Department of Anesthesiology and Perioperative Care, School of Medicine, University of California, Irvine, CA, USA; Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
Department of Anesthesiology and Perioperative Care, School of Medicine, University of California, Irvine, CA, USA.
Br J Anaesth. 2019 Dec;123(6):887-897. doi: 10.1016/j.bja.2019.08.021. Epub 2019 Oct 5.
An unintended consequence of medical technologies is loss of personal interactions and humanism between patients and their healthcare providers, leading to depersonalisation of medicine. As humanism is not integrated as part of formal postgraduate anaesthesiology education curricula, our goal was to design, introduce, and evaluate a comprehensive humanism curriculum into anaesthesiology training.
Subject-matter experts developed and delivered the humanism curriculum, which included interactive workshops, simulation sessions, formal feedback, and patient immersion experience. The effectiveness of the programme was evaluated using pre- and post-curriculum assessments in first-year postgraduate trainee doctors (residents).
The anaesthesiology residents reported high satisfaction scores. Pre-/post-Jefferson Scale of Patient Perceptions of Physician Empathy showed an increase in empathy ratings with a median improvement of 12 points (range; P=0.013). After training, patients rated the residents as more empathetic (31 [4] vs 22 [5]; P<0.001; 95% confidence interval [CI]: 7-12) and professional (47 [3] vs 35 [8]; P<0.001; 95% CI: 9-16). Patient overall satisfaction with their anaesthesia provider improved after training (51 [6] vs 37 [10]; P<0.001; 95% CI: 10-18). Patients rated their anxiety lower in the post-training period compared with pretraining (1.8 [2.3] vs 3.6 [1.6]; P=0.001; 95% CI: 0.8-2.9). Patient-reported pain scores decreased after training (2.3 [2.5] vs 3.8 [2.1]; P=0.010; 95% CI: 0.4-2.8).
Implementation of a humanism curriculum during postgraduate anaesthesiology training was well accepted, and can result in increased physician empathy and professionalism. This may improve patient pain, anxiety, and overall satisfaction with perioperative care.
医疗技术的一个意外后果是患者及其医疗服务提供者之间的人际互动和人本主义的丧失,导致医学去人性化。由于人本主义没有作为正式的麻醉学研究生教育课程的一部分纳入,我们的目标是设计、引入并评估一个全面的人本主义课程纳入麻醉学培训。
主题专家开发并提供了人本主义课程,其中包括互动研讨会、模拟课程、正式反馈和患者沉浸体验。使用第一年住院医师(住院医生)的课程前后评估来评估该计划的效果。
麻醉科住院医师报告了很高的满意度评分。在 Jefferson 患者对医生同理心感知量表(PRE/POST-Jefferson Scale of Patient Perceptions of Physician Empathy)上,同理心评分有所提高,中位数提高了 12 分(范围;P=0.013)。培训后,患者认为住院医生更有同理心(31 [4] 比 22 [5];P<0.001;95%置信区间 [CI]:7-12)和更专业(47 [3] 比 35 [8];P<0.001;95%CI:9-16)。培训后,患者对其麻醉提供者的整体满意度提高(51 [6] 比 37 [10];P<0.001;95%CI:10-18)。与培训前相比,患者在培训后报告的焦虑程度较低(1.8 [2.3] 比 3.6 [1.6];P=0.001;95%CI:0.8-2.9)。培训后,患者报告的疼痛评分降低(2.3 [2.5] 比 3.8 [2.1];P=0.010;95%CI:0.4-2.8)。
在麻醉学研究生培训期间实施人本主义课程受到广泛欢迎,并且可以提高医生的同理心和专业性。这可能会改善患者的疼痛、焦虑和对围手术期护理的整体满意度。