Department of Primary Care, Ohio University, Athens, OH, USA.
Department of Communication, University of Illinois at Urbana-Champaign, Urbana, IL, USA.
Patient Educ Couns. 2022 May;105(5):1298-1304. doi: 10.1016/j.pec.2021.09.004. Epub 2021 Sep 9.
We investigated changes in medical students' communication competence and communication anxiety during their third year of training when they are immersed in formative clinical experiences that shape their patient-centered care and communication skills.
We invited 282 students to complete a longitudinal, four-phase online survey during their third-year. Our response rate was 62.8% at Phase I (n = 177), 34.0% at Phase II (n = 96), 37.9% at Phase III (n = 107), and 48.9% at Phase IV (n = 138). Measures included communication competence, communication anxiety, and patient-centered attitudes and orientation. We employed hierarchical linear modeling to analyze the data.
Students' communication competence and anxiety improved over time. Female students reported greater communication anxiety and less competence related to information giving. At each phase, patient-centered attitudes significantly predicted communication competence and communication anxiety.
Students' competence and anxiety regarding communication during medical encounters improve during their third year and are significantly influenced by their attitudes and orientation towards patient-centered care and communication.
Schools should integrate curriculum that fosters positive attitudes toward patient-centered communication and provides opportunities to practice complex communication skills, which may increase competence and recognition that patient-centered communication is an important clinical skill.
当医学生沉浸在形成以患者为中心的护理和沟通技能的形成性临床体验中时，我们调查了他们在第三年培训中沟通能力和沟通焦虑的变化。
我们邀请了 282 名学生在第三年期间完成一项纵向、四阶段的在线调查。我们在第一阶段（n=177）的回复率为 62.8%，在第二阶段（n=96）为 34.0%，在第三阶段（n=107）为 37.9%，在第四阶段（n=138）为 48.9%。测量包括沟通能力、沟通焦虑以及以患者为中心的态度和取向。我们采用分层线性模型分析数据。
学生的沟通能力和焦虑随着时间的推移而提高。女生报告的信息给予方面的沟通焦虑和能力较低。在每个阶段，以患者为中心的态度都显著预测沟通能力和沟通焦虑。
在第三年，医学生在医疗接触中沟通的能力和焦虑有所提高，并且受到他们对以患者为中心的护理和沟通的态度和取向的显著影响。
学校应整合课程，培养对以患者为中心的沟通的积极态度，并提供练习复杂沟通技能的机会，这可能会提高能力，并认识到以患者为中心的沟通是一项重要的临床技能。
