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用于内科实习医生沟通技能形成性评估的四站式小组观察结构化临床问诊

Four-Station Group Observed Structured Clinical Encounter for Formative Assessment of Communication Skills for Internal Medicine Clerks.

作者信息

Ludwig Allison, Lee Rosa, Parish Sharon, Raff Amanda

机构信息

Assistant Professor of Medicine, Department of Medicine, Albert Einstein College of Medicine.

Associate Medical Professor, CUNY School of Medicine.

出版信息

MedEdPORTAL. 2016 Aug 26;12:10444. doi: 10.15766/mep_2374-8265.10444.

Abstract

INTRODUCTION

Communication with patients and among colleagues is critical to effective clinical care. A group observed structured clinical encounter (GOSCE) is an effective and resource-saving tool for teaching communication skills to medical students. While objective structured clinical exams (OSCEs) are a well-established assessment tool for communication skills, a GOSCE allows for formal observation of communication skills while also providing an opportunity for peer observation and feedback. Additionally, a GOSCE costs less and requires fewer faculty per learner than a traditional OSCE.

METHODS

This is a four-station GOSCE to teach advanced communication skills to medical students. The stations are smoking cessation, difficult doctor-patient encounter, shared decision making, and delivering bad news. A group is made up of four to six students and one faculty member. At each station, one student takes the lead in the patient interview, followed by a group interview and ending with feedback by all participants.

RESULTS

In the pilot phase, a total of 44 students were administered the GOSCE and were surveyed about their experience. Students felt the GOSCE was an enjoyable and educational experience. The GOSCE has subsequently been administered to more than 600 students, and 25 internal medicine faculty have participated.

DISCUSSION

Our work demonstrates that the GOSCE is a feasible curricular enhancement for formative assessment of communication skills during the internal medicine clerkship. It is easy to implement and has been well received by all participants, with minimal impact on limited medical school and faculty resources.

摘要

引言

与患者及同事之间的沟通对于有效的临床护理至关重要。小组观察结构化临床交流(GOSCE)是一种向医学生传授沟通技巧的有效且节省资源的工具。虽然客观结构化临床考试(OSCE)是一种成熟的沟通技巧评估工具,但GOSCE不仅能对沟通技巧进行正式观察,还能提供同伴观察和反馈的机会。此外,与传统的OSCE相比,GOSCE成本更低,每位学习者所需的教员数量更少。

方法

这是一个四站式的GOSCE,用于向医学生传授高级沟通技巧。这些站点分别是戒烟、艰难医患交流、共同决策以及传达坏消息。一个小组由四至六名学生和一名教员组成。在每个站点,一名学生率先进行患者访谈,随后进行小组访谈,最后由所有参与者提供反馈。

结果

在试点阶段,共有44名学生参加了GOSCE,并就他们的体验接受了调查。学生们认为GOSCE是一次有趣且有教育意义的经历。随后,GOSCE已应用于600多名学生,并有25名内科教员参与其中。

讨论

我们的工作表明,GOSCE是在内科实习期间对沟通技巧进行形成性评估的一种可行的课程改进方法。它易于实施,受到了所有参与者的好评,对有限的医学院校和教员资源影响最小。

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引用本文的文献

本文引用的文献

1
The Group Objective Structured Clinical Experience: building communication skills in the clinical reasoning context.
Patient Educ Couns. 2014 Jul;96(1):79-85. doi: 10.1016/j.pec.2014.04.003. Epub 2014 Apr 19.
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Teaching about Substance Abuse with Objective Structured Clinical Exams.
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Acad Med. 1994 Dec;69(12):990-2. doi: 10.1097/00001888-199412000-00018.
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Self-assessment and learning through GOSCE (group objective structured clinical examination).
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