Efficacy of communication skills training for giving bad news and discussing transitions to palliative care
Efficacy of communication skills training for giving bad news and discussing transitions to palliative care
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DOI：
10.1001/archinte.167.5.453
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发表时间：
2007-03-12
影响因子：
--
通讯作者：
Tulsky, James A.
中科院分区：
文献类型：
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作者：
Back, Anthony L.;Arnold, Robert M.;Tulsky, James A.
背景：很少有研究从行为层面评估沟通技能培训对研究生内科实习生的效果。我们为医学肿瘤学研究员设计了一个住宅沟通技能研讨会(Oncotalk)。干预设计建立在现有成功模式的基础上，通过教授特定的沟通任务与患者的疾病轨迹相联系。本研究评估了Oncotalk在改变可观察到的沟通行为方面的效果。方法：Oncotalk是一个为期4天的住宅工作坊，强调小组中的技能练习。这项干预前和干预后队列研究在为期3年的研究中涉及来自62个不同机构的115名肿瘤内科研究员。主要结果是可观察到的参与者沟通技能，在研讨会前后的标准化患者会面中进行测量，给出坏消息并讨论向姑息治疗的过渡。盲编码员使用有效的编码系统对标准化的患者会面进行录音和评估。结果：与研讨会前标准化的患者接触相比，研讨会后接触显示参与者平均获得5.4个坏消息技能(P
Background: Few studies have assessed the efficacy of communication skills training for postgraduate physician trainees at the level of behaviors. We designed a residential communication skills workshop (Oncotalk) for medical oncology fellows. The intervention design built on existing successful models by teaching specific communication tasks linked to the patient's trajectory of illness. This study evaluated the efficacy of Oncotalk in changing observable communication behaviors.Methods: Oncotalk was a 4-day residential workshop emphasizing skills practice in small groups. This preintervention and postintervention cohort study involved 115 medical oncology fellows from 62 different institutions during a 3-year study. The primary outcomes were observable participant communication skills measured during standardized patient encounters before and after the workshop in giving bad news and discussing transitions to palliative care. The standardized patient encounters were audiorecorded and assessed by blinded coders using a validated coding system. Before-after comparisons were made using each participant as his or her own control.Results: Compared with preworkshop standardized patient encounters, postworkshop encounters showed that participants acquired a mean of 5.4 bad news skills (P