Butler D J, Seidl J J, Holloway R L, Robertson R G
Department of Family and Community Medicine, Medical College of Wisconsin, Milwaukee, USA.
Fam Med. 1995 Jun;27(6):371-5.
Teaching office-based psychological counseling is an essential component of family practice training. Most counseling training has been adapted from other disciplines without adequately identifying residents' learning needs, attitudes, and beliefs about counseling. This study was designed to 1) assess family practice residents' perceived learning needs for counseling, and 2) elicit and clarify their attitudes and beliefs about counseling.
Three consecutive groups of residents anonymously recorded their questions about psychological counseling. These questions were presented to the residents in focus groups for elaboration and clarification of underlying attitudes and beliefs. A consensus panel then categorized the learning needs and identified residents' attitudes and beliefs.
Eighty-six distinct learning need questions were identified. These items clustered into four categories: skill development, problem/patient selection, practice management, and role confusion. Focus group findings identified four major themes: the need for limits and boundaries, limited understanding of change and the therapeutic process, doubts about personal readiness, and difficulty with the integration of mind and body.
These findings parallel the concerns of physicians in practice and reinforce the need to identify resident concerns about office-based counseling. Failure to identify and respond to learner concerns may limit the effectiveness of teaching efforts in this curricular area.
教授门诊心理咨询是家庭医疗培训的重要组成部分。大多数咨询培训是从其他学科改编而来，没有充分确定住院医师对咨询的学习需求、态度和信念。本研究旨在：1）评估家庭医疗住院医师对咨询的感知学习需求；2）引出并阐明他们对咨询的态度和信念。
连续三组住院医师匿名记录他们关于心理咨询的问题。这些问题在焦点小组中向住院医师提出，以详细阐述并澄清潜在的态度和信念。然后，一个共识小组对学习需求进行分类，并确定住院医师的态度和信念。
共确定了86个不同的学习需求问题。这些问题分为四类：技能发展、问题/患者选择、实践管理和角色困惑。焦点小组的结果确定了四个主要主题：对限制和边界的需求、对改变和治疗过程的理解有限、对个人准备情况的怀疑以及身心整合的困难。
这些发现与执业医生的担忧一致，并强化了识别住院医师对门诊咨询担忧的必要性。未能识别并回应学习者的担忧可能会限制该课程领域教学工作的有效性。
