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利用众包模拟患者为医生的沟通技巧提供反馈。

Using crowdsourced analog patients to provide feedback on physician communication skills.

机构信息

Meyers Primary Care Institute, United States; University of Massachusetts Medical School, United States.

National Board of Medical Examiners, United States.

出版信息

Patient Educ Couns. 2021 Sep;104(9):2297-2303. doi: 10.1016/j.pec.2021.02.047. Epub 2021 Mar 1.

Abstract

OBJECTIVE

Effective physician-patient communication is important, but physicians who are seeking to improve have few opportunities for practice or receive actionable feedback. The Video-based Communication Assessment (VCA) provides both. Using the VCA, physicians respond to communication dilemmas depicted in brief video vignettes; crowdsourced analog patients rate responses and offer comments. We characterized analog patients' comments and generated actionable recommendations for improving communication.

METHODS

Physicians and residents completed the VCA; analog patients rated responses and answered:"What would you want the provider to say in this situation?" We used qualitative analysis to identify themes.

RESULTS

Forty-three participants completed the VCA; 556 analog patients provided 1035 comments. We identified overarching themes (e.g., caring, empathy, respect) and generated actionable recommendations, incorporating analog patient quotes.

CONCLUSION

While analog patients' comments could be provided directly to users, conducting a thematic analysis and developing recommendations for physician-patient communication reduced the burden on users, and allowed for focused feedback. Research is needed into physicians' reactions to the recommendations and the impact on communication.

PRACTICE IMPLICATIONS

Physicians seeking to improve communication skills may benefit from practice and feedback. The VCA was designed to provide both, incorporating the patient voice on how best to communicate in clinical situations.

摘要

目的

有效的医患沟通很重要,但寻求提高沟通能力的医生很少有机会进行实践或获得可操作的反馈。基于视频的沟通评估(VCA)可以同时提供这两点。医生通过 VCA 对简短视频片段中描绘的沟通困境做出回应;众包的模拟患者对这些回应进行评分并提供意见。我们对模拟患者的意见进行了描述,并提出了改进沟通的可操作建议。

方法

医生和住院医生完成了 VCA;模拟患者对回答进行评分并回答:“在这种情况下,您希望提供者说什么?”我们使用定性分析来确定主题。

结果

43 名参与者完成了 VCA;556 名模拟患者提供了 1035 条意见。我们确定了总体主题(例如,关心、同理心、尊重),并生成了可操作的建议,其中包含了模拟患者的引述。

结论

虽然可以直接向用户提供模拟患者的意见,但对医患沟通进行主题分析并提出建议减轻了用户的负担,并允许提供有针对性的反馈。需要研究医生对建议的反应以及对沟通的影响。

实践意义

寻求提高沟通技巧的医生可能会受益于实践和反馈。VCA 的设计目的是同时提供这两者,在临床情况下如何进行最佳沟通方面纳入患者的声音。

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