Sloan D A, Donnelly M B, Johnson S B, Schwartz R W, Strodel W E
University of Kentucky College of Medicine, Lexington.
J Surg Res. 1994 Nov;57(5):613-8. doi: 10.1006/jsre.1994.1190.
Effective physician-patient interaction is an important part of surgical practice. This study had three goals: (1) to measure the interpersonal skills (IS) of surgical students and residents in structured clinical settings and to determine the reliability of such measurements; (2) to determine the relationship of IS to clinical performance; and (3) to determine the impact of level of training on IS. Twenty third-year medical students and 30 junior-level interns (23 PGY-1s, 7 PGY-2s) interacted with nine actual or simulated patients as part of an objective structured clinical examination. Using a global rating scale, faculty graded both the IS and the organizational skills of the candidates. A two-way analysis of variance indicated significant differences among the three groups of trainees (P = 0.0002) and among the IS scores for each of the nine patient problems (P < 0.0001). Both the PGY-2s and the medical students exhibited significantly better interpersonal skills than did the PGY-1s. The IS scores correlated significantly with the data gathering scores, the data interpretation scores, and the organizational scores. We conclude that faculty measurement of IS is moderately reliable even when a simple global rating scale is used. Overall IS scores were rather poor, particularly in the PGY-1 group. IS were highly correlated with overall objective clinical performance.
有效的医患互动是外科实践的重要组成部分。本研究有三个目标：（1）在结构化临床环境中测量外科学生和住院医师的人际技能（IS），并确定此类测量的可靠性；（2）确定人际技能与临床绩效之间的关系；（3）确定培训水平对人际技能的影响。作为客观结构化临床考试的一部分，20名三年级医学生和30名初级实习生（23名PGY-1、7名PGY-2）与9名真实或模拟患者进行了互动。教员使用整体评分量表对考生的人际技能和组织技能进行评分。双向方差分析表明，三组受训人员之间存在显著差异（P = 0.0002），九个患者问题中每个问题的人际技能得分之间也存在显著差异（P < 0.0001）。PGY-2和医学生的人际技能明显优于PGY-1。人际技能得分与数据收集得分、数据解释得分和组织得分显著相关。我们得出结论，即使使用简单的整体评分量表，教员对人际技能的测量也具有中等可靠性。总体人际技能得分相当低，尤其是在PGY-1组。人际技能与总体客观临床绩效高度相关。
