Department of English, City University of Hong Kong, 83 Tat Hong Avenue, Kowloon Tong, Hong Kong SAR, China.
BMC Prim Care. 2022 Jun 22;23(1):158. doi: 10.1186/s12875-022-01770-3.
In the absence of a well-rounded syllabus that emphasises both interpersonal and medical dimensions in clinical communication, medical students in the early stages of their career may find it challenging to effectively communicate with patients, especially when dealing with perceived priorities and challenges across different disciplines.
To explore the priorities, challenges, and scope of clinical communication teaching as perceived by clinicians from different clinical disciplines, we recruited nine medical educators, all experienced frontline clinicians, from eight disciplines across seven hospitals and two medical schools in Hong Kong. They were interviewed on their clinical communication teaching in the Hong Kong context, specifically its priorities, challenges, and scope. We then performed interpretative phenomenological analysis of the interview data.
The interview data revealed five themes related to the priorities, challenges, and scope of clinical communication teaching across a wide range of disciplines in the Hong Kong context, namely (1) empathising with patients; (2) using technology to teach both the medical and interpersonal dimensions of clinical communication; (3) shared decision-making with patients and their families: the influence of Chinese collectivism and cultural attitudes towards death; (4) interdisciplinary communication between medical departments; and (5) the role of language in clinician-patient communication.
Coming from different clinical disciplines, the clinicians in this study approached the complex nature of clinical communication teaching in the Hong Kong context differently. The findings illustrate the need to teach clinical communication both specifically for a discipline as well as generically. This is particularly important in the intensive care unit, where clinicians from different departments frequently cooperate. This study also highlights how communication strategies, non-verbal social cues, and the understanding of clinical communication in the Hong Kong Chinese context operate differently from those in the West, because of differences in sociocultural factors such as family dynamics and hierarchical social structures. We recommend a dynamic teaching approach that uses role-playing tasks, scenario-based exercises, and similar activities to help medical students establish well-rounded clinical communication skills in preparation for their future clinical practice.
在缺乏全面的教学大纲的情况下，该大纲强调临床沟通中的人际交往和医学方面，处于职业生涯早期的医学生可能会发现与患者有效沟通具有挑战性，尤其是在处理不同学科的感知优先级和挑战时。
为了探索不同临床学科的临床医生对临床沟通教学的优先级、挑战和范围的看法，我们招募了 9 名医学教育工作者，他们均来自香港的 8 家医院和 2 所医学院的 7 个不同科室，具有丰富的临床一线经验。我们对他们在香港背景下的临床沟通教学进行了访谈，具体内容是其优先级、挑战和范围。然后，我们对访谈数据进行了解释性现象学分析。
访谈数据揭示了香港背景下跨广泛学科的临床沟通教学的优先级、挑战和范围的 5 个主题，包括（1）同理心与患者；（2）使用技术教授临床沟通的医学和人际交往方面；（3）与患者及其家属共同决策：中国集体主义和对死亡的文化态度的影响；（4）医学部门之间的跨学科沟通；（5）语言在医患沟通中的作用。
来自不同临床学科的临床医生以不同的方式处理香港背景下临床沟通教学的复杂性。研究结果表明，需要具体针对特定学科和普遍学科教授临床沟通。这在重症监护病房中尤为重要，因为来自不同科室的医生经常合作。这项研究还强调了在香港的中国语境中，沟通策略、非言语社会线索以及对临床沟通的理解如何因社会文化因素（如家庭动态和等级社会结构）的差异而与西方不同。我们建议采用动态教学方法，使用角色扮演任务、基于场景的练习和类似活动，帮助医学生建立全面的临床沟通技能，为未来的临床实践做好准备。
