Training Clinicians with Communication Skills Needed to Match Medical Treatments to Patient Values
Training Clinicians with Communication Skills Needed to Match Medical Treatments to Patient Values
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DOI：
10.1111/jgs.15709
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发表时间：
2019-05-01
影响因子：
6.3
通讯作者：
Meier, Diane E.
中科院分区：
文献类型：
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作者：
Back, Anthony L.;Fromme, Erik K.;Meier, Diane E.
大多数临床医生目前在实践中没有接受循证沟通技能培训，他们需要提供高质量的沟通，为重病的老年人和他们的家人。临床医生的沟通技巧是实现患者和家人了解他们的疾病的关键因素，使他们能够分享决策，这将导致与他们的目标和价值观相一致的医疗和社会支持。研究表明，现有的临床医生沟通技能的能力是非常可变的，大多数临床医生需要特定的沟通培训，有足够的技能水平，并以证据为基础的培训是有效的。一项保守的估计表明，超过219，000名医生和高级实践提供者（APP）（50%的医生在高接触次专业和25%的所有APP）可以从培训中受益。将循证临床医生培训与卫生系统工作流程重新设计相结合，可能会最大限度地发挥这种培训的影响。最后，我们提出了一些建议，旨在通过有效的培训和卫生系统改革来解决沟通技能方面的差距，使所有严重疾病患者及其家属能够获得与其个人优先事项相一致的护理。J Am Geriatr Soc 67：S435-S441，2019.
Most clinicians currently in practice did not receive the evidence-based communication skills training they need to provide high-quality communication for seriously ill older adults and their families. Clinician communication skills are a critical factor in achieving a patient and family understanding of their illness that enables them to share in decision making that will result in medical treatments and social supports that are aligned with their goals and values. Research demonstrates that existing clinician competence in communication skills is extremely variable, that most clinicians need specific communication training to have an adequate level of skill, and that evidence-based training is efficacious. A conservative estimate suggests that more than 219,000 physicians and advance practice providers (APPs) (50% of physicians in high-contact subspecialties and 25% of all APPs) could benefit from training. Combining evidence-based clinician training with health system workflow redesign would likely maximize the impact of this training. We conclude with recommendations designed to address gaps in communication skills through effective training and health system changes in the service of enabling all patients with serious illness and their families to receive care aligned with their personal priorities. J Am Geriatr Soc 67:S435-S441, 2019.