explored issues not covered in previous teaching. Students reported changes in their approach to patients, including introducing themselves more often, and taking measures to make patients feel more at ease on ward rounds. Empathy is fundamentalto patient-centred care DISCUSSION: This study describes the use of patient video interviews to promote empathy in medical students, by stimulating reflective discussion on themes of health care communication and patient experience. Future use of these methods are recommended, although further research would benefit from larger student numbers and the use of objective clinical examination scores to assess behaviour change.
同理心是患者为中心的医疗护理的基础。已有研究表明,同理心可提高患者满意度和治疗效果。然而,教育干预在增强学生同理心方面的成效参差不齐,目前对于最有效的方法尚未达成共识。
对患者讨论其住院经历及与临床医生互动的过程进行录像。将这些视频展示给几组医学生,然后他们围绕医疗保健沟通和患者体验主题参与一场引导式讨论。该课程在七次课中面向48名学生开展,并通过系列态度问卷(患者 - 从业者导向量表,PPOS)和书面反馈进行评估。
参与者的PPOS得分有所提高,干预前和干预后的平均分分别为78.8和82.0,表明以患者为中心的态度有所改善。书面反馈强调了聆听患者故事所产生的情感影响,以及该讨论探讨了先前教学中未涉及的问题。学生们报告了他们对待患者方式的改变,包括更频繁地自我介绍,以及采取措施让患者在查房时感觉更自在。
本研究描述了通过激发对医疗保健沟通和患者体验主题的反思性讨论,利用患者视频访谈来促进医学生的同理心。尽管进一步的研究若能纳入更多学生并使用客观临床检查分数来评估行为变化将更有益,但建议未来继续使用这些方法。