Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.
Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy.
Patient Educ Couns. 2019 Jun;102(6):1104-1110. doi: 10.1016/j.pec.2019.01.013. Epub 2019 Jan 21.
To assess the effectiveness of a brief training program in relational/communication skills (RCS) for medical residents.
This longitudinal study enrolled 64 medical residents who participated in a RCS training program in small groups. Teaching was based on interviews with standardized patients and reflective practice. Video-recorded consultations were coded according to the Verona-Coding-Definitions-of-Emotional-Sequences (VR-CoDES) and a coding system developed to assess ten communication skills for breaking bad news. The outcome measures were: independent raters' score in RCS for breaking bad news and the percentage of providing space and empathic responses, by comparing baseline (T1) skills with those after three-days (T2) and three-months (T3).
After the training program residents provided more space for further disclosure of cues and concerns according to VR-CoDES definitions. There were significant improvements in seven of the ten communication skills for breaking bad news. All of these improvements were observed either at T2 or at T3.
This study demonstrates the effectiveness of a brief RCS training program designed to improve medical residents' ability to respond appropriately to patients' cues and concerns and to conduct a breaking bad news encounter.
Brief RCS training programs adopting multiple approaches, should be offered as mandatory during residency programs.
评估针对住院医师的简短关系/沟通技巧（RCS）培训计划的效果。
这项纵向研究纳入了 64 名参加 RCS 小组培训计划的住院医师。教学基于与标准化患者的访谈和反思性实践。根据维罗纳情绪序列编码定义（VR-CoDES）和开发的用于评估十种告知坏消息的沟通技巧的编码系统对视频记录的咨询进行编码。主要结局指标是：独立评估者在告知坏消息方面的 RCS 评分，以及在比较基线（T1）技能与三天后（T2）和三个月后（T3）技能时提供空间和同理心反应的百分比。
在培训计划之后，住院医师根据 VR-CoDES 定义为进一步揭示线索和关注点提供了更多的空间。告知坏消息的十种沟通技巧中有七种有显著改善。所有这些改进都在 T2 或 T3 时观察到。
这项研究表明，简短的 RCS 培训计划可以有效提高住院医师适当回应患者线索和关注点的能力，并进行告知坏消息的会谈。
应在住院医师培训计划中提供采用多种方法的简短 RCS 培训计划。
