Training residents in patient-centred communication and empathy: evaluation from patients, observers and residents
Training residents in patient-centred communication and empathy: evaluation from patients, observers and residents
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DOI：
10.1186/s12909-019-1555-5
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发表时间：
2019-05-02
影响因子：
3.6
通讯作者：
Hartman, T. C. olde
中科院分区：
文献类型：
--
作者：
Noordman, J.;Post, B.;Hartman, T. C. olde
背景以病人为中心的沟通和同情是以病人为中心的护理的关键推动因素。然而，一些研究表明，在医疗住院期间，医生的共情沟通技能呈下降趋势。众所周知，沟通培训可以对以患者为中心的沟通，同情和关系技能产生积极影响。培训居民以病人为中心的沟通和同情可以是一个机会，以改善以病人为中心的护理。为了评估培训的三焦点的角度来看，将used.MethodsA为期3天的培训，以提高居民的以病人为中心的沟通和同情心的技能，在学术医疗健康中心，在荷兰。培训内容包括：（1）以患者为中心的沟通和同情的基础知识（通过演讲，科学文献），（2）与演员一起练习，（3）反思居民的视频记录咨询（由他们自己和沟通专家）。进行了一项具有前后设计的试点研究，以从患者和观察者的角度评估培训。半结构式访谈被用来深入了解居民的观点。来自不同专业的9名住院医师接受了培训并参加了试点研究。在两个随机的日子里，居民和病人之间的磋商被录像记录下来。病人被要求填写两份问卷，表明他们对居民的同情心和沟通技巧的看法之前和之后的咨询。所有视频记录的咨询都被编码，以评价居民的沟通技巧，同情心，电脑使用和厕所设置。采用多水平分析进行统计分析。ResultsA共137名符合条件的患者参加了试点研究。经过培训的住院医师在患者评价的同理心得分方面表现出显著的改善。据观察员说，培训后居民的电脑使用情况有了明显改善。经过培训的住院医师的沟通技能没有显著提高。居民的议程设置呈下降趋势。几乎所有的居民都很满意的培训，特别是与video-feedback.ConclusionsA简短的培训显着增加居民的同理心分数，根据患者和显着减少居民的电脑使用，根据观察员。这些研究结果表明，以病人为中心的护理质量可以提高，通过整合以病人为中心的沟通到住院医师计划，在学术医疗健康中心。最终目标是将培训从结构上嵌入住院医师教育计划中。
BackgroundPatient-centred communication and empathy are key enablers for patient-centred care. However, several studies suggest a downward trend regarding the empathic communication skills of physicians during medical residency. It is known that communication training can have a positive effect on patient-centred communication, empathy and relational skills. Training residents in patient-centred communication and empathy can be an opportunity to improve the patient-centred care. To evaluate the training a tri-focal perspective will be used.MethodsA 3-day training was developed to improve residents' patient-centred communication and empathy skills at an academic medical health centre, in the Netherlands. The training included: (1) the basics of patient-centred communication and empathy (through presentations, scientific literature), (2) practicing with actors, and (3) reflecting on residents' video recorded consultations (by themselves and communication experts). A pilot study with a pre-post design was conducted to evaluate the training from patient and observer perspectives. Semi-structured interviews were used to get insight into residents' perspective. Nine residents from different specialities followed the training and enrolled in the pilot study. During two random days consultations between residents and patients were video recorded. Patients were asked to fill in two questionnaires, indicating their perspective on residents' empathy and communication skills before as well as after the consultation. All video recorded consultations were coded to rate residents' communication skills, empathy, computer use and agenda-setting. Statistical analysis were performed using multilevel analysis.ResultsA total of 137 eligible patients took part in the pilot study. Trained residents showed significant improvement in patient-rated empathy scores. According to observers, residents' computer use improved significantly after the training. The communication skills of trained residents did not improve significantly. Agenda setting by residents showed a downward trend. Almost all residents were satisfied with the training, especially with the video-feedback.ConclusionsA brief training significantly increased residents' empathy scores according to patients and significantly decreased residents' computer use according to observers. These findings indicate that the quality of patient-centred care can be improved by integrating patient-centred communication into residency programs, at an academic medical health centre. The ultimate goal is to structurally embed the training in residents' education program.