Zhou Lixin, Wu Bo, Wu Liyong, Cheng Xin, Hu Bo, Yao Ming, Zhu Yicheng, Peng Bin, Cui Liying, Ni Jun
Department of Neurology, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Science (CAMS) and Peking Union Medical College (PUMC), Beijing, 100730, China.
Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
BMC Med Educ. 2020 Sep 29;20(1):336. doi: 10.1186/s12909-020-02246-7.
Communication skill is a core competency in neurology residency training. Specific training in this area at the residency level is often lacking, especially regarding difficult conversations. The aim of this study is to evaluate the current state in teaching residents about difficult conversations in 5 Chinese accredited neurology residency training programs and determine whether there is a perceived need for a formalized curriculum in this field.
An anonymous, 27-question, cross-sectional online survey addressing difficult conversations for neurological residents were distributed to five grade-A, class-3 hospitals selected from the affiliated teaching hospitals of medical schools qualified to provide neurology residency training in China.
A total of 182 residents responded to the survey, and the response rate was 67.16% (182/271). Of the participants, 84.6% were female and the average age was 26.8 years. The majority of respondent residents (n = 168; 92.31%) reported being exposed to at least one difficult conversation in their medical careers. Only 43 (23.63%) participants reported having previously received formal communication skills training. In comparison with residents without previous training, those with previous training indicated significantly more confidence (P = 0.003) and were under lower pressure (P = 0.037) in managing difficult conversations. Only 97 (53.3%) residents indicated interest in receiving formal training. Time, lack of enthusiasm, lack of educational materials and faculty expertise were commonly cited barriers to formalized training.
This survey provides a preliminary assessment of the current status of education on the topic of difficult conversations in five accredited Chinese neurology residency training programs. Our results suggest that there is an unmet need to further develop and implement educational activities by teaching residents to lead difficult conversations. Future efforts should be made to establish and promote a standard and targeted communication curriculum in difficult conversation for Chinese neurological residents.
沟通技巧是神经科住院医师培训的核心能力。住院医师阶段在这方面的专项培训常常缺失，尤其是关于艰难对话的培训。本研究旨在评估中国5个获得认可的神经科住院医师培训项目中，向住院医师传授艰难对话相关知识的现状，并确定该领域是否存在对正式课程的需求。
针对神经科住院医师的艰难对话，开展了一项包含27个问题的匿名横断面在线调查，调查对象为从中国有资格提供神经科住院医师培训的医学院校附属医院中选取的5家三级甲等医院。
共有182名住院医师回复了调查，回复率为67.16%（182/271）。参与者中，84.6%为女性，平均年龄为26.8岁。大多数参与调查的住院医师（n = 168；92.31%）报告称在其医疗职业生涯中至少经历过一次艰难对话。只有43名（23.63%）参与者报告曾接受过正式的沟通技巧培训。与未接受过培训的住院医师相比，接受过培训的住院医师在处理艰难对话时表现出明显更高的信心（P = 0.003），压力也更小（P = 0.037）。只有97名（53.3%）住院医师表示有兴趣接受正式培训。时间、缺乏热情、缺乏教育材料和师资专业知识是被普遍提及的正式培训障碍。
本调查对中国5个获得认可的神经科住院医师培训项目中艰难对话主题的教育现状进行了初步评估。我们的结果表明，通过教导住院医师主导艰难对话来进一步开展和实施教育活动的需求尚未得到满足。未来应努力为中国神经科住院医师建立并推广关于艰难对话的标准化、有针对性的沟通课程。
