Saeed Lina, Sanchez Isabelle M, Botto Nina C, Ellis Charles N, Stratman Erik J, Thompson Jennifer, Shinkai Kanade
Department of Dermatology, University of California San Francisco, San Francisco, CA, USA.
Department of Dermatology, University of Michigan Medical School, Ann Arbor, MI, USA.
Dermatol Ther (Heidelb). 2019 Mar;9(1):179-184. doi: 10.1007/s13555-018-0270-1. Epub 2018 Nov 17.
Communication skills influence the quality of health care and patient experience; both may affect provider reimbursement. There are few opportunities available for practicing physicians to receive direct feedback on communication in patient encounters. The purpose of this simulation-based patient encounter workshop was for dermatologists to practice and obtain feedback on their communication skills.
In March 2016, dermatologists participated in a workshop with four simulated patient encounters. Cases were developed based on a prior needs assessment. Standardized patient educators evaluated participants' communication using the Master Interview Rating Scale and provided verbal feedback. Physicians rated the usefulness of the simulation and the feedback received through a survey upon workshop completion.
Of the 170 physicians who registered, 103 participated in the simulation. The workshop was highly rated in meeting its three learning objectives (score of 4.5-4.6 out of a maximum score of 5). The lowest-rated communication skills were as follows: allowing the patient to share their narrative thread (3.1), summarizing the patient's history from the provider (3.8), and assessing patient understanding (3.8).
Participants reported that this communication workshop effectively satisfied its learning objectives. Opportunities to practice and improve communication skills as part of continuing medical education will benefit the clinical experience of patients and physicians alike, and the workshop may be formatted to serve physicians of other specialties. The lowest-scoring communication areas identified in this study present an opportunity to develop a tailored curriculum for physician-patient communication in the future.
沟通技巧会影响医疗保健质量和患者体验;这两者都可能影响医疗服务提供者的报销情况。执业医师很少有机会在患者诊疗过程中就沟通情况获得直接反馈。这个基于模拟患者诊疗的工作坊旨在让皮肤科医生练习其沟通技巧并获得相关反馈。
2016年3月,皮肤科医生参加了一个包含四次模拟患者诊疗的工作坊。病例是根据之前的需求评估设计的。标准化患者教育者使用《主访谈评分量表》评估参与者的沟通情况并提供口头反馈。医生在工作坊结束后通过一项调查对模拟及所获反馈的有用性进行评分。
在170名注册医生中,103人参加了模拟。该工作坊在实现其三个学习目标方面获得了很高的评价(满分5分,得分4.5 - 4.6)。评分最低的沟通技巧如下:让患者讲述其故事脉络(3.1分)、从医疗服务提供者角度总结患者病史(3.8分)以及评估患者的理解情况(3.8分)。
参与者报告称这个沟通工作坊有效地实现了其学习目标。作为继续医学教育的一部分,练习和提高沟通技巧的机会将使患者和医生的临床体验都受益,并且该工作坊的形式也可用于其他专科的医生。本研究中确定的得分最低的沟通领域为未来制定针对医患沟通的定制课程提供了契机。