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教授医学生与有沟通障碍的患者进行有效沟通的技巧。

Teaching Medical Students Skills for Effective Communication With Patients Who Have Communication Disorders.

机构信息

Department of Rehabilitation Medicine, University of Washington, Seattle.

Department of Speech and Hearing Sciences, University of Washington, Seattle.

出版信息

Am J Speech Lang Pathol. 2019 Feb 21;28(1):155-164. doi: 10.1044/2018_AJSLP-18-0130.

Abstract

Purpose Patients with communication impairments including speech, language, cognition, or hearing disorders face many barriers to communication in health care settings. These patients report loss of autonomy in health care decision making, are at increased risk for medical errors, and are less satisfied with health care than patients without communication disorders. Although medical students receive training in effective patient-provider communication, most of this training assumes patients have intact communication abilities. Medical students and other health care providers are often unprepared to meet the communication needs of patients with communication disorders in health care encounters. The purpose of this study was to assess the impact of a curriculum for training medical students to communicate effectively with patients who have a range of communication disorders. Method Twenty-six 2nd-year medical students volunteered for assessments before and after a required workshop in a class. This workshop included instruction about different types of communication disorders and communication strategies, followed by practice with standardized patients portraying different communication disorders. Outcome measures included a knowledge test, ratings of self-efficacy, and evaluation of students' skills when interviewing standardized patients portraying aphasia and dysarthria. Results Medical students demonstrated significant improvements in knowledge, self-efficacy, and use of recommended communication techniques. Conclusions The curriculum appeared effective in changing medical students' knowledge and skills for working with patients with communication disorders. Equipping medical students to meet the needs of patients with communication disorders is 1 key element for improving the quality of health care for this patient population.

摘要

目的

患有言语、语言、认知或听力障碍等交流障碍的患者在医疗保健环境中面临着许多交流障碍。这些患者报告称在医疗保健决策中失去了自主权,更容易发生医疗差错,并且对医疗保健的满意度低于没有交流障碍的患者。尽管医学生接受了有效的医患沟通培训,但大多数培训都假设患者具有完整的沟通能力。医学生和其他医疗保健提供者通常没有准备好满足医疗保健中具有交流障碍的患者的沟通需求。本研究的目的是评估培训医学生与患有各种交流障碍的患者进行有效沟通的课程的影响。

方法

26 名二年级医学生自愿在一门课程的必修研讨课前和课后接受评估。该研讨会包括有关不同类型的交流障碍和交流策略的教学,然后与模拟不同交流障碍的标准化患者一起进行实践。评估指标包括知识测试、自我效能感评分,以及评估学生在访谈模拟患有失语症和构音障碍的标准化患者时的技能。

结果

医学生在知识、自我效能感和推荐的沟通技巧的使用方面均有显著提高。

结论

该课程似乎有效地改变了医学生与交流障碍患者合作的知识和技能。让医学生具备满足交流障碍患者需求的能力是改善该患者群体医疗保健质量的关键要素之一。

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Patient-Provider Communication for People with Severe Dysarthria: Referral Policies that Lead to Systems Change.
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