Jorgensen Merete, Thorsen Hanne, Siersma Volkert, Winther Bang Christine
Center for Education and Research in General Practice, Copenhagen University, Copenhagen, 1014, Denmark.
MedEdPublish (2016). 2022 Apr 29;12:18. doi: 10.12688/mep.17511.2. eCollection 2022.
The patient-centered consultation model comprises four elements: exploring health, illness and disease experiences, understanding the whole person, finding common ground, and enhancing the patient-doctor relationship. This method is taught at the course in general practice at Copenhagen University. The aim of the study was to develop a simple tool consisting of a questionnaire about the patient-centered elements and a test video consultation. The outcome is the change in the students' ability to identify these elements. Used as a pre-course and post-course test it can inform the teachers which elements of the patient-centered consultation need intensifying in the teaching. The students from a course in general practice volunteered to participate in all steps of the development. They took part in individual interviews to select items from an already existing questionnaire (DanSCORE). The preliminary questionnaire was tested for face and content validity, pilot-tested and tested for test-retest reliability. All video consultations were transcribed and assessed for patient-centered elements through a conversation analysis. The videos showed medical students seeing real patients. The preliminary version of the questionnaire (called DanOBS) had 23 items. In the subsequent interviews, items were reduced to 17, each with three response options. After a pilot test, the questionnaire was further reduced to 13 items, all strictly relevant to the model and with two response options. The final questionnaire had acceptable test-retest reliability. The number of test consultation videos underwent a reduction from six videos to one. The DanOBS combined with a test video consultation, used as a pre-and post-course test demonstrates for teachers which elements in the patient-centered consultation need to be intensified in the teaching.
探索健康、疾病及患病经历，了解患者全貌，找到共同点，以及加强医患关系。哥本哈根大学的全科医学课程教授这种方法。该研究的目的是开发一种简单工具，它由一份关于以患者为中心要素的问卷和一段测试视频咨询组成。结果是学生识别这些要素的能力发生变化。用作课程前后测试时，它可以告知教师在教学中需要强化以患者为中心咨询的哪些要素。来自全科医学课程的学生自愿参与开发的所有步骤。他们参加个人访谈，从已有的问卷（丹麦评分量表）中选择项目。对初步问卷进行了表面效度和内容效度测试、预测试，并测试了重测信度。对所有视频咨询进行转录，并通过会话分析评估以患者为中心的要素。视频展示的是医学生诊治真实患者的情况。问卷的初步版本（称为丹麦观察量表）有23个项目。在随后的访谈中，项目减少到17个，每个项目有三个回答选项。经过预测试后，问卷进一步减少到13个项目，所有项目都与该模式严格相关，并有两个回答选项。最终问卷具有可接受的重测信度。测试咨询视频的数量从六个减少到一个。丹麦观察量表与一段测试视频咨询相结合，用作课程前后测试，能向教师表明在以患者为中心的咨询中哪些要素在教学中需要强化。
