Doreille Alice, Vilaine Eve, Belenfant Xavier, Tabbi Wided, Massy Ziad, Corruble Emmanuelle, Basse Odile, Luque Yosu, Rondeau Eric, Benhamou Dan, François Helene
Department of Nephrology and Transplantation, Hôpital Tenon, AP-HP, Paris, France.
Department of Nephrology, CHU Ambroise Paré, AP-HP, Paris, France.
PLoS One. 2021 Sep 8;16(9):e0249956. doi: 10.1371/journal.pone.0249956. eCollection 2021.
Receiving the diagnosis of kidney failure has a major impact on patients. Yet, the way in which this diagnosis should be delivered is not formally taught within our medical curriculum. To fill this gap we set up a training course of kidney failure diagnosis delivery for nephrology trainees since 2016. This study assessed the effectiveness of this educational intervention.
The primary outcome was change in the empathy score immediately after the training session and several months afterward, based on the Jefferson Scale of Physician Empathy (JSPE). Self-reported change in clinical practice was also evaluated. As control groups, we assessed empathy levels in untrained nephrology trainees (n = 26) and senior nephrologists (n = 71). Later on (>6 months) we evaluated participants' perception of changes in their clinical practice due to the training.
Six training sessions permitted to train 46 trainees. Most respondents (76%) considered the training to have a durable effect on their clinical practice. Average empathy scores were not significantly different in pre-trained trainees (average JSPE: 103.7 ± 11.4), untrained trainees (102.8 ± 16.4; P = 0.81) and senior nephrologists (107.2 ± 13.6; P = 0.15). Participants' empathy score significantly improved after the training session (112.8 ± 13.9; P = 0.003). This improvement was sustained several months afterwards (average JSPE 110.5 ± 10.8; P = 0.04).
A single 4-hour training session can have long lasting impact on empathy and clinical practice of participants. Willingness to listen, empathy and kindness are thought to be innate and instinctive skills, but they can be acquired and should be taught.
肾衰竭的诊断对患者有重大影响。然而，我们的医学课程中并未正式教授传达这一诊断的方式。为填补这一空白，自2016年起我们为肾脏病学实习生开设了肾衰竭诊断传达培训课程。本研究评估了这一教育干预的效果。
主要结局是根据杰斐逊医生共情量表（JSPE），在培训课程结束后立即以及数月后共情得分的变化。还评估了临床实践中的自我报告变化。作为对照组，我们评估了未接受培训的肾脏病学实习生（n = 26）和资深肾脏病学家（n = 71）的共情水平。之后（>6个月），我们评估了参与者对培训导致其临床实践变化的认知。
六次培训课程共培训了46名实习生。大多数受访者（76%）认为培训对其临床实践有持久影响。培训前实习生（平均JSPE：103.7±11.4）、未培训实习生（102.8±16.4；P = 0.81）和资深肾脏病学家（107.2±13.6；P = 0.15）的平均共情得分无显著差异。培训课程后参与者的共情得分显著提高（112.8±13.9；P = 0.003）。这一改善在数月后得以维持（平均JSPE 110.5±10.8；P = 0.04）。
单次4小时的培训课程可对参与者的共情和临床实践产生长期影响。倾听的意愿、共情和友善被认为是天生的本能技能，但它们也可以习得且应该被传授。
