应用临床教学五步法进行形成性评价提升住院医师医患沟通能力  

Formative assessment with 5-microskills promotes residents competency of patient-physician communication

作　　者：冯黎[1] 周鸿雁[1] 申存周 赖蓉[1] 王海燕[1] 孙逊沙 冯慧宇[1] Feng Li;Zhou Hongyan;Shen Cunzhou;Lai Rong;Wang Haiyan;Sun Xunsha;Feng Huiyu(Department of Neurology,the First Affiliated Hospital,Sun Yat-sen University,Guangdong Provincial Key Laboratory of Diagnosis and Treatment of Major Neurological Diseases,National Key Clinical Department and Key Discipline of Neurology,Guangzhou 510080,Guangdong,China)

机构地区：[1]中山大学附属第一医院神经科,广东省重大神经疾病诊治研究重点实验室,国家临床重点专科和国家重点学科,广东广州510080

出　　处：《中国毕业后医学教育》2024年第1期67-70,共4页Chinese Journal of Graduate Medical Education

基　　金：中华医学会医学教育分会和中国高等教育学会医学教育专业委员会2020年医学教育研究立项课题(2020B-N02350);中山大学附属第一医院毕业后医学教育教学改革课题项目(B202202)。

摘　　要：目的研究应用临床教学五步法进行形成性评价提升住院医师医患沟通能力。方法采用自身对照的队列研究方法,由参与研究的指导医师对自愿纳入研究的住院医师进行5次关于医患沟通技能的形成性评价,每次均应用临床教学五步法进行反馈指导。对形成性评价前后住院医师的自评和他评结果进行对比分析。结果21名住院医师纳入研究。第5次形成性评价得分(90.00±2.47)分与第1次得分(61.24±9.86)分相比,差异有统计学意义(P<0.01)。18名住院医师完成自评问卷,结果提示,应用临床教学五步法进行形成性评价后,住院医师更注意在沟通前了解患方的社会文化背景,并据此拟定不同沟通策略。在沟通中,住院医师更注意观察患者的表情和语气的变化,主动询问患者的理解程度、治疗期望和意愿(P<0.05)。结论应用教学五步法进行形成性评价可有效提升住院医师医患沟通能力。Objective This study aimed to promote the residents'competence in physician-patient communication by applying the five-microskills in formative assessment.Methods The study was a self-control pilot study.The enrolled residents received formative assessment with 5-microskills for 5 rotations.The scores of communication competence of each assessment were compared and analyzed.Results 21 residents were enrolled.Compared with the total score of the first assessment,the score was significantly elevated after 5 formative assessments[(61.24±9.86)points vs(90±2.47)points,P<0.001].18 residents completed the questionnaire.It was suggested that the formative assessment with 5-microskills facilitated the residents to pay more attention to the socio-cultural background and fix strategy accordingly before communication.Additionally,the residents paid more attention to patients'face and tone,the interpretation,expectation and treatment will during communication after five formative assessments with 5-microskills(P<0.05).Conclusions The formative assessment with 5-microskills can effectively promote the communication competence of residents.

关 键 词：形成性评价 临床教学五步法 医患沟通 胜任力 住院医师规范化培训 

分 类 号：G40-034[文化科学—教育学原理] R4[文化科学—教育学]