Kapadia Muneera R, Lee Edmund, Healy Heather, Dort Jonathan M, Rosenbaum Marcy E, Newcomb Anna B
Department of Surgery, University of North Carolina, Chapel Hill, North Carolina.
Department of Surgery, Inova Fairfax Hospital, Falls Church, Virginia.
J Surg Educ. 2021 Mar-Apr;78(2):440-449. doi: 10.1016/j.jsurg.2020.08.018. Epub 2020 Sep 12.
Effective communication is critical in surgical practice and the Accreditation Council on Graduate Medical Education requires a focus on interpersonal and communication skills. Absent a national communication skills curriculum for surgical residents, individual programs have designed and implemented their own curricula. This scoping review explores communication training in North American surgical residency programs.
The review was conducted according to PRISMA guidelines, and included articles identified through searches of 6 publication databases conducted on June 25, 2019 and updated on April 2, 2020. Eligible studies described patient or family communication skills education for surgical residents in North America. Published abstracts were excluded. Article abstracts were screened by 2 reviewers. For articles meeting criteria, data on study setting, participants, curriculum design, educational techniques, and skills focus were extracted and analyzed.
A total of 2724 articles were identified after removing duplicates; 84 articles were reviewed in full text. Thirty-three met study criteria including 4 from 2006 to 2009 and 29 after 2010. The most common skills education focused on breaking bad news, followed by a range of topics, such as empathy, end of life and/or palliative care discussions, medical error disclosure, shared decision making, and informed consent. Some of the training was part of larger curriculum including team training or professionalism. Over half of the studies involved general surgery learners. The most common form of education included didactics followed by practice with peers or simulated patients. Only half of the programs described curricula involving multiple training sessions which is important for ongoing development and skill reinforcement.
Effective communication skills are important, necessary, and increasingly incorporated into surgical training programs. While the literature is expanding, few surgical residency programs have described communication curricula. This review serves as a guide for programs interested in developing their own communication curricula for surgical residents.
有效的沟通在外科实践中至关重要，研究生医学教育认证委员会要求关注人际和沟通技能。由于缺乏针对外科住院医师的全国性沟通技能课程，各个项目自行设计并实施了各自的课程。本范围综述探讨了北美外科住院医师培训项目中的沟通培训。
该综述按照PRISMA指南进行，纳入了通过检索2019年6月25日进行并于2020年4月2日更新的6个出版物数据库所识别的文章。符合条件的研究描述了北美外科住院医师的患者或家属沟通技能教育。已发表的摘要被排除。文章摘要由两名评审员进行筛选。对于符合标准的文章，提取并分析了关于研究背景、参与者、课程设计、教育技术和技能重点的数据。
去除重复项后共识别出2724篇文章；84篇文章进行了全文评审。33篇符合研究标准，其中2006年至2009年有4篇，2010年之后有29篇。最常见的技能教育集中在告知坏消息，其次是一系列主题，如同理心、临终和/或姑息治疗讨论、医疗差错披露、共同决策以及知情同意。部分培训是更大课程的一部分，包括团队培训或职业素养培训。超过一半的研究涉及普通外科学习者。最常见的教育形式包括讲授法，其次是与同行或模拟患者进行练习。只有一半的项目描述了包含多次培训课程的课程，这对于持续发展和技能强化很重要。
有效的沟通技能很重要、必要且越来越多地纳入外科培训项目。虽然文献在不断增加，但很少有外科住院医师培训项目描述沟通课程。本综述为有兴趣为外科住院医师开发自身沟通课程的项目提供了指导。
