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住院医师对家庭医学门诊就诊期间医患沟通的反思。

Resident reflections on resident-patient communication during family medicine clinic visits.

机构信息

Communication, Culture & Technology, Georgetown University, Washington, D.C., USA.

Department of Communication, University of Dayton, Dayton, USA.

出版信息

Patient Educ Couns. 2020 Mar;103(3):484-490. doi: 10.1016/j.pec.2019.09.011. Epub 2019 Sep 13.

Abstract

OBJECTIVE

Residency programs emphasize effective doctor and patient interaction. However, training can be time intensive and logistically challenging. This paper examines a blog providing resident peer feedback and an opportunity to explore how residents think about patient communication.

METHODS

A grounded theory approach examined peer commenting on doctor patient interactions. Between 2012-2015, at a U.S. East Coast Family Medicine Clinic, 35 family medicine residents were recorded interacting with patients, producing a total of 84 videos which were posted to a blog. Residents reflected on these videos resulting in 356 responses, 3162 meaning units and 211 codes. Codes were grouped into 10 themes. Further analysis explored how residents signaled positive and negative doctor communications-related behavior.

RESULTS

Most common themes identified were Rapport/Relationship building skills, Negotiating the appointment, and Peer interaction. Most common themes discussed in light of both positive and negative behavior were Education, Use of technology, and Negotiating the appointment.

CONCLUSIONS

Residents view their communication with patients as more of a transmission of critical information than an opportunity for dialogue.

PRACTICE IMPLICATIONS

Findings support how online tools can be used for resident reflections. These tools can reveal resident perceptions of salient communication information in a clinical encounter.

摘要

目的

住院医师培训强调有效的医患互动。然而,培训可能需要大量的时间和繁琐的安排。本文探讨了一种为住院医师提供同行反馈的博客,并探讨了住院医师如何看待医患沟通。

方法

采用扎根理论方法考察同行对医患互动的评论。在 2012 年至 2015 年间,在美国东海岸的一家家庭医学诊所,35 名家庭医学住院医师记录了与患者的互动,共产生了 84 个视频,这些视频被发布到一个博客上。住院医师对这些视频进行了反思,共产生了 356 条回复、3162 个意义单位和 211 个代码。代码被分为 10 个主题。进一步的分析探讨了住院医师如何示意积极和消极的与医生沟通相关的行为。

结果

确定的最常见主题是建立融洽关系/建立关系的技巧、预约协商和同行互动。从积极和消极行为两方面讨论最多的主题是教育、使用技术和预约协商。

结论

住院医师认为他们与患者的沟通更多的是传递关键信息,而不是对话的机会。

实践意义

研究结果支持在线工具如何用于住院医师的反思。这些工具可以揭示住院医师在临床接触中对重要沟通信息的看法。

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