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以患者为中心的高风险沟通技能评估在瑞士联邦医学执照考试中的开发与全国共识研究。

Development and national consensus finding on patient-centred high stakes communication skills assessments for the Swiss Federal Licensing Examination in Medicine.

机构信息

Institute for Medical Education, University of Bern, Switzerland; Office of Educational Affairs, Faculty of Medicine, University of Rostock, Ernst-Heydemann-Str. 8, 18057, Rostock, Germany.

Office of the Dean, Faculty of Medicine, University of Zurich, Switzerland.

出版信息

Patient Educ Couns. 2021 Jul;104(7):1765-1772. doi: 10.1016/j.pec.2020.12.003. Epub 2020 Dec 9.

Abstract

OBJECTIVE

To describe and evaluate a consensus finding and expert validation process for the development of patient-centred communication assessments for a national Licensing Exam in Medicine.

METHODS

A multi-professional team of clinicians and experts in communication, assessment and role-play developed communication assessments for the Swiss Federal Licensing Examination. The six-month process, informed by a preceding national needs-assessment, an expert symposium and a critical literature review covered the application of patient-centred communication frameworks, the development of assessment guides, concrete assessments and pilot-tests. The participants evaluated the process.

RESULTS

The multiple-step consensus process, based on expert validation of the medical and communication content, led to six high-stakes patient-centred communication OSCE-assessments. The process evaluation revealed areas of challenge such as calibrating rating-scales and case difficulty to the graduates' competencies and integrating differing opinions. Main success factors were attributed to the outcome-oriented process and the multi-professional exchange of expertise. A model for developing high stakes patient-centred communication OSCE-assessments was derived.

CONCLUSIONS

Consensus finding was facilitated by using well-established communication frameworks, by ensuring outcome-orientated knowledge exchange among multi-professional experts, and collaborative validation of content through experts.

PRACTICE IMPLICATIONS

We propose developing high-stakes communication assessments in a multi-professional expert consensus and provide a conceptual model.

摘要

目的

描述并评估一个共识发现和专家验证过程,以制定国家医学执照考试中的以患者为中心的沟通评估。

方法

一个由临床医生和沟通、评估和角色扮演方面的专家组成的多专业团队为瑞士联邦执照考试开发了沟通评估。该为期六个月的过程以先前的国家需求评估、专家研讨会和批判性文献回顾为基础,涵盖了以患者为中心的沟通框架的应用、评估指南的制定、具体评估和试点测试。参与者对该过程进行了评估。

结果

基于医学和沟通内容的专家验证的多步骤共识过程,导致了六项高风险的以患者为中心的沟通 OSCE 评估。过程评估揭示了一些挑战领域,例如将评分量表和案例难度与毕业生的能力相匹配,以及整合不同的意见。主要成功因素归因于面向结果的过程和多专业专业知识的交流。得出了开发高风险以患者为中心的沟通 OSCE 评估的模型。

结论

共识的达成得益于使用成熟的沟通框架,确保多专业专家之间面向结果的知识交流,以及通过专家对内容进行协作验证。

实践意义

我们建议在多专业专家共识中制定高风险沟通评估,并提供一个概念模型。

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