Does patient feedback improve the consultation skills of general practice trainees? A controlled trial
Does patient feedback improve the consultation skills of general practice trainees? A controlled trial
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DOI：
10.1111/j.1365-2923.2009.03569.x
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发表时间：
2010-02-01
影响因子：
6
通讯作者：
van Marwijk, Harm W. J.
中科院分区：
文献类型：
--
作者：
Reinders, Marcel E.;Blankenstein, Annette H.;van Marwijk, Harm W. J.
背景本研究旨在评估是否额外的患者反馈培训计划导致更好的咨询技能，在全科实习生（GPT）比定期沟通技巧培训，以及过程测量是否方法：我们进行了一项对照试验，其中两个小组的GPT被分配到一个干预组（n = 23）对照组（n = 30）。在2006年，分配在VU大学医学中心的一年级GPT参加了病人反馈培训方案，除了定期的沟通技巧培训。对照组只参加常规的沟通技巧训练。受训者进行了评估，模拟病人参观的做法，并在基线和3个月后的咨询录像。录像带被随机分配给8名受过训练的工作人员。MAAS-全球工具（0-6级）用于评估受训者的咨询技能（变化）。结果采用多水平线性混合模型进行分析。干预组和对照组的GPT都提高了他们的咨询技能：所有参与者的平均MAAS-Global评分在基线时为3.29（标准差[SD] 0.75），在随访时为3.54（SD 0.66）（P = 0.047）。干预组的MAAS-Global评分的改善与对照组的改善没有显著差异。分析表明，在病人的反馈计划，以预测更大的改善MAAS-全球scores. Discussion的参与强度的趋势，虽然基线分数已经在高范围内，在两组的咨询技能显着改善。这对目前的教学方法来说是令人放心的。病人反馈方案并没有比常规沟通技能培训更能提高咨询技能。然而，与积极性较低的分组相比，密集参加方案的一个分组的一般专业技术人员确实进一步提高了他们的咨询技能。
CONTEXT This study aimed to assess if an additional patient feedback training programme leads to better consultation skills in general practice trainees (GPTs) than regular communication skills training, and whether process measurements (intensity of participation in the programme) predict the effect of the intervention.METHODS We carried out a controlled trial in which two sub-cohorts of GPTs were allocated to an intervention group (n = 23) or a control group (n = 30), respectively. In 2006, allocated first-year GPTs in the VU University Medical Centre attended a patient feedback training programme in addition to the regular communication skills training. The control group attended only regular communication skills training. Trainees were assessed by simulated patients who visited the practices and videotaped the consultations at baseline and after 3 months. The videotapes were randomly assigned to eight trained staff members. The MAAS-Global Instrument (range 0-6) was used to assess (a change in) trainee consultation skills. Results were analysed using a multi-level, linear mixed-model analysis.RESULTS Data on 50 GPTs were available for the follow-up analysis. Both intervention group and control group GPTs improved their consultation skills: mean MAAS-Global scores for all participants were 3.29 (standard deviation [SD] 0.75) at baseline and 3.54 (SD 0.66) at follow-up (P = 0.047). The improvement in MAAS-Global scores in the intervention group did not differ significantly from the improvement in the control group. The analysis showed a trend for intensity of participation in the patient feedback programme to predict greater improvement in MAAS-Global scores.DISCUSSION Although the baseline scores were already in the high range, consultation skills in both groups improved significantly. This is reassuring for current teaching methods. The patient feedback programme did not improve consultation skills more than regular communication skills training. However, a subgroup of GPTs who participated intensively in the programme did improve their consultation skills further in comparison with the less motivated subgroup.