提高医学生医患沟通能力之我见

医患关系是以医疗职业为基础，道德为核心，法律为准绳，并在医疗实践活动中产生和发展的一种人际关系，是医疗人际关系中最主要的一种关系。加强学习与病人沟通的艺术，改善与患者沟通的技巧与策略，是建立良好医患关系，减少医疗纠纷的关键。近几年我国的高等教育迅速发展，高等医学教育也随之进入发展的快车道，社会对医学人才的培养质量也提出了更高的标准。如何提高医学生医患沟通能力，引导、培养医学生建立和谐的医患关系，成为摆在我们面前的一项刻不容缓的课题。     

我院医学生医患沟通能力培养初探

基于当前医患关系以及目前医学生人际沟通能力的现状,探讨了临床实习中加强医患沟通的目的、意义及沟通技能培养的方法,为开展医学生实践教育提供有针对性、可操作性强的对策,为实现有效的医患交流提出r合理建议。     

关于医学生医患沟通能力培养的探索

医患关系矛盾日益加剧,如何教育医学类学生与病人进行良好的沟通还相对滞后,加大这方面的培养是缓解矛盾的重要一环.该文从夯实专业知识,提高人文修养,优化课程结构等方面提出了加强医学生医患沟通能力培养的具体方法.     

如何培养与提高医学生的医患沟通能力

目前我国的高等医学教育只注重医学专业知识和技能的掌握,而对医患沟通能力的培养重视不够。本文通过分析医学生的医患沟通能力培养的重要性和必要性,提出加强医学生医患沟通能力培养的主要途径与措施,以达到提高医学生医患沟通能力培养的教学目标。     

教学中应渗透对医学生医患沟通能力的培养

医学是一门理论性和实践性都很强的学科,精湛的医疗技术必不可少,但良好的医患沟通也是保证临床治疗成功的前提。我国的医学教育普遍缺乏关于医患沟通方面的教育,医学生毕业后往往出现此项意识和能力的缺失。本文探讨了医患沟通教育的必要性,提出了在对医学生的教学过程中如何加强和渗透医患沟通能力培养教育,从而提高医学生的医学技能和人文素养,规避医疗风险,减少医患纠纷。     

医学生医患沟通能力培养研究

【摘要】 目的 了解医学生医患沟通能力培养的现状和存在的主要问题,提出医患沟通能力培养途径的建议。方法 文献法和问卷调查法,自制调查表对沈阳医学院临床医学专业大一至大五的学生各年级抽200人进行抽样调查。 结果 绝大多数医学生认为非常有必要加强医患沟通能力培养,然而在实际学习中,大部分学生没有参加过有关培养医患沟通能力培养的活动,学生接受的医患沟通能力培养方式主要是通过相关课程,大部分学生认为有效提高医患沟通能力的方式是临床带教及假期社会实践等方式。结论 医学生医患沟通意识较强,但自主参加实践的行动弱,学校对医患沟通能力的培养有待加强,医学生可以通过角色模拟练习、假期社会实践及临床带教等方式提高医患沟通能力。     

建立医学生医患沟通能力培养体系研究初探

本文通过分析建立医学生医患沟通能力培养体系的重要性和国外先进的培养经验，探索制定一个全面、系统、可操作性强的医学生医患沟通能力规范化培养的指标体系，作为培养、评价医学生医患沟通能力的工具，用于医学生医患沟通能力的规范化培养，以提高医学生的医患沟通能力。     

在教学实践中提高医学生医患沟通能力

在我国医疗卫生事业改革不断发展的同时,临床教学工作也在努力探索之中。医学教育不仅要将学生培养成为一名专业合格的医生,更要注重医学生的医患沟通能力的培养,以适应和面对当前国内医患矛盾紧张的形势。临床实习是医学生锻炼和提高自身沟通能力的重要时机,通过系统的沟通技能培训和临床实践运用,采用PBL教学、角色扮演、讨论总结等方式转变医学生思维模式,强化沟通意识,全面提高医学生临床诊疗能力,促进疾病治疗和技术进步,维护医患关系的稳定,保证医疗质量的提高和推动医疗事业的发展。     

结合内科学教学实际,培养医学生医患沟通能力

本文根据内科学的教学现状及教学特点,探讨如何在临床教学中加强对医学生医患沟通能力的培养,以适应现代医学教育模式转变及医疗工作的实际需要。     

儿科医学生医患沟通能力的培养

本文讲述了培养儿科医学生的医患沟通能力的重要性。提出通过树立信心,完成心理转变;加强专业学习;实践中强化医患沟通能力培训等几方面进行训练。     

Conversation analysis, doctor-patient interaction and medical communication

INTRODUCTION: This paper introduces medical educators to the field of conversation analysis (CA) and its contributions to the understanding of the doctor-patient relationship. THE CONVERSATION ANALYSIS APPROACH: Conversation analysis attempts to build bridges both to the ethnographic and the coding and quantitative studies of medical interviews, but examines the medical interview as an arena of naturally occurring interaction. This implies distinctive orientations and issues regarding the analysis of doctor-patient interaction. We discuss the CA approach by highlighting 5 basic features that are important to the enterprise, briefly illustrating each issue with a point from research on the medical interview. These features of conversation analytic theory and method imply a systematic approach to the organisation in interaction that distinguishes it from studies that rely on anecdote, ethnographic inquiry or the systematic coding of utterances. CONVERSATION ANALYSIS AND THE MEDICAL INTERVIEW: We then highlight recent CA studies of the "phases" of the internal medicine clinic and the implications of these studies for medical education. We conclude with suggestions for how to incorporate CA into the medical curriculum. It fits with biopsychosocial, patient-centred and relationship-centred approaches to teaching about medical communication.     

Learning in a problem-based medical curriculum: students' conceptions

The purpose of this study was to examine students' conception of their learning in a problem-based learning medical curriculum. A multiple case study design was used with two units of analyses: two PBL lab groups; and 15 individual students within each lab group. Data collected included weekly journals by students, video-tapes of PBL sessions, focus group interviews with students, two open-ended questionnaires completed by students, and interviews with the PBL tutors. Three thematic categories of students' conceptions of their learning emerged: (1) awareness of PBL goals and expectations; (2) efficiency and expertise; and (3) the role of the tutor.     

Use of student-centred, computer-mediated communication to enhance the medical school curriculum

OBJECTIVES: While it is clear that computers will play an important role in the study and practice of medicine their introduction into the curriculum remains controversial. Computer purchase has been made compulsory for incoming students. DESIGN: Members of the incoming class were allowed to purchase any computer and modem capable of using the communication program chosen by the school. No formal computer training was given. Students were encouraged to call for assistance or bring in their computers for configuration. The primary object of the system was for communication between the students and between students and faculty. SETTING: The School of Medicine of the University of New Mexico. SUBJECTS: First-year medical students. RESULTS: The vast majority of students set up their computers and connected to the system with little assistance. At the end of the first week of studies all the students were connected. Most of the students used the system on a daily basis. The greatest interest was in discussions concerning examinations with 93% of students reading these postings. The least-used aspect of the system was the exchange of learning issues from small group case discussions. Students also downloaded the curricular material provided but were discriminating in accessing this content. CONCLUSIONS: The student use of the computer as a communication tool has been a success. Students used the system in a variety of ways and by so doing also learned the basics of computer use and maintenance. The area of faculty training is often ignored but is considered crucial to the success of such a project.     

Medical students' perspective on the teaching of medical statistics in the undergraduate medical curriculum

Two undergraduate medical students at the University of Bristol commented on their experiences of learning medical statistics. In general, medical students' focus is on acquiring skills needed to practice clinical medicine, and great care must be taken to explain why disciplines such as statistics and epidemiology are relevant to this. Use of real examples and an emphasis on the need for evidence has meant that medical students are increasingly aware of the pressure on clinicians to justify their treatment decisions, and the associated need to be able to understand and critically appraise medical research. It was felt that medical statistics courses should focus on critical appraisal skills rather than on the ability to analyse data, which can be acquired by particular students when they need to do this. Medical statistics should be taught early in the curriculum, but there is a need to reinforce such skills throughout the course. Teaching and assessment methods should recognize that what is being taught is a practical skill of clinical relevance. This means that problem based small groups, data interpretation exercises and objective structured clinical examinations will be more productive than traditional teaching and examination methods.     

Impact of a new curriculum on medical students' interpersonal and interviewing skills

OBJECTIVES: In 1998 we reported on the rise and fall of medical student communication skills during the 4 years of medical school. Since then, the University of Connecticut School of Medicine has completed a major curriculum renewal project with an emphasis on early clinical work, lifelong learning and more ambulatory training. The goals of this study were to compare students' interviewing and interpersonal skills in standardised patient (SP) assessments in the old and new curricula and to assess the success of the new curriculum in preventing a decline in student skills in this domain. METHODS: The clinical skills of 202 students were measured longitudinally during encounters with SPs in each of their 4 years of medical school. Students in this study and the earlier study were evaluated using the Arizona Clinical Interviewing Rating (ACIR) Scale. RESULTS: Compared with students from the previous curriculum, students on the new curriculum in this study showed an improvement in ACIR scores. Year 1 mean ACIR scores (1 = poor to 5 = excellent) were, respectively, 3.6 for the old curriculum cohort and 4.0 for the new curriculum group. In Year 4 the mean score for the old curriculum cohort was 3.7 and that for the new curriculum group was 3.8. Students on the new curriculum still showed a decline in ACIR scores from Years 1 to 4, but it was not as severe a decline as it had been previously. CONCLUSIONS: Pre-clinical medical students perform better on measures of interpersonal communication than their clinical counterparts. The students who participated in the new curriculum demonstrated an earlier acquisition of and a less steep decline in interviewing and interpersonal skills during the course of medical school.