Lin Yu-Xuan, Pham Thi Ngoc, Weng Li-Chueh, Fang Chun-Kai, Hsieh Ming-Ju, Chang Yu-Che, Fujimori Maiko, Tang Woung-Ru
School of Nursing, Chang Gung University, Taoyuan, Taiwan.
Faculty of Nursing and Midwifery, Hanoi Medical University, Hanoi, Vietnam.
J Gen Intern Med. 2025 May;40(6):1403-1410. doi: 10.1007/s11606-024-09268-7. Epub 2024 Dec 11.
Shared decision-making (SDM) is crucial in healthcare to facilitate effective communication between providers and patients, aiding in making optimal medical decisions. Communication skills training (CST) can improve physicians' ability in SDM. However, SDM CST for medical students in Taiwan is scarce, and research comparing online versus in-person CST outcomes is lacking.
This study aims to assess the effectiveness of online versus face-to-face SDM CST on medical students' decision-making proficiency and communication skills over time.
This study employs a retrospective quasi-experimental design, analyzing 323 questionnaires from the CST training database.
Participants (fourth-year medical students) were divided into two groups: face-to-face CST (n = 160) and online CST (n = 163).
Assessments were conducted before (T0) and immediately after (T1) CST. Paired t-tests and generalized estimating equations were used to evaluate within-group and between-group differences in SDM decision-making proficiency and communication skills.
In the within-group comparison, both groups showed a significant improvement in SDM decision-making proficiency and communication skills. For SDM decision-making proficiency, the face-to-face group demonstrated a large effect (t = 12.9, p < 0.001, d = 0.87), and the online group achieved a moderate effect (t = 8.98, p < 0.001, d = 0.64). In terms of communication skills, both groups reached a moderate effect (face-to-face, t = 9.77, p < 0.001, d = 0.67; online, t = 8.00, p < 0.001, d = 0.54). No significant differences were found between groups in SDM decision-making proficiency and communication skills.
This study has demonstrated that both online and face-to-face SDM CST effectively enhance the SDM decision-making proficiency and communication skills of medical students. The effectiveness of online CST is on par with face-to-face CST. It is recommended to use online CST when face-to-face classes are not feasible, especially during epidemics or budget constraints. Future research should explore the long-term impacts of these CST methods on students' skills, considering additional follow-up time points.
共同决策（SDM）在医疗保健中至关重要，有助于促进医疗服务提供者与患者之间的有效沟通，辅助做出最佳医疗决策。沟通技能培训（CST）可以提高医生在共同决策方面的能力。然而，台湾针对医学生的共同决策沟通技能培训很少，且缺乏比较在线培训与面对面培训效果的研究。
本研究旨在评估随着时间推移，在线与面对面的共同决策沟通技能培训对医学生决策能力和沟通技巧的有效性。
本研究采用回顾性准实验设计，分析了来自沟通技能培训数据库的323份问卷。
参与者（四年级医学生）分为两组：面对面培训组（n = 160）和在线培训组（n = 163）。
在培训前（T0）和培训后立即（T1）进行评估。配对t检验和广义估计方程用于评估共同决策能力和沟通技巧在组内和组间的差异。
在组内比较中，两组在共同决策能力和沟通技巧方面均有显著提高。对于共同决策能力，面对面培训组显示出较大效果（t = 12.9，p < 0.001，d = 0.87），在线培训组达到中等效果（t = 8.98，p < 0.001，d = 0.64）。在沟通技巧方面，两组均达到中等效果（面对面培训组，t = 9.77，p < 0.001，d = 0.67；在线培训组，t = 8.00，p < 0.001，d = 0.54）。两组在共同决策能力和沟通技巧方面未发现显著差异。
本研究表明，在线和面对面的共同决策沟通技能培训均能有效提高医学生的共同决策能力和沟通技巧。在线培训的效果与面对面培训相当。建议在面对面课程不可行时，特别是在疫情期间或预算有限的情况下，使用在线培训。未来的研究应考虑增加后续时间点，探索这些培训方法对学生技能的长期影响。
