Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital Tuebingen, Internal Medicine, Tuebingen, Germany.
TIME-Tuebingen Insitute for Medical Education, University of Tuebingen, Tuebingen, Germany.
Stress Health. 2023 Aug;39(3):553-561. doi: 10.1002/smi.3206. Epub 2022 Nov 3.
Taking patients' medical history correctly is the basis of diagnosis and therapy. Medical students as a vulnerable group may perceive patient-physician interactions as stressful. This study examines stress among medical students in different degrees of fidelity when taking a patient's medical history. In this longitudinal study, students' stress levels were assessed during scenarios with different degrees of fidelity (role-play, simulated patient encounters and real patient encounters) using standardised questionnaires (State-Trait Anxiety Inventory and a distress scale) and the physiological measurement of heart rate variability. The stress level of participating medical students (N = 128) was expected to significantly increase during scenarios of increasing fidelity (M = 2.08 ± 0.92; SPEs: M = 2.68 ± 1.08; RPEs: M = 3.35 ± 1.08; p < 0.001). Whereas physiological stress was significantly higher with real patients (N = 106), psychological stress was not affected by the fidelity of the scenarios (N = 85). Medical students experienced stress when taking patients' medical history. Medical students might be unaware of their perceived stress based on the results. Thus, they should know how to cope with stress in such situations.
正确采集患者病史是诊断和治疗的基础。医学生作为一个弱势群体,可能会将医患互动视为一种压力源。本研究旨在探讨不同逼真度下采集患者病史时医学生的压力水平。在这项纵向研究中,使用标准化问卷(状态-特质焦虑量表和苦恼量表)和心率变异性的生理测量,评估了学生在不同逼真度场景(角色扮演、模拟患者就诊和真实患者就诊)下的压力水平。研究预计,参与医学生(N=128)的压力水平在逼真度增加的情况下会显著升高(M=2.08±0.92;SPEs:M=2.68±1.08;RPEs:M=3.35±1.08;p<0.001)。而真实患者的生理压力明显更高(N=106),但心理压力不受场景逼真度的影响(N=85)。医学生在采集患者病史时会感到压力。基于研究结果,医学生可能没有意识到自己所感受到的压力。因此,他们应该知道如何在这种情况下应对压力。