Communication skills curriculum for foreign medical graduates in an internal medicine residency program.
Communication skills curriculum for foreign medical graduates in an internal medicine residency program.
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DOI：
10.1111/jgs.13094
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发表时间：
2014-11
影响因子：
6.3
通讯作者：
Kelley AS
中科院分区：
文献类型：
--
作者：
Ramaswamy R;Williams A;Clark EM;Kelley AS
有效的沟通是照顾老年人的一个重要方面，老年人更有可能患有多种疾病，健康知识有限，在护理方面存在心理社会障碍。在美国，大约一半的内科（IM）学员是外国医学毕业生，可能没有接受过沟通技能教育。这一新颖的IM实习生沟通技巧课程旨在提高学员的信心和使用特定的沟通工具与老年人，特别是在传递坏消息和进行家庭会议。该讲习班包括2个互动会议，在一个小组与2名学习者和1-2名主持人，在老年学块的实习年。23名IM实习生在开始和结束时的4周块，并在3个月后完成的研讨会上，他们的知识，信心和沟通技巧进行了调查，并询问任何挑战，以有效地与老年患者沟通。主要结果测量是4周时自我报告的信心和沟通行为的变化。在4点Likert量表上，自我报告的沟通信心平均提高了0.70，并在研讨会结束后持续3个月。参与者报告了有效沟通的一些患者、医生和系统障碍。沟通技巧的教育，在一个小团体的设置和反复实践和自我反思的机会，导致在IM实习生与老年人沟通的整体信心持续增加，并可能有助于克服某些病人和医生的具体沟通障碍。
Effective communication is an important aspect of caring for the elderly, who are more likely to have multimorbidity, limited health literacy and psychosocial barriers to care. About half of Internal Medicine (IM) trainees in the United States are foreign medical graduates, and may not have been exposed to prior communication skills education. This novel communication skills curriculum for IM interns aimed to increase trainees' confidence and use of specific communication tools with older adults, particularly in delivering bad news and conducting family meetings. The workshop consisted of 2 interactive sessions, in a small group with 2 learners and 1-2 facilitators, during the Geriatrics block of the internship year. Twenty-three IM interns were surveyed at the beginning and at the end of the 4-week block and at 3 months after completion of the workshop about their knowledge, confidence and skill in communication, and asked about any challenges to effective communication with older patients. The primary outcome measure was change in self-reported confidence and behavior in communication at 4 weeks. On a 4-point Likert scale, there was an average improvement of 0.70 in self-reported confidence in communication, which sustained at 3 months after completion of the workshop. Participants reported several patient, physician and system barriers to effective communication. Communication skills education in a small-group setting and the opportunity for repeated practice and self-reflection resulted in sustained increase in overall confidence among IM interns in communication with older adults, and may help overcome certain patient and physician-specific communication barriers.