Adnan Adlene I
Internal Medicine: Dermatology, Harrogate District Hospital, Leeds, GBR.
Cureus. 2022 Jul 10;14(7):e26717. doi: 10.7759/cureus.26717. eCollection 2022 Jul.
Communication skills are the vital basis for patient-doctor interactions in undergraduate medical education. With excellent patient-physician interaction and communication, patients will likely build better rapport and trust with the physician. This allows all the necessary information to be divulged with the reassurance of confidentiality and devise appropriate investigations and treatment plans that patients would be more inclined to follow. The most common and effective ways of teaching communication skills to medical students are by using simulated patients and volunteer outpatients. However, which types of patients to use for better development of practical communication skills training. Establishing the demonstrable difference between using two kinds of patients would refine the training scheme for students. This would produce doctors that have practical communication skills and enhance their care to assist patients on their road to recovery or palliative care. This review compares and establishes the effectiveness of medical students' communication skills training using simulated patients and volunteer outpatients about the adult learning theories. This research is carried out following a critical review of internationally reputed guidelines from the World Health Organisation (WHO) and the General Medical Council (GMC). Several search terms were used on various online databases such as Medline (Ovid), PubMed, and Academic Medicine. A thorough selection process was applied using the inclusion and exclusion criteria to narrow the search. Four studies related to this review's aim were collected and critically analyzed. The methods of obtaining the studies were structured using the PRISMA guidelines. The studies showed that one study favored volunteer outpatients while the other preferred having simulated patients. Another study showed that students considered both types of patients essential for communication skills training. All the studies presented the strengths and weaknesses of both simulated and volunteer outpatients. Discussion of the validity of all analyses was based on the CASP criteria. Study design, sample selection, and biases were scrutinized for each study. Various adult learning theories were used to correlate the effects of the communication skills training. In conclusion, simulated patients are more useful for pre-clinical years, intimate examination, and giving instructions about the physical examination. Whereas volunteer outpatients are put to better use in clinical years to incorporate more medical aspects such as obtaining a differential diagnosis, management of illness, and procedural techniques. Introducing different types of patients based on their study progression and topic of discussion could be adapted.
沟通技巧是本科医学教育中患者与医生互动的重要基础。通过出色的医患互动和沟通，患者可能会与医生建立更好的融洽关系和信任。这使得所有必要信息能够在保密的前提下得以透露，并制定出患者更愿意遵循的适当检查和治疗计划。向医学生教授沟通技巧最常见且有效的方法是使用模拟患者和志愿门诊患者。然而，使用哪种类型的患者能更好地开展实践沟通技巧培训。明确两种患者在使用上的显著差异将完善学生的培训方案。这将培养出具备实践沟通技巧的医生，并加强他们的护理工作，以帮助患者走向康复或接受姑息治疗。本综述比较并确定了使用模拟患者和志愿门诊患者进行医学生沟通技巧培训的效果，并参考了成人学习理论。本研究是在对世界卫生组织（WHO）和英国医学总会（GMC）等国际知名指南进行批判性审查之后开展的。在多个在线数据库（如Medline（Ovid）、PubMed和学术医学数据库）上使用了多个搜索词。通过应用纳入和排除标准进行全面的筛选过程，以缩小搜索范围。收集并批判性分析了四项与本综述目标相关的研究。获取研究的方法按照PRISMA指南进行构建。研究表明，一项研究倾向于志愿门诊患者，而另一项则更青睐模拟患者。另一项研究表明，学生认为这两种类型的患者对于沟通技巧培训都至关重要。所有研究都呈现了模拟患者和志愿门诊患者的优缺点。所有分析的有效性讨论均基于CASP标准。对每项研究的研究设计、样本选择和偏差进行了审查。运用各种成人学习理论来关联沟通技巧培训的效果。总之，模拟患者在临床前几年、体格检查以及给予体格检查指导方面更有用。而志愿门诊患者在临床年中能得到更好的利用，以纳入更多医学方面的内容，如进行鉴别诊断、疾病管理和操作技术。可以根据学生的学习进程和讨论主题引入不同类型的患者。
