McCarrick Cathleen A, Moynihan Alice, McEntee Philip D, Boland Patrick A, Donnelly Suzanne, Heneghan Helen, Cahill Ronan A
Section of Surgery and Surgical Specialities, School Of Medicine, University College Dublin, Dublin, Ireland.
UCD Centre for Precision Surgery, 47 Eccles Street, Nelson Street, Dublin 7, Dublin, Ireland.
BMC Med Educ. 2025 Jul 18;25(1):1078. doi: 10.1186/s12909-025-07671-0.
Communication skills are essential for surgeons; typified regarding consent. We evaluated communication simulation training (CST) for informed consent competency in senior medical students.
With institutional ethics approval, CST was implemented during our undergraduate clinical surgery module. Students were divided in two groups by randomized cluster sampling and assessed at baseline on consent competency using a simulated patient (SP) for a colonoscopy scenario. The control group proceeded with standard clinical learning, while the intervention group received CST, which included tutor-led roleplay of good and poor consent for laparoscopic cholecystectomy, followed by peer reenactment and discussion. All students then underwent repeat assessment-an observed SP consent for laparoscopic appendicectomy-by an independent, single-blinded senior clinician within the same week. Communication skills were scored by Objective Structured Clinical Examination (OSCE) using both the University College of Dublin School of Medicine OSCE scoring rubric and the externally validated Global Communication Rating Scale (GCRS). Intervention group students were surveyed including anonymously reporting consent confidence pre- and post-CST. All procedures chosen are the three most commonly witnessed by students within their surgical rotations and all are typically familiar with them at this stage in their training.
Of the 122 students who participated, 61 received Communication Skills Training (CST). Baseline UCD and GCRS scores were similar across groups, but post-intervention scores were significantly higher in the CST group. Their average grade improved from a C to a B+, with a medium to large effect size (0.79), while the control group remained at a C. CST students also showed significant gains in GCRS domains-initiation, verbal communication, session structuring, and information relay. Self-confidence improved notably: only 11 students initially felt confident obtaining consent, compared to 62 post-training, with over 80% survey response rate.
Medical student CST improves consent communication skills versus observational learning demonstrating its impactful role within clinical undergraduate training.
ISRCTN10251799.
31.10.24.
沟通技巧对外科医生至关重要，在知情同意方面尤为典型。我们评估了针对高年级医学生知情同意能力的沟通模拟培训（CST）。
经机构伦理批准，在本科临床外科模块中实施CST。通过随机整群抽样将学生分为两组，并在基线时使用模拟患者（SP）进行结肠镜检查场景的知情同意能力评估。对照组进行标准临床学习，而干预组接受CST，其中包括由导师引导的腹腔镜胆囊切除术良好和不良知情同意的角色扮演，随后进行同伴重演和讨论。然后，所有学生在同一周内由一名独立的、单盲的资深临床医生进行重复评估——观察SP对腹腔镜阑尾切除术的知情同意。使用都柏林大学医学院OSCE评分标准和外部验证的全球沟通评分量表（GCRS）通过客观结构化临床考试（OSCE）对沟通技巧进行评分。对干预组学生进行了调查，包括匿名报告CST前后的知情同意信心。所选的所有程序都是学生在外科轮转中最常目睹的三个程序，并且在他们培训的这个阶段，他们通常都很熟悉这些程序。
在参与的122名学生中，61名接受了沟通技巧培训（CST）。两组的基线UCD和GCRS评分相似，但干预后CST组的评分显著更高。他们的平均成绩从C提高到了B +，效应量为中到大（0.79），而对照组仍为C。CST学生在GCRS领域——开场、言语沟通、会话组织和信息传递方面也有显著提高。自信心显著提高：最初只有11名学生对获得知情同意有信心，而培训后有62名，调查回复率超过80%。
与观察性学习相比，医学生CST提高了知情同意沟通技巧，证明了其在临床本科培训中的重要作用。
ISRCTN10251799。
2024年10月31日。
