Monash Centre for Scholarship in Health Education (MCSHE), Monash University, Clayton, Victoria, Australia.
Department of Medical Education, The University of Melbourne, Melbourne, Victoria, Australia.
BMJ Open. 2019 Feb 19;9(2):e025445. doi: 10.1136/bmjopen-2018-025445.
The literature focuses on teaching communication skills in the 'classroom', with less focus on how such skills are informally learnt in the healthcare workplace. We grouped healthcare work based on the cure:care continuum to explore communication approaches based on work activities. This study asks: 1) How do healthcare professionals believe they learn communication in the workplace? 2) What are the differences (if any) across the 'type of work' as represented by the cure:care continuum?
This qualitative study used semi-structured individual interviews.
Community care and acute hospitals in Australia (Victoria and New South Wales).
Twenty qualified healthcare professionals (medicine n=4, nursing n=3, allied health n=13) from various clinical specialties (eg, acute, rehabilitation, surgery, palliative care) participated.
Data were analysed using framework analysis, which involved the development of a thematic coding framework. Findings were mapped to participants' descriptions of work using the cure:care continuum.
Three themes were identified that varied across the cure:care continuum: professional discourse-tying communication approaches to work activities; personal identities-the influence of personal identities on healthcare communication and role modelling-the influence of others in the socially bound context of healthcare work.
This study highlights the influence of professional, personal and social factors on the learning of healthcare communication in the workplace. Our study illuminates differences in communication practice related to work activities, as conceptualised by the cure:care continuum. The results call for further examination of the 'nature' of work activities and the concomitant influence on developing healthcare communication.
文献侧重于在“课堂”中教授沟通技巧，而较少关注在医疗保健工作场所中如何非正式地学习这些技能。我们根据治疗-关怀连续体对医疗保健工作进行分组，以探索基于工作活动的沟通方法。本研究提出以下两个问题：1）医疗保健专业人员如何认为他们在工作场所中学习沟通？2）在以治疗-关怀连续体表示的“工作类型”方面有何差异（如果有的话）？
本定性研究使用半结构式个体访谈。
澳大利亚（维多利亚州和新南威尔士州）的社区护理和急性医院。
来自各种临床专业（如急性、康复、外科、姑息治疗）的 20 名合格医疗保健专业人员（医学 4 名、护理 3 名、联合健康 13 名）参加了研究。
使用框架分析法对数据进行分析，该方法涉及主题编码框架的发展。研究结果根据治疗-关怀连续体与参与者对工作的描述进行映射。
确定了三个主题，这些主题在治疗-关怀连续体中有所不同：专业话语-将沟通方法与工作活动联系起来；个人身份-个人身份对医疗保健沟通的影响和角色模型-他人在医疗保健工作的社会约束背景下的影响。
本研究强调了专业、个人和社会因素对工作场所中医疗保健沟通学习的影响。我们的研究阐明了与治疗-关怀连续体概念相关的工作活动相关的沟通实践差异。研究结果呼吁进一步研究“工作性质”以及对发展医疗保健沟通的相应影响。
