Centre for Research in Patient Communication, Odense University Hospital, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Centre for Organisational Change in Person-Centred Healthcare, School of Medicine, Deakin University, Geelong, Australia.
Centre for Organisational Change in Person-Centred Healthcare, School of Medicine, Deakin University, Geelong, Australia.
Patient Educ Couns. 2022 Nov;105(11):3334-3338. doi: 10.1016/j.pec.2022.08.004. Epub 2022 Aug 6.
Despite the evidence that person-centred communication underpins all that we do in our interactions with patients, caregivers and team members, the knowledge about the implementation of systematic communication skills training is still in its infancy. This position paper describes some of the main contextual facilitators for translating knowledge about communication skills training for health care professionals (HCP) and recommends ways to guide practical implementation. Based on the literature that has been published over the last two decades, it seems evident that communication skills training programs should be underpinned by clinician self-reflection, be experiential, and focused on behaviour change and implementation of new skills into practice. The programs should be delivered by trainers possessing an understanding of communication micro skills, the skills and confidence to observe interactions, and coach learners through the rehearsal of alternative approaches. Communication skills programs should be flexible to adapt to individual learners, local needs, and circumstances. Interventions should not be limited to the empowerment of individual HCP but should be a part of the organisational quality assurance framework, e.g., by including communication skills in clinical audits. Implementation science frameworks may provide tools to align programs to the context and to address the determinants important for a sustained implementation process. Programs need to be embedded as 'core business', otherwise the culture change will be elusive and sustainability under threat if they are only dependent on provisional funding.
尽管有证据表明,以患者、护理人员和团队成员为中心的沟通是我们在与他们互动中所做的一切的基础,但关于系统沟通技巧培训实施的知识仍处于起步阶段。本立场文件描述了将医疗保健专业人员(HCP)沟通技巧培训知识转化为实践的一些主要背景促进因素,并为指导实际实施提供了建议。根据过去二十年来发表的文献,沟通技巧培训计划似乎应该以临床医生的自我反思为基础,具有体验性,并侧重于行为改变和将新技能付诸实践。培训师应该具备沟通微技能的理解,观察互动的技能和信心,并通过对替代方法的排练来指导学习者。沟通技巧计划应该灵活,以适应个别学习者、当地需求和情况。干预措施不应仅限于增强个别 HCP 的能力,而应成为组织质量保证框架的一部分,例如,通过将沟通技巧纳入临床审核。实施科学框架可以提供工具,使计划与背景保持一致,并解决对持续实施过程重要的决定因素。这些计划需要嵌入“核心业务”,否则,如果仅依赖临时资金,文化变革将难以实现,可持续性也将受到威胁。