How to optimize physicians' communication skills in cancer care: Results of a randomized study assessing the usefulness of posttraining consolidation workshops
How to optimize physicians' communication skills in cancer care: Results of a randomized study assessing the usefulness of posttraining consolidation workshops
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DOI：
10.1200/jco.2003.08.031
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发表时间：
2003-08-15
影响因子：
45.3
通讯作者：
Delvaux, N
中科院分区：
文献类型：
--
作者：
Razavi, D;Merckaert, I;Delvaux, N
目的：虽然有广泛的认识，提高医生的沟通技巧的有用性，还没有研究评估培训后巩固讲习班的疗效。本研究旨在评估6个3小时的巩固车间进行后，2.5天的基本training program.Methods：医生，参加了基本的培训计划，被随机分配到巩固车间或等候名单的疗效。通过模拟和实际患者访谈评估培训效果，这些访谈在基线时和巩固研讨会后对巩固研讨会组进行录音，以及在等待名单组基础培训结束后约5个月进行录音。根据癌症研究运动研讨会评估手册评估沟通技巧。患者的沟通技巧的改善的看法进行了评估，使用14项questionnaire.Results：63名医生完成了培训计划。与等待名单组相比，巩固研讨会组的沟通技巧得到了更大的改善。在模拟访谈中，按时间分组的重复测量方差分析显示，开放式和开放式指导性问题（P = 0.014）和提醒患者注意现实的话语（P = 0.049）显著增加，过早保证（P = 0.042）显著减少。在实际的病人访谈中，结果显示，在表达（P = 0.022）和移情陈述（P = 0.009），在有根据的猜测（P = 0.041）和谈判（P = 0.008）中有显著增加。与医生谁受益于巩固研讨会的患者互动报告较高的分数关于他们的医生对他们的疾病的理解（P =.004）。结论：巩固研讨会进一步提高了沟通技巧培训计划的有效性，并促进转让所获得的技能，临床实践。
Purpose: Although there is wide recognition of the usefulness of improving physicians' communication skills, no studies have yet assessed the efficacy of post-training consolidation workshops. This study aims to assess the efficacy of six 3-hour consolidation workshops conducted after a 2.5-day basic training program.Methods: Physicians, after attending the basic training program, were randomly assigned to consolidation workshops or to a waiting list. Training efficacy was assessed through simulated and actual patient interviews that were audiotaped at baseline and after consolidation workshops for the consolidation-workshop group, and approximately 5 months after the end of basic training for the waiting-list group. Communication skills were assessed according to the Cancer Research Campaign Workshop Evaluation Manual. Patients' perceptions of communication skills improvement were assessed using a 14-item questionnaire.Results : Sixty-three physicians completed the training program. Communication skills improved significantly more in the consolidation-workshop group compared with the waiting-list group. In simulated interviews, group-by-time repeated measures analysis of variance showed a significant increase in open and open directive questions (P =.014) and utterances alerting patients to reality (P =.049), as well as a significant decrease in premature reassurance (P =.042). In actual patient interviews, results revealed a significant increase in acknowledgments (P =.022) and empathic statements (P =.009), in educated guesses (P =.041), and in negotiations (P =.008). Patients interacting with physicians who benefited from consolidation workshops reported higher scores concerning their physicians' understanding of their disease (P =.004).Conclusion: Consolidation workshops further improve a communication skills training program's efficacy and facilitate the transfer of acquired skills to clinical practice.