Department of General, Internal and Psychosomatic Medicine, Center for Psychosocial Medicine, Heidelberg University Hospital, Heidelberg, Germany.
Department of Gynecology and Obstetrics, Heidelberg University Hospital, Heidelberg, Germany.
PLoS One. 2020 May 29;15(5):e0233682. doi: 10.1371/journal.pone.0233682. eCollection 2020.
Communication is a core competence in medical care. Failure of physicians to properly communicate inherent risks of medical interventions has been linked with inadequate training at school. This study analyses a medical curriculum for assessing the content and quality of teaching risk communication to students.
A checklist based on the national guidelines of core competencies on risk communication required of physicians was developed. Participant observers surveyed all teaching sessions at a medical school during a semester to record the frequency, characteristics and clinical context used by lectures during classes. Data were analyzed using statistical and descriptive methods to determine the prevalence and quality of teaching content.
231 teaching sessions were surveyed. The inter-rater reliability was 81%. Lecturers mentioned topics of risk communication in 61.5% of teaching sessions (83.7% in surgery, 43.3% in internal medicine) but core biostatistics concepts were not discussed in more than 80% of these sessions. Important topics such as patient safety and preventable diseases were underrepresented. Risk communication was mainly taught in large-group, theoretical sessions and rarely with supplementary teaching material (7.4%). Students asked questions in 15.2% of courses, more often in surgery classes than in internal medicine.
Statistical and clinical topics relevant for teaching risk communication to medical students are not only underrepresented but also minimally explained by lecturers. Supplementary material on risk communication is rarely provided to students during classes. High-resource demanding, small-group teaching formats are not necessarily interactive as students ask few questions.
沟通是医疗保健的核心能力。医生未能正确传达医疗干预的固有风险，这与学校的培训不足有关。本研究分析了医学课程，以评估向学生传授风险沟通能力的内容和质量。
根据要求医生具备风险沟通核心能力的国家指南，制定了一份基于检查表的教学内容。参与者观察员在一个学期内调查了医学院的所有教学课程，以记录课堂上讲座的频率、特点和临床背景。使用统计和描述性方法分析数据，以确定教学内容的普遍性和质量。
共调查了 231 个教学课程。评分者间的可靠性为 81%。讲师在 61.5%的教学课程中提到了风险沟通的主题（外科课程为 83.7%，内科课程为 43.3%），但这些课程中超过 80%的课程没有讨论核心生物统计学概念。重要主题，如患者安全和可预防疾病，代表性不足。风险沟通主要在大组理论课程中教授，很少有补充教学材料（7.4%）。在 15.2%的课程中，学生提问，外科课程比内科课程更常见。
向医学生传授风险沟通的统计和临床主题不仅代表性不足，而且讲师的解释也很少。在课堂上很少向学生提供风险沟通的补充材料。高资源需求的小组教学形式不一定具有互动性，因为学生很少提问。
