Pfeiffer C, Madray H, Ardolino A, Willms J
University of Connecticut, School of Medicine, Farmington 06030-3975, USA.
Med Educ. 1998 May;32(3):283-8. doi: 10.1046/j.1365-2923.1998.00222.x.
A gradual shift towards a more humanistic conception of medicine has occurred in recent years. Along with this shift have come attempts by medical educators to include interviewing and communication skills as part of the medical curriculum. The current study evaluates the effectiveness of a clinical medicine curriculum which emphasizes interviewing skills. Between 1992 and 1994 and 292 graduates of the University of Connecticut School of Medicine participated in five clinical skills teaching and assessment programmes during the four years of medical school. During each of these five programmes, the students' interviewing skills were rated using the Arizona Clinical Interview Rating Scale (ACIR). The raters were standardized patients with whom they had just completed a medical encounter. Results show that students' development of skills differed, with closure items showing the greatest increase and social history items showing the greatest decline, with an overall initial increase and then a decline in interviewing skills over the four years. Explanations for these findings include the de-emphasis of communication skills during the clinical years and the culture of medicine to which students are exposed during these years.
近年来，医学观念逐渐向更加人文主义的方向转变。随着这种转变，医学教育工作者试图将问诊和沟通技巧纳入医学课程。本研究评估了一门强调问诊技巧的临床医学课程的效果。1992年至1994年期间，康涅狄格大学医学院的292名毕业生在医学院的四年中参加了五个临床技能教学和评估项目。在这五个项目的每个项目中，学生的问诊技巧都使用亚利桑那临床问诊评分量表（ACIR）进行评分。评分者是他们刚刚完成一次医疗问诊的标准化病人。结果显示，学生技能的发展存在差异，结束项目的提升最大，社会史项目的下降最大，在这四年中，问诊技巧总体上先是上升然后下降。这些发现的解释包括临床阶段对沟通技巧的不重视以及学生在这些年所接触的医学文化。
