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临床科室的基于工作场所的沟通技巧培训:通过定位理论考察同事关系的作用。

Workplace-based communication skills training in clinical departments: Examining the role of collegial relations through positioning theory.

机构信息

a Centre for Health Sciences Education , Aarhus University , Aarhus , Denmark.

出版信息

Med Teach. 2019 Mar;41(3):309-317. doi: 10.1080/0142159X.2018.1464647. Epub 2018 Apr 27.

Abstract

INTRODUCTION

Studies suggest that the workplace is a key to understanding how clinical communication skills learning takes place and that medical communication skills need to be reinforced over time in order not to deteriorate. This study explored the perceptions of doctors in four hospital departments who participated in a workplace-based communication training project. Its specific focus was the relationship between collegial relations and learning communication skills.

METHODS

The study applied a qualitative design using an ethnographic methodology, i.e. interviews and observations. Positioning theory was used as the theoretical framework.

RESULTS

Training communication skills with colleagues in the actual workplace setting was valued by the participants who experienced more sharing of communication challenges, previously understood as something private one would not share with colleagues. However, collegial relations were also barriers for providing critical feedback, especially from junior doctors to their seniors.

CONCLUSION

The position as "colleague" both reinforced the communication skills training and hindered it. The communication skills educational model had a flat, non-hierarchical structure which disturbed the hierarchical structure of the workplace, and its related positions.

摘要

简介

研究表明,工作场所是理解临床沟通技巧学习如何发生的关键,并且为了防止技能退化,医学沟通技巧需要随着时间的推移不断加强。本研究探讨了参与基于工作场所的沟通培训项目的四个医院科室的医生的看法。其具体重点是同事关系和学习沟通技巧之间的关系。

方法

该研究采用了定性设计,使用了民族志方法,即访谈和观察。定位理论被用作理论框架。

结果

参与者非常重视在实际工作场所与同事一起培训沟通技巧,他们更多地分享沟通挑战,这些挑战之前被认为是私人的,不会与同事分享。然而,同事关系也是提供关键反馈的障碍,尤其是来自初级医生对上级的反馈。

结论

作为“同事”的职位既加强了沟通技巧培训,也阻碍了培训。沟通技巧教育模式具有扁平化、非层级结构,扰乱了工作场所的层级结构及其相关职位。

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