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1.
《Patient education and counseling》2019,102(6):1104-1110
ObjectiveTo assess the effectiveness of a brief training program in relational/communication skills (RCS) for medical residents.MethodsThis longitudinal study enrolled 64 medical residents who participated in a RCS training program in small groups. Teaching was based on interviews with standardized patients and reflective practice. Video-recorded consultations were coded according to the Verona-Coding-Definitions-of-Emotional-Sequences (VR-CoDES) and a coding system developed to assess ten communication skills for breaking bad news. The outcome measures were: independent raters’ score in RCS for breaking bad news and the percentage of providing space and empathic responses, by comparing baseline (T1) skills with those after three-days (T2) and three-months (T3).ResultsAfter the training program residents provided more space for further disclosure of cues and concerns according to VR-CoDES definitions. There were significant improvements in seven of the ten communication skills for breaking bad news. All of these improvements were observed either at T2 or at T3.ConclusionThis study demonstrates the effectiveness of a brief RCS training program designed to improve medical residents’ ability to respond appropriately to patients’ cues and concerns and to conduct a breaking bad news encounter.Practice implicationsBrief RCS training programs adopting multiple approaches, should be offered as mandatory during residency programs. 相似文献
2.
《Patient education and counseling》2020,103(11):2384-2387
ObjectiveThis study explores whether an Experiential Training Programme (ETP) in communication skills (CS) improves students' ability to identify patients clues compared to those who follow a non-experiential training throughout their medical studies.MethodIntervention Group (IG): 85 4th-year medical students who received the ETP and Control Group (CG): 67 recently graduated students who did not receive it. Their immediate (written) response was requested to three expressions offered by patients containing communicative clues. The answers were grouped into 2 categories: Clue recognised and response patient-centred and the opposite. Three researchers analysed the answers.ResultsResponses 366 (65 from the CG and 77 from the IG): 280 did not recognise clues: 131 (62%) in IG and 149 (96%) in CG and 86 recognised them: 80 (37.9%) in IG and 6 (3.9%) in CG (p = 0.000). Some clues were more elusive than others (p = 0,003).ConclusionsThe students who received the ETP in CS showed greater ability to explore patients perspective taking advantage of different types of communicative clues than those who did not receive it in a non-relational context.Practice implicationsFurther research is needed to assess whether this ability is maintained in simulated or real clinical situations. 相似文献
3.
Background
Patients provide emotional cues during consultations which may be verbal or non-verbal. Many studies focus on patient verbal cues as predictors of physicians' ability to recognize and address patient needs but this project focused on non-verbal cues in the form of facial micro-expressions. This pilot study investigated first year medical students' (n = 75) identified as being either good or poor communicators abilities to detect emotional micro-expressions before and after training using the Micro Expression Training Tool (METT) . 相似文献4.
The process of AIDS education poses exceptional challenges for teachers and students. Medical students are in a unique position in the health care system. They are young enough to be ideal role models for high school and college students. They are mature enough to be responsible educators. We describe a special program designed and implemented by a medical student to train other medical students to become AIDS educators. This student-run program provides education for student volunteers who are able to educate other students and members of the community. The program is designed to educate a generation of physicians who will be well-equipped to combat the HIV epidemic and who can serve the community as AIDS educators while still in medical school. 相似文献
5.
The education of residents and medical students in ambulatory care settings continues to play a greater role in medical education than was the case even a few years ago. This report documents the use of college health services, commonly called student health centers, at California institutions of higher education, as training sites for residents and medical students in 1988. Directors of residency programs that had used student health centers for their residents reported that they were pleased with the association. The directors of student health centers that had had residents on educational rotations also reported a high level of overall satisfaction. Student health centers represent an untapped resource, as only 20% of such centers in California were being used to train residents at the time of this study. 相似文献
6.
Thirty-four medical residents at a hospital serving a predominantly black inner-city area were trained to counsel their patients to quit smoking. They were tested before the training session and again 4 months later with questionnaires assessing smoking knowledge, attitude, and clinical practice. The training consisted of two 1-hour lectures, printed materials, and a 1.5-hour Objective Simulated Clinical Exam. Most of the residents were males (88.2%), in internal medicine (87.5%), under the age of 35 (79.4%), and foreign-born (76.5%). Asians (44.1%) comprised the largest racial group, followed by whites (29.4%) and blacks (20.6%). The impact of the training was assessed by comparing the pre- and posttests using paired Student''s t tests. Overall score increased from 69.3 to 89.1 (P = .0001) out of a maximum of 131. Scores increased significantly for attitudes and beliefs (38 to 52; P = .0001), knowledge (5.3 to 6.6; P = .0001), and usual practices with smoking patients (25 to 30; P = .002). These data provide evidence that training increased the confidence, motivation, and reported practice of these residents in intervening with their patients, the majority of whom are black. This has special significance because physicians are least likely to advise black patients and those in lower socioeconomic groups to quit smoking. The demographic profile of our residents is characteristic of many inner-city hospitals. 相似文献
7.
Objective
The model of expert performance predicts that neither physicians in training nor experienced physicians will reach an expert level in communication. This study tested this hypothesis.Methods
Seventy-one students, twenty-five residents and fourteen consultants performed a ‘breaking bad news’ exercise with a simulated patient. Their communication competency was assessed with the CELI instrument. Actor assessments were also obtained. The differences in communication competency between students, residents and consultants were established.Results
The mean performance scores ranged from bad to adequate. An expert level of performance was seldom reached. Novice students scored lower than the other groups in their competency and in the actor assessment. First-year students scored lower than the consultants in their competency and in the actor assessment. No differences in performance were found between third-year students, interns, residents and consultants.Conclusion
Students acquire a ‘satisfactory’ level of communication competency early in the curriculum. Communication courses in the curriculum do not enhance this level. Clinical experience has also a limited effect.Practice implications
The learning conditions for deliberate practice must be fulfilled in medical curricula and in postgraduate training in order to provide medical students and physicians the opportunity to attain an expert level in communication. 相似文献8.
Antoine Chéret Christine Durier Nicolas Noël Katia Bourdic Chantal Legrand Catherine D’Andréa Evelyne Hem Cécile Goujard Patrick Berthiaume Silla M. Consoli 《Patient education and counseling》2018,101(11):1934-1941
Objective
To evaluate the impact of brief training in motivational interviewing (MI) from a non-specialist professional for medical students.Methods
Students (n?=?20) received three four-hour sessions of MI training over one week. They interviewed caregivers acting as patients in two standardised medical situations, six weeks before and three weeks after training. Global scores from the MITI-3.1.1 code, including “MI- Spirit”, were attributed to the audiotaped interviews by two independent coders, blind the pre- or post-training status of the interview. Secondary outcomes were: caregivers’ perception of students’ empathy (CARE questionnaire), students’ evaluation of self-efficacy to engage in a patient-centred relationship (SEPCQ score), and students’ satisfaction with their own performance (analogue scale).Results
MI-Spirit score increased significantly after training (p?<?0.0001, effect size 1.5). Limited improvements in CARE score (p?=?0.034, effect size 0.5) and one of the SEPCQ dimensions (sharing information and power with the patient; p?=?0.047, effect size 0.5) were also noted. Students’ satisfaction score was unaffected (p?=?0.69).Conclusion
These findings suggest that brief MI training can improve communication skills in medical students.Practice implications
Such an intervention is feasible and could be generalised during medical studies. 相似文献9.
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11.
Jamie A. Green Alda Maria Gonzaga Elan D. Cohen Carla L. Spagnoletti 《Patient education and counseling》2014
Objective
To develop, pilot, and test the effectiveness of a clear health communication curriculum to improve resident knowledge, attitudes, and skills regarding health literacy.Methods
Thirty-one internal medicine residents participated in a small group curriculum that included didactic teaching, practice with a standardized patient, and individualized feedback on videotaped encounters with real patients. Outcomes were assessed using a pre-post survey and a communication skills checklist.Results
Mean knowledge scores increased significantly from 60.3% to 77.6% (p < 0.001). Residents also reported increased familiarity with the concept of health literacy (mean response 3.2 vs. 4.5 on a 5 point scale), importance placed on health literacy (4.2 vs. 4.9), frequency of considering health literacy in patient care (3.3 vs. 4.0), and confidence in communicating with low literacy patients (3.3 vs. 4.1) (all p < 0.001). Use of plain language increased significantly from 33% to 86% (p = 0.023). There were nonsignificant increases in the use of teach-back (0–36%, p = 0.116) and encouraging questions (0–14%, p = 0.502).Conclusion
Training in clear health communication improves resident knowledge, attitudes, and skills regarding health literacy.Practice implications
The increased use of clear health communication techniques can significantly improve the care and outcomes of vulnerable patients with limited health literacy. 相似文献12.
J-L Wautier J-J Cabaud J-P Cazenave P Fialon M-F Fruchart M Joussemet V Leblond J-Y Muller P Rouger D Vignon C Waller J-J Lefrère B Worms F Vileyn 《Transfusion Clinique et Biologique》2005,12(1):59-69
In France, transfusion medicine training program has been updated. A national committee of professors in transfusion medicine propose a series of 13 items which represent the minimum knowledge that general practitioners should possess. This overview of transfusion medicine is far below the level that specialists should reach and they will need an additional specialized training. Several French universities have set up their own training program which is quite similar to the work of the committee of professors. The following recommendations are not strict guidelines but is a common basis which will be improved in 2005 according to new evidence based transfusion medicine. 相似文献
13.
T. R. Brooks 《Journal of the National Medical Association》1993,85(1):61-64
The federal government, as well as teaching institutions, are concerned about the current negative attitudes of doctors, medical students, and paramedical personnel toward the elderly. Increased life expectancy at birth and lowered birth rates are changing the demographics of America. As the number of elderly citizens increases, greater demands are being placed on medical educators to train physicians who can meet the "geriatric imperative." The Institute of Medicine has recommended that comprehensive humanistic medical education in geriatrics be integrated throughout the curricula of medical schools. Research is needed to see if change can be implemented in physician training to improve attitudes toward the elderly. Previous attempts to improve medical students'' attitudes toward the elderly have met with mixed success. Control groups have seldom been used. It is important to determine whether the effects of medical education extends beyond the immediate boundaries of a training curriculum. This article reports the results of a study on negative attitudes toward the elderly among residents, medical students, and physician''s assistant students in the family medicine department at the King/Drew Medical Center in Los Angeles, California. 相似文献
14.
Solomon M Shapiro William J Lancee Christopher M Richards-Bentley 《BMC medical education》2009,9(1):11-8
Background
Effective doctor-patient communication has been linked to numerous benefits for both patient and physician. The purpose of this study was to evaluate the effectiveness of the University of Toronto's Therapeutic Communication Program (TCom) at improving first-year medical students' communication skills. 相似文献15.
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17.
Although delivering bad news is something that occurs daily in most medical practices, the majority of clinicians have not received formal training in this essential and important communication task. A variety of models are currently being used in medical education to teach skills for delivering bad news. The goals of this article are (1) to describe these available models, including their advantages and disadvantages and evaluations of their effectiveness; and (2) to serve as a guide to medical educators who are initiating or refining curriculum for medical students and residents. Based on a review of the literature and the authors' own experiences, they conclude that curricular efforts to teach these skills should include multiple sessions and opportunities for demonstration, reflection, discussion, practice, and feedback. 相似文献
18.
Silva CS Souza MB Silva Filho RS Medeiros LM Criado PR 《Clinics (S?o Paulo, Brazil)》2011,66(4):619-622
INTRODUCTION:
Dermatological disorders are common in medical practice. In medical school, however, the time devoted to teaching dermatology is usually very limited. Therefore, online educational systems have increasingly been used in medical education settings to enhance exposure to dermatology.OBJECTIVE:
The present study was designed to develop an e-learning program for medical students in dermatology and evaluate the impact of this program on learning.METHODS:
This prospective study included second year medical students at the University of Technology and Science, Salvador, Brazil. All students attended discussion seminars and practical activities, and half of the students had adjunct online seminars (blended learning). Tests were given to all students before and after the courses, and test scores were evaluated.RESULTS:
Students who participated in online discussions associated with face-to-face activities (blended learning) had significantly higher posttest scores (9.0±0.8) than those who only participated in classes (7.75±1.8, p <0.01).CONCLUSIONS:
The results indicate that an associated online course might improve the learning of medical students in dermatology. 相似文献19.
20.
As integral members of the mental health or human service team, receptionists and secretaries can do a great deal to facilitate the helping process. This paper evaluates a training program designed to increase the communication skills of receptionists and secretaries. Participants in the full-day workshop gave the training experience high ratings, demonstrated significantly higher levels of communication skills than a comparison group, and reported using the skills in their actual work settings. 相似文献