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年轻医生的会诊技巧:II——大多数年轻医生不擅长提供信息。

Consultation skills of young doctors: II--Most young doctors are bad at giving information.

作者信息

Maguire P, Fairbairn S, Fletcher C

出版信息

Br Med J (Clin Res Ed). 1986 Jun 14;292(6535):1576-8. doi: 10.1136/bmj.292.6535.1576.

Abstract

Forty young doctors, half of whom had had feedback training in interviewing as students, were assessed five years later. Each interviewed three patients and after being given results of examination, investigations, and diagnosis and prognosis returned to discuss them with each patient for 10 minutes. These discussions were filmed on videotape and evaluated. There was no difference between the scores of interview trained and control doctors. Though most gave simple information on diagnosis and treatment, few mentioned investigations, aetiology, or prognosis. Very few obtained and took any account of patients' views or expectations of these matters. Some young doctors do discover for themselves how best to give patients information and advice, but most remain extremely incompetent. This is presumably because they get no training as students in this important aspect of clinical practice. This deficiency should be corrected, and competence tested before qualification to practise.

摘要

四十名年轻医生在五年后接受了评估,其中一半在学生时期接受过面试反馈培训。每人面试三名患者,在得知检查、调查结果以及诊断和预后情况后,返回与每位患者讨论10分钟。这些讨论被录像并进行评估。接受过面试培训的医生和对照组医生的得分没有差异。虽然大多数人提供了关于诊断和治疗的简单信息,但很少有人提及检查、病因或预后。极少数人获取并考虑了患者对这些问题的看法或期望。一些年轻医生确实自己发现了如何最好地向患者提供信息和建议,但大多数人仍然极其不称职。这大概是因为他们在学生时期没有接受过临床实践这一重要方面的培训。这种缺陷应该得到纠正,并且在获得执业资格前应测试能力。

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本文引用的文献

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The patient's role in clinical decision-making.患者在临床决策中的角色。
Ann Intern Med. 1980 Nov;93(5):718-22. doi: 10.7326/0003-4819-93-5-718.

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