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使用家庭会议模拟练习提高居民的沟通技巧
Lauryn Ando1,2, Brent Matsuda2,3, Travis Watai2,3
1Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, Hawaii, USA.
The clinical teacher
|April 23, 2025
概括
这项研究提高了居民传递坏消息的能力. 模拟和讲座显著提高了沟通技巧和领导家庭会议的信心.
科学领域:
- 医学教育 医学教育
- 沟通技巧培训 培训 沟通技巧培训
- 患者与医生的沟通 患者与医生的沟通
背景情况:
- 有效的沟通对于向患者和家人传递严重的新闻至关重要.
- 医疗人员需要提高敏感讨论的技能,特别是在重症监护机构.
- 科尔布的体验式学习理论为发展沟通能力提供了一个框架.
研究的目的:
- 评估基于模拟的课程对居民的沟通技巧和对传递坏消息的信心的影响.
- 通过使用科尔布的体验式学习理论来评估小型讲座和模拟干预的有效性.
- 为了提高居民在医疗重症监护室 (MICU) 轮换期间进行家庭会议的能力.
主要方法:
- 在MICU轮换期间,对26名内科住院医生进行了教育干预.
- 住户参与了一个模拟的家庭会议 (迷你临床评估练习 - 迷你CEX),使用未经训练的参与者和SPIKES协议评估工具.
- 发表了关于SPIKES协议的30分钟互动讲座,随后进行了教学后的Mini-CEX和干预前/后舒适度调查.
主要成果:
- 住户报告说,在干预后,在促进终身家庭聚会方面,舒适度显著增加 (p < 0.001).
- 迷你CEX得分显示,所有20个SPIKES项目都显著改善 (p < 0.001),整体得分显著增加 (24.7至46.1,p < 0.001).
- 国际医学毕业生 (IMG) 和美国医学毕业生 (USMG) 在所有SPIKES组件中都表现出显著的得分改善.
结论:
- 模拟家庭会议和关于SPIKES协议的简短教学讲座的组合有效地提高了居民的技能和信心.
- 干预成功地提高了居民在领导家庭会议讨论方面的能力,这是医疗护理的关键方面.
- 这种以体验式学习为基础的教育方法为研究生医学培训中沟通技能的发展提供了有价值的模型.
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