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家庭医学住院医师培训期间师生沟通的挑战:一项定性研究。

Challenges in teacher-student communication during family medicine residency: A qualitative study.

机构信息

Facultad de Medicina, Subdivisión de Medicina Familiar, Universidad Nacional Autónoma de México, Ciudad de México, México.

Facultad de Filosofía y Letras, Posgrado en Pedagogía, Universidad Nacional Autónoma de México, Ciudad de México, México.

出版信息

PLoS One. 2024 Sep 17;19(9):e0310455. doi: 10.1371/journal.pone.0310455. eCollection 2024.

Abstract

BACKGROUND

Deficiencies in communication among healthcare professionals, recognized by medical educators and healthcare institutions, can negatively impact medical education and clinical practice. Analyzing teacher-resident communication difficulties shed light on this issue and propose practical strategies for its mitigation.

OBJECTIVE

To identify common communication challenges between teacher and residents during Family Medicine residency and to analyze their impact on interactions with peers, the work team, and patients.

DESIGN

Qualitative study, the critical incident technique was used to collect information of interest.

PARTICIPANTS

Seventy teachers, and fifty third-year residents from the Mexican Republic described critical incidents related to their communication experiences during Family Medicine residency.

RESULTS

192 critical incidents were collected (several participants reported more than one incident), comprising 127 reports from teachers, and 65 from residents. Four themes were identified: 1) asymmetric communication, 2) assertive communication, 3) organizational communication, and 4) effective communication. The main challenges identified were abuse of power in communication, lack of communication skills, and the absence of institutional communication channels. These issues significantly impacted learning, work environment, interpersonal relationships, and medical care.

CONCLUSION

This study highlights communication issues within Family Medicine residency in Mexico. The issues detected hindered learning and effective collaboration and negatively impacted the work environment, interpersonal relationships, and the quality of medical care. These findings underscore the urgent need to reorient the medical specialty curriculum towards an approach that includes communication skills.

摘要

背景

医疗保健专业人员之间的沟通不足,这一点已被医学教育者和医疗机构所认识,可能会对医学教育和临床实践产生负面影响。分析教师与住院医师之间的沟通困难可以揭示这个问题,并提出缓解这一问题的实用策略。

目的

确定家庭医学住院医师培训期间教师与住院医师之间常见的沟通挑战,并分析其对与同事、工作团队和患者互动的影响。

设计

定性研究,采用关键事件技术收集相关信息。

参与者

来自墨西哥共和国的 70 名教师和 50 名三年级住院医师描述了与家庭医学住院医师培训期间沟通经历相关的关键事件。

结果

共收集了 192 个关键事件(一些参与者报告了不止一个事件),包括教师的 127 份报告和住院医师的 65 份报告。确定了四个主题:1)不对称沟通,2)果断沟通,3)组织沟通,4)有效沟通。确定的主要挑战包括沟通中的权力滥用、缺乏沟通技巧和缺乏机构沟通渠道。这些问题严重影响了学习、工作环境、人际关系和医疗保健。

结论

本研究强调了墨西哥家庭医学住院医师培训中的沟通问题。检测到的问题阻碍了学习和有效的协作,并对工作环境、人际关系和医疗保健质量产生了负面影响。这些发现强调了迫切需要重新调整医学专业课程,使其包含沟通技巧。

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本文引用的文献

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Storylines of family medicine VI: ways of being-in the office with patients.家庭医学叙事 VI:在诊室与患者相处之道。
Fam Med Community Health. 2024 Apr 12;12(Suppl 3):e002793. doi: 10.1136/fmch-2024-002793.

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