School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia.
Centre for Investigative Interviewing, Griffith Criminology Institute, Griffith University, Brisbane, Queensland, Australia.
Teach Learn Med. 2022 Jan-Mar;34(1):1-12. doi: 10.1080/10401334.2021.1893175. Epub 2021 Mar 31.
Communication is a complex and essential element of clinical practice. It is widely accepted that communication skills can be taught and learned, but challenges remain for clinicians in achieving effective communication with patients. This study explored the patient-communication challenges faced by both medical students and experienced clinicians.
Semi-structured interviews were conducted with twenty medical students and nineteen experienced clinicians from a range of medical disciplines. Interviews were recorded and transcribed, and transcriptions subjected to thematic analysis and coding to quantify the challenges discussed.
There was remarkable consistency in the challenges described by both groups of participants, with eight predominant challenges identified: time constraints and chaotic environments, rapport building, patient characteristics, reluctance, omissions, assumptions, decision-making, and keeping conversations focused.
Medical curricula often focus on communication challenges associated with complex or sensitive clinical situations, but many of the challenges identified occur in routine consultations. Both pre-service and post-graduate medical training should adopt strategies to help build students' and clinicians' skills in managing these challenges from the outset of training.
沟通是临床实践中的一个复杂而重要的环节。人们普遍认为沟通技巧可以被教授和学习，但临床医生在与患者进行有效沟通方面仍然面临挑战。本研究探讨了医学生和经验丰富的临床医生在医患沟通中所面临的挑战。
对来自不同医学专业的二十名医学生和十九名经验丰富的临床医生进行了半结构化访谈。访谈进行了录音并转录，转录本进行了主题分析和编码，以量化讨论的挑战。
两组参与者描述的挑战非常一致，确定了八个主要挑战：时间限制和混乱的环境、建立融洽关系、患者特征、不情愿、遗漏、假设、决策和保持对话的重点。
医学课程通常侧重于与复杂或敏感的临床情况相关的沟通挑战，但许多确定的挑战出现在常规咨询中。医学生和临床医生的职前和毕业后医学培训都应该采取策略，帮助学生和临床医生从培训一开始就掌握管理这些挑战的技能。
