Communication Skills Training: Describing a New Conceptual Model
Communication Skills Training: Describing a New Conceptual Model
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DOI：
10.1097/acm.0b013e31815c631e
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发表时间：
2008-01-01
影响因子：
7.4
通讯作者：
Bylund, Carma L.
中科院分区：
文献类型：
--
作者：
Brown, Richard F.;Bylund, Carma L.
目前的研究在医患协商沟通是多学科和多方法。随着这项研究的进展，已经积累了大量关于医患沟通最佳实践的证据。这一证据为各级医学教育的沟通技能培训（CST）提供了基础。尽管CST文献已经证明沟通技能是可以教授的，但对这一文献的一个批评是，并不总是清楚哪些技能正在教授，以及这些技能是否与正在评估的技能相匹配。纪念斯隆-凯特琳癌症中心CST的Comskil模型试图通过明确定义咨询的重要组成部分来回答这些批评，该模型基于目标，计划，行为理论和社会语言学理论。顺序指南作为一种机制，用于教学有关特定的通信挑战是改编自这些其他方法。作者提出，咨询沟通可以由一个总体目标，这是通过使用一套预定的策略来实现。国家技术服务小组的战略是共同的;然而，战略往往包含嵌入式沟通技能，这些技能可以存在于战略中，Comskil模型试图使它们在这些背景下明确。与技能分开的是需要在教学中解决的过程任务和认知评价。作者还描述了评估实践如何通过仔细编码学员的沟通接触和直接反馈，促进所教授的技能和评估的技能之间的一致性。
Current research in communication in physician-patient consultations is multidisciplinary and multimethodological. As this research has progressed, a considerable body of evidence on the best practices in physician-patient communication has been amassed. This evidence provides a foundation for communication skills training (CST) at all levels of medical education. Although the CST literature has demonstrated that communication skills can be taught, one critique of this literature is that it is not always clear which skills are being taught and whether those skills are matched with those being assessed.The Memorial Sloan-Kettering Cancer Center Comskil Model for CST seeks to answer those critiques by explicitly defining the important components of a consultation, based on Goals, Plans, and Actions theories and sociolinguistic theory. Sequenced guidelines as a mechanism for teaching about particular communication challenges are adapted from these other methods. The authors propose that consultation communication can be guided by an overarching goal, which is achieved through the use of a set of predetermined strategies. Strategies are common in CST; however, strategies often contain embedded communication skills, These skills can exist across strategies, and the Comskil Model seeks to make them explicit in these contexts. Separate from the skills are process tasks and cognitive appraisals that need to be addressed in teaching. The authors also describe how assessment practices foster concordance between skills taught and those assessed through careful coding of trainees' communication encounters and direct feedback.