多模态综合沟通技能培训与人工智能视频分析对急性老年病治疗的影响：一项混合方法研究。

Effect of multimodal comprehensive communication skills training with video analysis by artificial intelligence for physicians on acute geriatric care: a mixed-methods study.

机构信息

Department of Geriatric Medicine, National Hospital Organization Tokyo Medical Centre, Meguro-ku, Japan

Division of Geriatric Medicine, Rochester Regional Health System, Rochester, New York, USA.

出版信息

BMJ Open. 2023 Mar 3;13(3):e065477. doi: 10.1136/bmjopen-2022-065477.

DOI:10.1136/bmjopen-2022-065477

PMID:36868602

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9990644/

Abstract

OBJECTIVES

To quantitatively analyse by artificial intelligence (AI) the communication skills of physicians in an acute care hospital for geriatric care following a multimodal comprehensive care communication skills training programme and to qualitatively explore the educational benefits of this training programme.

DESIGN

A convergent mixed-methods study, including an intervention trial with a quasi-experimental design, was conducted to quantitatively analyse the communication skills of physicians. Qualitative data were collected via physicians' responses to an open-ended questionnaire administered after the training.

SETTING

An acute care hospital.

PARTICIPANTS

A total of 23 physicians.

INTERVENTIONS

In a 4-week multimodal comprehensive care communication skills training programme, including video lectures and bedside instruction, from May to October 2021, all the participants examined a simulated patient in the same scenario before and after their training. These examinations were video recorded by an eye-tracking camera and two fixed cameras. Then, the videos were analysed for communication skills by AI.

MAIN OUTCOME MEASURES

The primary outcomes were the physicians' eye contact, verbal expression, physical touch and multimodal communication skills with a simulated patient. The secondary outcomes were the physicians' empathy and burnout scores.

RESULTS

The proportion of the duration of the participants' single and multimodal types of communication significantly increased (p<0.001). The mean empathy scores and the personal accomplishment burnout scores also significantly increased after training. We developed a learning cycle model based on the six categories that changed after training from the physicians' perspective: multimodal comprehensive care communication skills training; increasing awareness of and sensitivity to changes to geriatric patients' condition; changes in clinical management; professionalism; team building and personal accomplishments.

CONCLUSIONS

Our study showed that multimodal comprehensive care communication skills training for physicians increased the proportions of time spent performing single and multimodal communication skills by video analysis through AI.

TRIAL REGISTRATION NUMBER

UMIN Clinical Trials Registry (UMIN000044288; https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000050586).

摘要

目的

通过人工智能（AI）对接受多模式综合护理沟通技巧培训计划后的老年护理急性护理医院医生的沟通技巧进行定量分析，并定性探讨该培训计划的教育收益。

设计

一项收敛混合方法研究，包括采用准实验设计的干预试验，对医生的沟通技巧进行定量分析。定性数据通过医生在培训后对开放式问卷的回答收集。

设置

急性护理医院。

参与者

共 23 名医生。

干预措施

在 2021 年 5 月至 10 月的 4 周多模式综合护理沟通技巧培训计划中，所有参与者在培训前后在相同场景下检查模拟患者。这些检查由眼动追踪摄像头和两个固定摄像头进行视频记录。然后，使用 AI 分析视频中的沟通技巧。

主要观察指标

医生与模拟患者的眼神交流、言语表达、身体接触和多模态沟通技巧。次要观察指标为医生的同理心和倦怠得分。

结果

参与者单一和多模式沟通类型的持续时间比例显著增加（p<0.001）。培训后，平均同理心得分和个人成就感倦怠得分也显著增加。我们从医生的角度出发，根据培训后发生变化的六个类别开发了一个学习循环模型：多模式综合护理沟通技巧培训；提高对老年患者病情变化的认识和敏感性；临床管理变化；专业精神；团队建设和个人成就。