Park Seung Guk, Park Kyung Hye
Department of Family Medicine, Inje University College of Medicine, Busan, Korea.
Department of Medical Education, Yonsei University Wonju College of Medicine, Wonju, Korea.
Korean J Med Educ. 2018 Sep;30(3):199-208. doi: 10.3946/kjme.2018.94. Epub 2018 Aug 27.
Nonverbal communication (NVC) may be a crucial factor affecting effective communication between patients and medical students during the objective structured clinical examination (OSCE), but it has not been intensively studied. We examined NVC and its correlation with patient-physician interaction (PPI) in the OSCE.
A total of 68 video recordings of routine check-up OSCEs were included. A checklist for NVC was developed that included seven nonverbal factors in a mute state (NVM) and four nonverbal factors in speech (NVS), and one point was assigned to each factor. The scores for history taking, PPI, NVM, and NVS were compared, and correlations of each score were evaluated.
Students with adequate facial expressions, accorded speech rate and voice volume, adequately matched voice tone, and few or no moments of unnecessary silence showed better PPI scores. The PPI score was correlated with history taking and the NVS score, but not the NVM score.
Our results suggest that NVS may be more influential to PPI during OSCEs than NVM. Communication teachers should help students to be better prepared to use both NVS and NVM properly.
在客观结构化临床考试(OSCE)中,非言语沟通(NVC)可能是影响患者与医学生之间有效沟通的关键因素,但尚未得到深入研究。我们在OSCE中研究了NVC及其与医患互动(PPI)的相关性。
共纳入68段常规体检OSCE的视频记录。制定了一份NVC清单,其中包括七种无声状态下的非言语因素(NVM)和四种言语中的非言语因素(NVS),每个因素计1分。比较了病史采集、PPI、NVM和NVS的得分,并评估了各得分之间的相关性。
面部表情恰当、语速和音量适中、语调匹配良好且极少或没有不必要沉默时刻的学生,其PPI得分更高。PPI得分与病史采集及NVS得分相关,但与NVM得分无关。
我们的结果表明,在OSCE期间,NVS对PPI的影响可能比NVM更大。沟通教师应帮助学生更好地做好准备,正确运用NVS和NVM。