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利用与医学生和社区成员的故事讲述来培养好奇心和信任:一项试点干预措施的混合方法评估

Harnessing storytelling with medical students and community members to build curiosity and trust: A mixed methods evaluation of a pilot intervention.

作者信息

Rudel Rebecca K, Kaufmann Nicole D, Burrowes Shana A B, Harding Cheryl, Solomon Cara, Linas Benjamin P, Drainoni Mari-Lynn, Barnett Katherine Gergen

机构信息

Section of Infectious Diseases, Department of Medicine, Boston Medical Center & Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA.

Evans Center for Implementation and Improvement Sciences, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA.

出版信息

PEC Innov. 2025 Jul 9;7:100420. doi: 10.1016/j.pecinn.2025.100420. eCollection 2025 Dec.

Abstract

BACKGROUND

Mistrust of medical providers disproportionately affects individuals from racialized communities. Mistrust of providers negatively influences willingness to seek care, which exacerbates health disparities. Patient-centered communication can mitigate this mistrust.

OBJECTIVE

To assess the impact of a three-hour pilot workshop entitled , which brings medical students and Black, Indigenous and other People of Color (BIPOC) community members together to practice the skills underlying patient-centered communication, on medical student patient-centered communication self-efficacy and community member trust.

METHODS

Medical students completed the Self-Efficacy in Patient-Centeredness Questionnaire (SEPCQ-27) before, after, and one-month post-participation in the workshop, while community members completed two sub-scales of the Collaboration Trust Scale at the same time points. Community members also participated in focus group discussions approximately one week after workshop completion. Focus group transcripts were analyzed using the Social Cognitive Theory.

RESULTS

Median medical student SEPCQ-27 score increased 18 % pre to post-workshop ( < 0.001). Similarly, median scores of the Collaboration Trust Survey sub-scales "Trust in Communication" and "Trust in Partner Investment and Community Well-Being" increased 23.3 % ( = 0.025), and 18.75 % ( = 0.013), respectively. Analysis of focus group discussions identified five themes: 1) The workshop cultivated an open and comfortable environment; 2) Community members desire additional information and direction prior to the program; 3) Training medical students may have a downstream impact, but there is a pressing need to train current providers; 4) The workshop articulates opportunities for community members to assert their strength and empowers them to pursue them; and 5) Dismantling medical mistrust requires ongoing efforts.

CONCLUSION

The Storytelling workshop may build trust between patients from historically marginalized communities and medical practitioners.

INNOVATION

This is the first evaluation of a trust-building intervention that brings both medical providers and potential patients together in one room.

摘要

背景

对医疗服务提供者的不信任对来自种族化社区的个人影响尤为严重。对医疗服务提供者的不信任会对寻求医疗服务的意愿产生负面影响,从而加剧健康差距。以患者为中心的沟通可以缓解这种不信任。

目的

评估一个名为“ ”的三小时试点工作坊的影响,该工作坊将医学生与黑人、原住民及其他有色人种(BIPOC)社区成员聚集在一起,练习以患者为中心的沟通所基于的技能,对医学生以患者为中心的沟通自我效能感和社区成员信任的影响。

方法

医学生在参加工作坊前、参加后以及参加后一个月完成以患者为中心的自我效能感问卷(SEPCQ - 27),而社区成员在相同时间点完成合作信任量表的两个子量表。社区成员还在工作坊结束后约一周参加焦点小组讨论。使用社会认知理论对焦点小组记录进行分析。

结果

医学生SEPCQ - 27得分中位数在工作坊前后增加了18%(<0.001)。同样,合作信任调查子量表“沟通信任”和“对伙伴投资和社区福祉的信任”的中位数得分分别增加了23.3%(=0.025)和18.75%(=0.013)。对焦点小组讨论的分析确定了五个主题:1)工作坊营造了一个开放且舒适的环境;2)社区成员在项目之前希望获得更多信息和指导;3)培训医学生可能会产生下游影响,但迫切需要培训现有的医疗服务提供者;4)工作坊阐明了社区成员发挥自身优势的机会,并赋予他们追求这些机会的权力;5)消除医疗不信任需要持续努力。

结论

讲故事工作坊可能会在历史上被边缘化社区的患者和医疗从业者之间建立信任。

创新点

这是对一项将医疗服务提供者和潜在患者聚集在一个房间的建立信任干预措施的首次评估。

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