Chou Calvin, DeVries Charlie
Professor, Department of Medicine, University of California, San Francisco, School of Medicine.
Graduate Student, Department of Social and Behavioral Sciences, University of California, San Francisco, School of Medicine.
MedEdPORTAL. 2016 Nov 2;12:10490. doi: 10.15766/mep_2374-8265.10490.
The patient-centered medical home model is transforming the delivery of outpatient care, with improved quality of care, better patient experiences, and enhanced processes of care. However, teams of interprofessional health care workers have diverse viewpoints that occasionally present instances of miscommunication. In addition, few materials exist that provide potential assessments for graduate-level interprofessional trainees. We constructed an interprofessional objective structured clinical examination (IPOSCE) to assess patient-centered behaviors of nurse practitioner residents and third-year internal medicine residents.
This IPOSCE comprises two phases. First, learners interact with a standardized patient with complex medical and psychosocial issues. Next, they engage in a series of stations with standardized interprofessional colleagues, each of whom is trained to deliver a non-patient-centered challenging line during their interaction.
Trainees felt that the cases reasonably reflected their typical outpatient practices but had some concerns about logistics and thought the cases may have presented heightened communication challenges compared with typical practice.
In sum, this IPOSCE workplace simulation successfully assessed communication skills of our resident trainees with standardized patients and standardized instructors in a realistic setting.
以患者为中心的医疗之家模式正在改变门诊医疗服务,带来了更高的医疗质量、更好的患者体验以及优化的医疗流程。然而,跨专业医护团队成员观点各异,偶尔会出现沟通不畅的情况。此外,针对研究生阶段跨专业实习生的潜在评估材料也很少。我们构建了一个跨专业客观结构化临床考试(IPOSCE),以评估执业护士住院医师和内科三年级住院医师以患者为中心的行为。
这个IPOSCE包括两个阶段。首先,学习者与患有复杂医疗和心理社会问题的标准化患者进行互动。接下来,他们会与一系列经过标准化培训的跨专业同事在不同站点进行交流,每位同事在互动过程中都会被训练说出以非患者为中心的具有挑战性的话语。
实习生们认为这些案例合理地反映了他们典型的门诊工作情况,但对一些后勤问题有所担忧,并且觉得这些案例相比典型工作可能带来了更大的沟通挑战。
总之,这个IPOSCE工作场所模拟在实际场景中成功地评估了我们住院医师实习生与标准化患者和标准化指导教师之间的沟通技巧。