Efficacy of a Cancer Research UK communication skills training model for oncologists: a randomised controlled trial
Efficacy of a Cancer Research UK communication skills training model for oncologists: a randomised controlled trial
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DOI：
10.1016/s0140-6736(02)07810-8
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发表时间：
2002-02-23
期刊：
影响因子：
168.9
通讯作者：
Eves, R
中科院分区：
文献类型：
--
作者：
Fallowfield, L;Jenkins, V;Eves, R
背景医生与患者的沟通通常由于缺乏这一核心技能的培训而受到阻碍。本研究的目的是评估一个为期3天的密集培训课程的沟通技巧在一个随机对照试验的两个由两个析因设计和几个outcomes.Methods 160肿瘤学家从34个英国癌症中心随机分配到四组：书面反馈，然后当然，当然，单独的书面反馈：和控制。在两个评估期的每个评估期，对每位医生与6至10名连续同意的患者的磋商进行录像。2407名患者参与。结果测量包括由研究人员、医生和护士进行的客观和主观评分。和病人。主要结果是干预后关键沟通技能的客观改善。课程内容包括结构化的反馈，录像带审查的咨询，角色扮演模拟病人，互动小组演示。并由训练有素的主持人引导讨论。调查结果在对沟通行为计数的Poisson回归分析中，课程出勤率显着改善了关键结果。估计的效应量对应于更高的使用率集中的问题：课程参加者[n=80]和非参加者[n=80]之间的差异34%，p=0.003），集中和开放的问题（27%，p=0.005），同情的表达（69%，p=0.003），以及对患者线索的适当反应（38%）。p=0.026），引导性问题的使用率降低24%（p=0.11）。几乎没有证据表明书面反馈的有效性。解释在癌症医学领域工作的高级医生的沟通问题不能通过时间和临床经验来解决。这项试验表明，培训课程显著提高了关键的沟通技能。应拨出更多资源，满足医生在这一重要领域的培训需求。
Background Doctors' communication with patients is commonly hampered by lack of training in this core skill. This study aimed to assess the efficacy of an intensive 3-day Training course on communication skills in a randomised controlled trial with a two-by-two factorial design and several outcomes.Methods 160 oncologists from 34 UK cancer centres were randomly allocated to four groups: written feedback followed by course; course alone; written feedback alone: and control. At each of Two assessment periods, consultations with six to ten consecutive, consenting patients per doctor were videotaped. 2407 patients participated. Outcome measures included objective and subjective ratings made by researchers, doctors. and patients. The primary outcomes were objective improvements after the intervention in key communication skills. Course content included structured feedback, videotape review of consultations, role-play with simulated patients, interactive group demonstrations. and discussion led by a trained facilitator.Findings In Poisson regression analysis of counts of communication behaviours, course attendance significantly improved key outcomes. The estimated effect sizes corresponded to higher rates of use of focused questions :difference between course attenders [n=80] and nonattenders [n=80] 34%, p=0.003), focused and open questions (27%, p=0.005), expressions of empathy (69%, p=0.003), and appropriate responses to patients cues (38%. p=0.026), and a 24% lower rate of use of leading questions p=0.11). there was little evidence for the effectiveness of written feedback.Interpretation The communication problems of senior doctors working in cancer medicine ore not resolved by time and clinical experience. This trial shows that training courses significantly improve key communication skills. More resources should be allocated to address doctors' training needs in this vital area.