Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, NE29 8NH, United Kingdom.
Faculty of Medical Sciences, School of Psychology, Newcastle University, 4 Floor Dame Margaret Barbour Building, Wallace Street, Newcastle Upon Tyne, NE1 7RU, England.
BMC Med Educ. 2024 Mar 22;24(1):328. doi: 10.1186/s12909-024-05306-4.
The complexity and uncertainty around Persistent Physical Symptoms (PPS) make it difficult to diagnose and treat, particularly under time-constrained consultations and limited knowledge. Brief interventions that can be utilised in day-to-day practice are necessary to improve ways of managing PPS. This review aimed to establish (i) what training primary and secondary healthcare practitioners have undertaken to develop their clinical skills when working with PPS, (ii) what training techniques or theoretical models have been used within these interventions, and (iii) how effective was the training.
A systematic literature search was undertaken on eight databases to identify professional development interventions for healthcare practitioners working with PPS, were of any study design, and at a minimum were single measure studies (i.e., training outcome alone). Studies were assessed using the Mixed Methods Appraisal Tool (MMAT) and narratively synthesised.
Despite high methodological heterogeneity across the six included studies, they all aimed to improve healthcare practitioners' communication skills through educational (theory, awareness, attitudes, assessment, treatment, and management of PPS) and experiential (role play) learning.
The review findings demonstrate that developing healthcare practitioners' communicative behaviours led to increased confidence and self-efficacy when working with PPS, which facilitated improved consultations and improvements on some patient outcomes. Barriers to the uptake of training programmes and implementation into daily clinical practice are discussed, including the need for PPS to be formally implemented into undergraduate teaching and post-qualification continuous professional development.
This review was registered at PROSPERO [CRD42022315631] prior to the review starting.
持续性身体症状（PPS）的复杂性和不确定性使得其难以诊断和治疗，尤其是在时间受限的咨询和有限的知识背景下。在日常实践中需要利用简短的干预措施来改善 PPS 的管理方式。本综述旨在确定：（i）初级和二级保健从业者在处理 PPS 时为提高其临床技能接受了哪些培训；（ii）这些干预措施中使用了哪些培训技术或理论模型；以及（iii）培训的效果如何。
在八个数据库中进行了系统文献检索，以确定针对处理 PPS 的医疗保健从业者的专业发展干预措施，这些干预措施具有任何研究设计，并且至少是单一测量研究（即，仅培训结果）。使用混合方法评估工具（MMAT）对研究进行评估，并进行叙述性综合。
尽管纳入的六项研究在方法学上存在高度异质性，但它们都旨在通过教育（理论，意识，态度，评估，治疗和 PPS 的管理）和体验（角色扮演）学习来提高医疗保健从业者的沟通技巧。
综述结果表明，培养医疗保健从业者的沟通行为可提高他们在处理 PPS 时的信心和自我效能感，从而促进咨询的改善，并改善某些患者的结局。讨论了培训计划的采用和在日常临床实践中的实施障碍，包括需要将 PPS 正式纳入本科教学和资格后持续专业发展中。
在开始综述之前，本综述已在 PROSPERO [CRD42022315631]上进行了注册。
