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丹麦本科医学教育中关于沟通课程内容的共识:一项德尔菲研究。

Consensus on communication curriculum content in Danish undergraduate medical education: A Delphi study.

机构信息

Copenhagen Academy for Medical Education and Simulation (CAMES), Centre for HR and Education and the University of Copenhagen, Copenhagen, Denmark.

Massachusetts General Hospital, Boston, MA, USA.

出版信息

Med Teach. 2022 Nov;44(11):1221-1227. doi: 10.1080/0142159X.2022.2072280. Epub 2022 Jun 1.

Abstract

BACKGROUND

The acquisition of skills in patient-centered communication is a critical aspect of medical education which demands both resource-intensive instruction and longitudinal opportunities for learning. Significant variation currently exists in the content and timing of communication education. The aim of this study was to establish consensus regarding communication curriculum content for undergraduate medical education (UME) within the country of Denmark.

METHODS

This study employed a Delphi process which is a widely accepted method for establishing consensus among experts and can be utilized to guide planning and decision-making in education. For this study, consensus was based on greater than 60% agreement between participants. Diverse stakeholders, representing all four universities with medical schools in Denmark, participated in an iterative three-round Delphi process which involved: (1) identifying key curricular elements for medical student education, (2) rating the importance of each item, and (3) prioritizing items relative to one another and rating each item based on the level of mastery that was expected for each skill (i.e. knowledge, performance with supervision, or performance independently).

RESULTS

A national sample of 149 stakeholders participated with a 70% response rate for round 1, 81% for round 2, and 86% for round 3. The completed Delphi process yielded 56 content items which were prioritized in rank order lists within five categories: (1) establishing rapport, engaging patient perspectives and responding to needs; (2) basic communication skills and techniques; (3) phases and structure of the encounter; (4) personal characteristics and skills of the student; (5) specific challenging patient groups and context-dependent situations.

DISCUSSION

Using a Delphi process, it was possible to achieve consensus regarding communication curriculum content for UME. These findings provide an important foundation for ensuring greater uniformity in UME, as well as supporting the important longitudinal goals of communication skill development across medical training.

摘要

背景

掌握以患者为中心的沟通技能是医学教育的一个关键方面,这需要资源密集型的指导和学习的长期机会。目前沟通教育的内容和时间存在显著差异。本研究的目的是在丹麦国内建立本科医学教育(UME)沟通课程内容的共识。

方法

本研究采用德尔菲法(Delphi),这是一种广泛接受的专家共识建立方法,可用于指导教育规划和决策。在这项研究中,共识是基于参与者之间超过 60%的一致性。来自丹麦四所医学院的不同利益相关者代表参与了一个迭代的三轮德尔菲法过程,包括:(1)确定医学生教育的关键课程要素,(2)对每个项目的重要性进行评分,以及(3)对项目进行排序,根据每个技能的预期掌握程度(即知识、在监督下的表现或独立表现)对项目进行评分。

结果

全国共有 149 名利益相关者参与,第一轮的回复率为 70%,第二轮为 81%,第三轮为 86%。完成的德尔菲法过程产生了 56 个内容项目,这些项目按五个类别进行了排序:(1)建立融洽关系,参与患者视角并回应需求;(2)基本沟通技巧和技术;(3)接触的阶段和结构;(4)学生的个人特征和技能;(5)特定的具有挑战性的患者群体和依赖情境的情况。

讨论

使用德尔菲法,可以就 UME 的沟通课程内容达成共识。这些发现为确保 UME 的更大一致性提供了重要基础,也支持了医学培训中沟通技能发展的重要纵向目标。

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