Brooks James S, Muller David, Campbell Peter, Yu Allen, Southwell Brian, Korin Maya
Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Institute for Equity and Justice in Health Sciences Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
J Med Educ Curric Dev. 2024 Sep 27;11:23821205241278182. doi: 10.1177/23821205241278182. eCollection 2024 Jan-Dec.
Communication about health often involves descriptions of risk: the probability or likelihood of an unfavorable outcome. Communicating risk helps individuals make choices about their own health by building understanding of potential outcomes and providing context for the importance of procedures, health interventions, and lifestyle choices. However, medical education in the United States does not provide future physicians with adequate statistical literacy to communicate risk effectively and rarely encourages them to practice communicating risk in pre-clinical years. Risk communication in military intelligence, a field with formalized risk language and training, offers a unique perspective into potential improvements for medical risk communication. With backgrounds in the military, public health, communication, surgery, and medical education, the authors offer the following recommendations to improve risk communication for medical students. (1) Encourage the use of numerical absolute risk when communicating among health practitioners to avoid varied interpretations of what different risk descriptors ("uncommon," "likely," or "low") might mean; (2) build efficient, teachable skills in use of patient-facing risk communication tools like comparative probabilities and visual aids; and (3) practice estimating risk through role-play of risk communication between medical students and standardized patients. By improving risk communication in medical education, future doctors will be better equipped to build trust through open communication and improve the health of the patients and the communities for whom they care.
即不良后果发生的概率或可能性。交流风险有助于个人通过增进对潜在结果的理解,并为医疗程序、健康干预措施和生活方式选择的重要性提供背景信息,从而做出关乎自身健康的选择。然而,美国的医学教育并未为未来的医生提供足够的统计素养,使其能够有效地交流风险,而且在临床前几年也很少鼓励他们练习风险交流。军事情报领域的风险交流,拥有形式化的风险语言和培训,为医学风险交流的潜在改进提供了独特视角。凭借军事、公共卫生、交流、外科手术和医学教育方面的背景,作者们提出以下建议以改善医学生的风险交流。(1)鼓励在医疗从业者之间交流时使用数值绝对风险,以避免对不同风险描述词(“不常见”、“可能”或“低”)的含义产生不同解读;(2)培养高效、可传授的技能,使用面向患者的风险交流工具,如比较概率和视觉辅助工具;(3)通过医学生与标准化患者之间风险交流的角色扮演来练习风险评估。通过改善医学教育中的风险交流,未来的医生将更有能力通过开放交流建立信任,并改善他们所照顾的患者和社区的健康状况。