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同伴辅助病史采集小组:对其对医学生问诊技巧影响的主观评估

Peer-Assisted History-Taking Groups: A Subjective Assessment of their Impact Upon Medical Students' Interview Skills.

作者信息

Keifenheim Katharina Eva, Petzold Ernst Richard, Junne Florian, Erschens Rebecca Sarah, Speiser Natalie, Herrmann-Werner Anne, Zipfel Stephan, Teufel Martin

机构信息

University Hospital of Tübingen, Department of Psychosomatic Medicine and Psychotherapy, Tübingen, Germany.

RWTH Aachen, Department of Psychosomatics and Psychotherapeutic Medicine, Aachen, Germany.

出版信息

GMS J Med Educ. 2017 Aug 15;34(3):Doc35. doi: 10.3205/zma001112. eCollection 2017.

Abstract

Among the clinical skills needed by all physicians, history taking is one of the most important. The teaching model for peer-assisted history-taking groups investigated in the present study consists of small-group courses in which students practice conducting medical interviews with real patients. The purpose of this pilot study was to investigate the expectations, experiences, and subjective learning progress of participants in peer-assisted history-taking groups. The 42 medical student participants completed a 4-month, peer-assisted, elective history-taking course, which both began and ended with a subjective assessment of their interview skills by way of a pseudonymized questionnaire. Measures comprised the students' self-assessment of their interview skills, their expectations of, and their experiences with the course and especially with the peer tutors. Medical students' most important motivations in attending peer-assisted history-taking groups were becoming able to complete a structured medical interview, to mitigate difficult interviewing situations, and to address patients' emotional demands appropriately. By the end of the course, students' self-assessment of both their interview skills and management of emotional issues improved significantly. Students especially benefitted from individual feedback regarding interview style and relationship formation, as well as generally accepted and had their expectations met by peer tutors. To meet the important learning objectives of history-taking and management of emotional issues, as well as self-reflection and reflection of student-patient interactions, students in the field greatly appreciate practicing medical interviewing in small, peer-assisted groups with real patients. At the same time, peer tutors are experienced to be helpful and supportive and can help students to overcome inhibitions in making contact with patients.

摘要

在所有医生都需要具备的临床技能中,病史采集是最重要的技能之一。本研究中所调查的同伴辅助病史采集小组的教学模式,包括一些小组课程,学生们在这些课程中练习对真实患者进行医学访谈。这项试点研究的目的是调查同伴辅助病史采集小组参与者的期望、经历和主观学习进展。42名医学生参与者完成了一门为期4个月的同伴辅助选修病史采集课程,该课程开始和结束时都通过一份匿名问卷对他们的访谈技能进行主观评估。测量内容包括学生对自己访谈技能的自我评估、他们对课程尤其是对同伴辅导老师的期望以及他们的课程体验。医学生参加同伴辅助病史采集小组的最重要动机是能够完成结构化的医学访谈、缓解困难的访谈情况以及恰当地应对患者的情感需求。到课程结束时,学生对自己访谈技能和情感问题处理能力的自我评估都有了显著提高。学生们尤其从关于访谈风格和关系建立的个人反馈中受益,并且普遍认可同伴辅导老师,觉得他们达到了自己的期望。为了实现病史采集、情感问题处理以及自我反思和对医患互动反思等重要的学习目标,该领域的学生非常感激能在小型同伴辅助小组中与真实患者一起练习医学访谈。同时,同伴辅导老师经验丰富,乐于助人且给予支持,能够帮助学生克服与患者接触时的拘谨。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7bed/5569984/ed3a30e897c9/JME-34-35-t-001.jpg

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