Department of Medicine, Adult Palliative Care Services, Columbia University Medical Center, New York, New York.
Department of Surgery, Division of General Surgery, Columbia University Medical Center, New York, New York.
J Surg Educ. 2019 Sep-Oct;76(5):1223-1230. doi: 10.1016/j.jsurg.2019.04.001. Epub 2019 Apr 18.
Although good communication skills are essential for surgeons, there is no formal communication training during general surgery residency.
To implement a communication skills training program based on evidence-based teaching methods in general surgery residency.
We developed a 2-hour communication skills training program for general surgery residents, consisting of a small group skill practice session using role play with simulated patients along with real-time feedback from facilitators and observing peer residents. A board-certified palliative care physician and a board-certified surgeon facilitated each session. Outcome measures were self-assessment of preparedness with the session immediately before and after the session and 2 months after the session, resident satisfaction, and self-report frequency of skill practice. Results were compared between junior residents (postgraduate year 1-3) and senior residents (postgraduate year 4-5).
Columbia University Medical Center in New York City, a tertiary care, urban academic center with a 5-year General Surgery Residency program.
Thirty-one out of 39 (79.4%) general surgery residents (20 junior and 11 senior) were trained over a 9-month period. All participants completed the immediate pre- and post-session surveys, and twenty residents (64.5%) completed the 2-month postsession follow-up survey.
Overall, self-assessment of preparedness for specific communication challenges improved significantly for 7 of 11 tasks. At baseline, senior residents felt significantly more prepared than junior residents in all 11 tasks. Junior residents' self-assessment of preparedness improved significantly in 10 of 11 tasks. Overall satisfaction with the session was very high (mean 4.74 on a 5-point scale). Residents reported high frequency of self-directed skill practice in the 2-month follow-up survey.
This 2-hour communication skills practice session for general surgery residents was feasible, and it improved resident self-assessment of preparedness in communication and augmented self-directed skill practice.
尽管良好的沟通技巧对于外科医生来说至关重要，但在普通外科住院医师培训期间并没有正式的沟通培训。
在普通外科住院医师培训中实施基于循证教学方法的沟通技巧培训计划。
我们为普通外科住院医师开发了一个 2 小时的沟通技巧培训计划，该计划包括使用模拟患者进行小组技能练习，以及由促进者提供实时反馈和观察同行住院医师。一名经过董事会认证的姑息治疗医师和一名经过董事会认证的外科医师共同主持每一次会议。评估指标包括在会议前后立即进行自我评估，并在会议结束后 2 个月进行评估，还包括住院医师的满意度和自我报告的技能练习频率。结果在初级住院医师（住院医师 1-3 年）和高级住院医师（住院医师 4-5 年）之间进行了比较。
纽约市哥伦比亚大学医学中心，这是一家三级保健、城市学术中心，拥有为期 5 年的普通外科住院医师培训计划。
在 9 个月的时间里，共有 31 名（79.4%）普通外科住院医师（20 名初级住院医师和 11 名高级住院医师）接受了培训。所有参与者都完成了会议前后的即时调查，其中 20 名参与者（64.5%）完成了 2 个月后的会议调查。
总体而言，在 11 项任务中，有 7 项特定沟通挑战的准备情况自我评估显著提高。在基线时，高级住院医师在所有 11 项任务中都比初级住院医师更有准备。初级住院医师在 11 项任务中的准备情况自我评估显著提高。对会议的总体满意度非常高（5 分制平均 4.74 分）。住院医师在 2 个月的随访调查中报告了高频率的自我指导技能练习。
这个针对普通外科住院医师的 2 小时沟通技巧实践课程是可行的，它提高了住院医师在沟通方面的自我准备评估，并增加了自我指导的技能练习。
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