Department of Psychosomatic Medicine and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Clinic of Dermatology and Venereology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
PLoS One. 2018 Oct 5;13(10):e0205315. doi: 10.1371/journal.pone.0205315. eCollection 2018.
To investigate the effect of the number of coaching sessions after communication skills training on the medical communicative performance of oncologists in clinical practice.
METHODS/DESIGN: The training, consisting of a workshop and one (control group) vs. four (intervention group) sessions of individual coaching, was evaluated in a randomized controlled trial. Eligible participants included physicians working in any setting where patients with oncological diseases were treated. Real medical consultations were video recorded at three time points: before the workshop (t0), after the workshop (t1) and after completion of coaching (t2). The 1.5-day workshop was based on role-playing in small groups; in the coaching sessions, the videos recorded at t1 were analyzed in detail by both the trainer and the physician. The coaching sessions were manualized and based on the physician's learning goals. The primary hypothesis was that the intervention group would improve to a higher extent than the control group, as assessed by external raters using rating scales specially developed for this project. Physicians were stratified for sex and setting and randomized by an independent statistician. The group assignment was revealed for physicians and trainers at the end of the workshop, while the raters were blinded to group assignments and assessment points.
A total of 72 physicians participated in one of 8 workshops and could be allocated to either the control or intervention group. The intervention group showed a statistically significant improvement (ES d = 0.41, p<.01) in the All items domain of the rating scales between t1 and t2 and showed a significant advantage compared with the CG (ES = .41, p = .04). The impact on diverse specified skills was heterogeneous; a larger sample is necessary for more detailed analysis.
The training achieved some observable and significant changes in the communicative behavior of oncologists in clinical practice. The four coaching sessions showed some significant advantages compared to the single coaching session. Considerable effort is necessary to achieve sustained changes in communication in clinical every-day practice. Thus, our coaching concept is a promising method for this purpose.
研究沟通技巧培训后辅导次数对临床肿瘤医生医学沟通表现的影响。
方法/设计：该培训由一个工作坊和一（对照组）vs. 四（干预组）次个别辅导组成，在一项随机对照试验中进行了评估。合格参与者包括在任何治疗肿瘤疾病患者的环境中工作的医生。在三个时间点记录真实的医疗咨询：工作坊前（t0）、工作坊后（t1）和辅导结束后（t2）。为期 1.5 天的工作坊基于小组角色扮演；在辅导课程中，由培训师和医生详细分析在 t1 记录的视频。辅导课程是基于医生的学习目标进行的，并进行了规范化处理。主要假设是，干预组的改善程度将高于对照组，这是由专门为此项目开发的评分量表的外部评估者评估的。根据性别和环境对医生进行分层，并由独立的统计学家进行随机分组。组分配在工作坊结束时向医生和培训师揭示，而评估者对组分配和评估点保持盲态。
共有 72 名医生参加了 8 个工作坊中的一个，并被分配到对照组或干预组。干预组在评分量表的所有项目领域显示出统计学上的显著改善（ES d = 0.41，p<.01），并且与 CG 相比具有显著优势（ES =.41，p =.04）。对不同特定技能的影响是异质的；需要更大的样本量进行更详细的分析。
培训在临床实践中对肿瘤医生的沟通行为产生了一些可观察到的显著变化。与单次辅导相比，四次辅导显示出一些显著优势。要在临床日常实践中实现沟通的持续变化，需要付出相当大的努力。因此，我们的辅导概念是实现这一目标的一种有前途的方法。
