Assistant Professor of Medicine, Harvard Medical School; Associate Physician, Department of Medicine, Massachusetts General Hospital.
Resident, Departments of Neurology, Brigham and Women's Hospital and Massachusetts General Hospital.
MedEdPORTAL. 2021 Apr 14;17:11141. doi: 10.15766/mep_2374-8265.11141.
Patients' hospital experiences can be adversely affected by clinicians' negative behaviors. Simple positive behaviors, however, can have a dramatic impact on patient-clinician relationships. Medical students starting clinical training are ideal educational targets for learning good behavioral habits that promote kind, compassionate care.
We developed the Kind Care Bundle, a collection of concrete verbal and nonverbal behaviors for showing compassion in patient interactions. The curriculum was taught in 3-hour small-group interactive sessions to first-year students. Students reflected on personal experiences of compassionate care and role-played the use of the Kind Care Bundle. In pairs, students interviewed patients about their experiences of kind, compassionate care while practicing the Kind Care Bundle. Students completed a postsession evaluation with Likert scales and free-text responses.
Thirty-seven of 40 students (92%) completed postsession evaluation forms. Session organization was considered excellent (27 of 37 students, 73%) or very good (nine of 37, 27%). Session relevance was rated as excellent by 30 of 37 students (81%) and very good by six of 37 students (16%). Students believed the bundle filled an educational gap. Qualitative themes included appreciation of concrete behaviors in the bundle, importance of empathy, and opportunity to reflect on one's own experience of compassion.
Students appreciated learning about specific behaviors for improving patient interactions. Targeting preclinical medical students has the potential to promote kinder and more compassionate patient interactions during subsequent clinical training. The long-term impact on students' behavior and on their personal and professional development requires further study.
患者的就医体验可能会受到临床医生负面行为的不利影响。然而,简单的积极行为可以对医患关系产生巨大影响。开始临床培训的医学生是学习促进友善、富有同情心的护理的良好行为习惯的理想教育对象。
我们开发了“友善关怀包”,这是一套在与患者互动时表现出同情心的具体言语和非言语行为。该课程以 3 小时的小组互动形式教授给一年级学生。学生反思个人富有同情心的护理经历,并角色扮演使用“友善关怀包”。学生两两一组,在练习“友善关怀包”的同时,采访患者关于他们友善、富有同情心的护理体验。学生通过李克特量表和自由文本回答完成课后评估。
40 名学生中有 37 名(92%)完成了课后评估表。课程组织被认为非常好(27/37,73%)或很好(9/37,27%)。30 名学生(81%)认为课程相关性非常好,6 名学生(16%)认为课程相关性很好。学生认为该课程填补了教育空白。定性主题包括对包裹中具体行为的欣赏、同理心的重要性以及反思自己的同情心体验的机会。
学生赞赏学习改善患者互动的具体行为。针对临床前医学生开展教学活动,有可能在后续临床培训中促进更友善、更富有同情心的医患互动。对学生行为及其个人和职业发展的长期影响需要进一步研究。