Eisenthal S, Stoeckle J D
Department of Psychiatry, Massachusetts General Hospital, Boston 02114, USA.
Psychol Rep. 1998 Jun;82(3 Pt 2):1375-86. doi: 10.2466/pr0.1998.82.3c.1375.
A questionnaire was sent to all 77 general medical residents at one teaching hospital (18 primary care and 59 the traditional program), to investigate retrospectively their psychosocial training in medical school. 62 complete surveys (81%) were returned. The training was rated good by 62% of the residents and important for psychosocial practice by 45%. In ambulatory settings, supervisors were rated as supporting the doctor-patient relationship (79%) and spending time on psychosocial problems (65%). In inpatient settings, spending time on psychosocial problems was not widely supported (36%). Training to interview was rated far from optimal by 49% of the residents. Psychosocial attitudes in residency did not have substantial correlations with training. In the choice of residency program, what distinguished residents in primary care from those in the traditional program was the positive ratings given their supervisors' psychosocial orientation, but not the supervisors' nor the residents' psychosocial competency or weeks spent in training. In sum, the two most potent influences on psychosocial orientation appear to be positive role models and the clinical setting.
一份问卷被发送给一家教学医院的所有77名普通内科住院医师（18名初级保健医师和59名传统项目医师），以回顾性调查他们在医学院的社会心理培训情况。共收回62份完整问卷（81%）。62%的住院医师认为培训良好，45%的住院医师认为培训对社会心理实践很重要。在门诊环境中，住院医师对上级医师支持医患关系（79%）以及花时间处理社会心理问题（65%）给予了较高评价。在住院环境中，花时间处理社会心理问题的情况未得到广泛支持（36%）。49%的住院医师认为访谈培训远未达到最佳状态。住院医师培训期间的社会心理态度与培训之间没有显著相关性。在住院医师项目的选择上，初级保健住院医师与传统项目住院医师的区别在于他们对上级医师社会心理导向的积极评价，而不是上级医师或住院医师的社会心理能力，也不是培训所花的周数。总之，对社会心理导向影响最大的两个因素似乎是积极的榜样和临床环境。
