Taveira-Gomes Isabel, Mota-Cardoso Rui, Figueiredo-Braga Margarida
Medical Psychology Unit, Department of Clinical Neurosciences and Mental Health, Faculty of Medicine of University of Porto, Portugal.
Child and Adolescent Psychiatry Resident at Centro Hospitalar do Porto, Portugal.
Porto Biomed J. 2016 Nov-Dec;1(5):173-180. doi: 10.1016/j.pbj.2016.08.002. Epub 2016 Sep 29.
Effective communication is the cornerstone of a fruitful patient-physician relationship. Teaching clinical communication has become a pivotal goal in medical education. However, approaches measuring the maintenance of learned skills are needed since a decline in some communication skills during medical school has been reported.
Explore medical students' communication skills in a simulated clinical encounter before and after clerkships.
Two-hundred-fifty-five undergraduate students attending the second year of medical course, at the Faculty of Medicine of University of Porto, completed a 1.5-h per week course over 4 months on basic communication skills. The students' final evaluation consisted in an interview with a simulated patient, assessed by a teacher using a standardized framework. Three years later, while attending clerkships, 68 students from the same population completed a re-evaluation interview following the same procedure.
Medical students maintained a communication skill mean level similar to that of the original post-training evaluation, but significant differences in specific communication abilities were detected in this group of students. Empathic attitudes and ability to collect information improved whereas interview structure and non-verbal behavior showed a decline during clerkships expressing a balance between the competencies that improved, those that declined, and those that remained unchanged.
Present findings emphasize the importance of patient contact, context and clinical role models on the maintenance of learned skills, underscoring the importance of an integrated approach of clinical communication teaching throughout medical school.
有效的沟通是建立良好医患关系的基石。临床沟通教学已成为医学教育的关键目标。然而，由于有报道称医学生在校期间某些沟通技能会下降，因此需要衡量所学技能维持情况的方法。
探讨医学生在临床实习前后模拟临床问诊中的沟通技能。
255名就读于波尔图大学医学院医学课程第二年的本科生，在4个月的时间里每周完成一门1.5小时的基础沟通技能课程。学生的最终评估包括与一名模拟患者进行访谈，由一名教师使用标准化框架进行评估。三年后，同一批学生中的68名在参加临床实习时，按照相同程序完成了一次重新评估访谈。
医学生的沟通技能平均水平维持在与最初培训后评估相似的水平，但在这组学生中发现了特定沟通能力的显著差异。共情态度和收集信息的能力有所提高，而访谈结构和非语言行为在临床实习期间有所下降，这表明在有所提高、有所下降和保持不变的能力之间达到了一种平衡。
目前的研究结果强调了患者接触、环境和临床榜样对所学技能维持的重要性，突出了在整个医学院校采用综合临床沟通教学方法的重要性。
