Glod Susan A, Kang Ashley, Wojnar Margaret
Associate Professor, Department of Medicine, Penn State College of Medicine.
Medicine Clerkship Director, Penn State College of Medicine.
MedEdPORTAL. 2020 Mar 6;16:10883. doi: 10.15766/mep_2374-8265.10883.
Effective communication skills are widely recognized as an important aspect of medical practice. Several tools and curricula for communications training in medicine have been proposed, with increasing attention to the need for an evidence-based curriculum for communication with families of patients in the intensive care unit (ICU).
We developed a curriculum for internal medicine residents rotating through the medical ICU that consisted of a didactic session introducing basic and advanced communication skills, computer-based scenarios exposing participants to commonly encountered dilemmas in simulated family meetings, and experiential learning through the opportunity to identify potential communication challenges prior to facilitating actual family meetings, followed by structured peer debriefing. Seventeen residents participated in the study.
We administered the Communication Skills Attitude Scale to participants before and after participation in the curriculum, as well as a global self-efficacy survey, with some items based on the Common Ground rating instrument, at the end of the academic year. There were no significant changes in either positive or negative attitudes toward learning communication skills. Resident self-perceived efficacy in several content domains improved but did not reach statistical significance.
Our curriculum provided interactive preparatory training and an authentic experience for learners to develop skills in family meeting facilitation. Learners responded favorably to the curriculum. Use of the Family Meeting Behavioral Skills (FMBS) tool helped residents and educators identify and focus on specific skills related to the family meeting. Next steps include gathering and analyzing data from the FMBS tool.
有效的沟通技巧被广泛认为是医疗实践的一个重要方面。已经提出了几种医学沟通培训的工具和课程，越来越关注为重症监护病房（ICU）患者家属沟通制定基于证据的课程的必要性。
我们为在内科重症监护病房轮转的内科住院医师开发了一门课程，该课程包括一个讲授基本和高级沟通技巧的教学环节、通过基于计算机的场景让参与者在模拟家庭会议中面对常见困境、通过在实际主持家庭会议之前识别潜在沟通挑战的机会进行体验式学习，随后进行结构化的同伴汇报。17名住院医师参与了该研究。
我们在参与者参加课程前后对其进行了沟通技能态度量表测试，以及在学年末进行了一项总体自我效能调查，其中一些项目基于共同基础评分工具。对学习沟通技能的积极或消极态度均无显著变化。住院医师在几个内容领域的自我感知效能有所提高，但未达到统计学意义。
我们的课程为学习者提供了互动式的预备培训和真实体验，以培养主持家庭会议的技能。学习者对该课程反应良好。使用家庭会议行为技能（FMBS）工具帮助住院医师和教育工作者识别并专注于与家庭会议相关的特定技能。下一步包括收集和分析来自FMBS工具的数据。
