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培养重症监护住院医师的同理心和软技能:一项强制性、基于模拟、体验式培训的效果。

Cultivating Empathy and Soft Skills Among Intensive Care Residents: Effects of a Mandatory, Simulation-Based, Experiential Training.

机构信息

Department of Health Sciences, University of Milan, Milan, Italy.

Unit of Anesthesia and Intensive Care, San Paolo Hospital, ASST Santi Paolo e Carlo, Milan, Italy.

出版信息

Ann Transplant. 2021 Aug 13;26:e931147. doi: 10.12659/AOT.931147.

Abstract

BACKGROUND Communication with families is crucial in ICU care. However, only a few residency programs include communication and relationship training in their curricula. This study aimed to assess the impact of a communication-skill course on residents' empathy and self-reported skills. MATERIAL AND METHODS A single-center, observational study was conducted. Since 2017, the 4th-year residents of the Anaesthesia and Intensive Care School, University of Milan attended the mandatory "Program to Enhance Relational and Communication Skills in ICU (PERCS-ICU)". PERCS-ICU lasted 10 hours and involved small groups of residents. The course was articulated around the simulation and debriefing of 3 difficult conversations with trained actors. Before and after the course, residents completed the Jefferson Scale of Empathy and a questionnaire measuring self-assessed preparation, communication skills, relational skills, confidence, anxiety, emotional awareness, management of emotions, and self-reflection when conducting difficult conversations. The quality and usefulness of the course and the case scenario were assessed on a 5-point Likert scales. RESULTS Between 2017 and 2019, 6 PERCS-ICU courses were offered to 71 residents, 69 of whom completed the questionnaires. After the course, residents reported improvements in empathy (p<.05), preparation (p<.001), communication skills (p<.005), confidence (p<.001), self-reflection (p<.001), and emotional awareness (p<.001). Residents perceived the course as very useful (mean=4.79) and high-quality (mean=4.58). The case scenario appeared very realistic (mean=4.83) and extremely useful (mean=4.91). All residents recommended the course to other colleagues. CONCLUSIONS PERCS-ICU proved to be a well-received and effective course to improve residents' empathy and some self-reported skills. The long-term effects remain to be investigated.

摘要

背景

在 ICU 护理中,与家属的沟通至关重要。然而,只有少数住院医师培训计划将沟通和关系培训纳入课程。本研究旨在评估沟通技巧课程对住院医师同理心和自我报告技能的影响。

材料和方法

这是一项单中心、观察性研究。自 2017 年以来,米兰大学麻醉与重症监护学校的四年级住院医师参加了强制性的“重症监护室增强关系和沟通技能计划(PERCS-ICU)”。PERCS-ICU 持续 10 小时,涉及小组成员的住院医师。该课程围绕着与经过培训的演员进行 3 次困难对话的模拟和讨论展开。在课程前后,住院医师完成了杰斐逊同理心量表和一份自我评估准备、沟通技巧、关系技巧、信心、焦虑、情绪意识、情绪管理和进行困难对话时的自我反思的问卷。课程和案例场景的质量和有用性通过 5 分李克特量表进行评估。

结果

在 2017 年至 2019 年期间,向 71 名住院医师提供了 6 次 PERCS-ICU 课程,其中 69 名完成了问卷。课程结束后,住院医师报告同理心(p<.05)、准备(p<.001)、沟通技巧(p<.005)、信心(p<.001)、自我反思(p<.001)和情绪意识(p<.001)方面有所提高。住院医师认为该课程非常有用(均值=4.79)和高质量(均值=4.58)。案例场景非常逼真(均值=4.83)和极其有用(均值=4.91)。所有住院医师都向其他同事推荐了该课程。

结论

PERCS-ICU 被证明是一门广受欢迎且有效的课程,可以提高住院医师的同理心和一些自我报告技能。长期效果仍有待研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fcee/8369950/79dd54998b01/anntransplant-26-e931147-g001.jpg

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