The Impact of Communication Skills Training on Cardiology Fellows' and Attending Physicians' Perceived Comfort with Difficult Conversations
The Impact of Communication Skills Training on Cardiology Fellows' and Attending Physicians' Perceived Comfort with Difficult Conversations
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DOI：
10.1089/jpm.2016.0509
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发表时间：
2017-07-01
影响因子：
2.8
通讯作者：
Teuteberg, Winifred
中科院分区：
文献类型：
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作者：
Berlacher, Kathryn;Arnold, Robert M.;Teuteberg, Winifred
背景：心脏病专家需要确定哪些治疗方法适合重症患者，以及这些方法是否符合患者的目标。使医疗选择与患者的意愿相协调需要熟练的沟通技巧。尽管有证据表明沟通技巧是可教的，但很少有心脏病专家接受过正式培训。
目的：证明为心脏病专家提供沟通技能培训是可行的，并提高他们对主导困难谈话的自我感知准备程度（PP）。
方法：“心脏对话”（CardioTalk）是一个通过简短的讲授课程以及随后与标准化患者的互动来改善沟通的工作坊。能力包括传达坏消息、确定治疗目标、对情绪做出反应、支持宗教信仰以及停止治疗。
设置/研究对象：第一年的心脏病学研究员、心力衰竭研究员以及心脏重症监护病房的主治医师。
测量：调查评估了课程的效果以及学员在工作坊前后的自我感知准备程度。
结果：8名心脏病学主治医师和20名心脏病学研究员参与其中。89%的人表示之前接受过任何沟通方面的教育。研究员表示之前接受过教育的比例高于主治医师（100%对62.5%，p = 0.017）。所有学员在所有能力方面的自我感知准备程度都有所提高。96%的受访者会向同行推荐该培训。所有主治医师都认为心脏重症监护病房的心脏病专家应该接受此培训，并表示在向学员教授沟通技巧方面有了更好的准备。
结论：所有学员在沟通能力的自我感知准备程度方面都有所提高。“心脏对话”是首个被描述的培训项目，它使心脏病专家为与重症患者交谈时面临的挑战做好准备。
Background: Cardiologists need to decide which treatments are appropriate for seriously ill patients and whether they align with patient goals. Reconciling medical options with patients' wishes requires skilled communication. Although there is evidence that communication is teachable, few cardiologists receive formal training.Objective: To demonstrate that providing communication skills training to cardiologists is feasible and improves their perceived preparedness (PP) for leading difficult conversations.Methods: CardioTalk is a workshop to improve communication through short didactic sessions followed by interactions with standardized patients. Competencies include giving bad news, defining goals of care, responding to emotion, supporting religious beliefs, and withdrawing therapies.Settings/Subjects: First year cardiology fellows, heart failure fellows, and cardiac intensive care unit attendings.Measurements: Surveys evaluated the curriculum's efficacy and learners' PP before and after the workshop.Results: Eight cardiology attendings and 20 cardiology fellows participated. Eighty-nine percent reported having any prior education in communication. Fellows reported more prior education than attendings (100% vs. 62.5%, p = 0.017). Level of PP improved in all competencies for all learners. Ninety-six percent of respondents would recommend the training to peers. All attendings felt that it should be required for cardiologists in the cardiac intensive care unit and reported improved preparedness to teach communication to learners.Conclusion: All learners improved in levels of PP in communication competencies. CardioTalk is the first described training program that prepares cardiologists for the challenges they face when having conversations with seriously ill patients.