Associate Professor, Departments of Medicine and Pediatrics, and Director of Clinical Skills, Yale School of Medicine.
Professor, Department of Medicine, and Director of Communication Skills Education, Yale School of Medicine.
MedEdPORTAL. 2021 May 27;17:11163. doi: 10.15766/mep_2374-8265.11163.
Medical students often lack training in advanced communication skills encompassing emotionally fraught situations and those in which an intense emotional response is expected. Such skills are required for clinical situations encountered during residency. We created and evaluated an advanced communication skills workshop (ACSW) using standardized patients for senior medical students. The workshop emphasized communication skills for four scenarios-strong emotion, goals of care, medical error, and palliative care assessment-and utilized formative peer assessment and feedback.
We created the four ACSW cases with case-specific communication behavior checklists and a common modified Master Interview Rating Scale in a Capstone Course for senior medical students. In groups of three, students rotated through three of four stations. Each student conducted one of the interviews while the other two completed the checklists and provided verbal feedback. We performed one-way analyses of variance on Likert responses and content analysis on open responses on a post-ACSW survey.
Ninety-one students completed the ACSW and survey. Students assigned high value to all four ACSW student roles: interviewer, observer, feedback recipient, and feedback provider. Students rated the experience above average to excellent on nearly all survey items. Open-response themes included "liked the opportunity to give or receive peer feedback" (46%) and "found the checklists helpful" (45%).
Feasible and well received by senior medical students, our ACSW offers an opportunity to practice and observe advanced communication skills and peer feedback. A peer-assisted, formative learning model, the ACSW efficiently addresses a key aspect of residency preparation.
医学生通常缺乏高级沟通技巧的培训，这些技巧包括涉及情绪激动的情况和需要强烈情感反应的情况。这些技能是在住院医师期间遇到的临床情况所需要的。我们为高年级医学生创建并评估了一个使用标准化患者的高级沟通技巧研讨会（ACSW）。该研讨会强调了针对四种情况的沟通技巧 - 强烈的情绪、治疗目标、医疗错误和姑息治疗评估 - 并利用形成性同伴评估和反馈。
我们在高年级医学生的顶峰课程中使用特定案例的沟通行为清单和共同的修改后的主访谈评分量表创建了四个 ACSW 案例。学生三人一组轮流进行四个站中的三个。每个学生进行一次访谈，而另外两个学生完成清单并提供口头反馈。我们对 ACSW 后的调查中的李克特反应进行单向方差分析，并对开放反应进行内容分析。
91 名学生完成了 ACSW 和调查。学生对所有四个 ACSW 学生角色都给予了高度评价：访谈者、观察员、反馈接受者和反馈提供者。学生几乎对所有调查项目的评价都高于平均水平到优秀。开放反应的主题包括“喜欢给予或接受同伴反馈的机会”（46%）和“发现清单很有帮助”（45%）。
对于高年级医学生来说，我们的 ACSW 是可行的，并且受到了欢迎，它为练习和观察高级沟通技巧和同伴反馈提供了机会。ACSW 是一种同伴辅助的、形成性的学习模式，有效地解决了住院医师准备的一个关键方面。
