情景模拟教学与案例教学结合在培养住院医师医患沟通能力中的应用

The Application of Scenario Simulation Teaching Combined with Case Teaching in the Cultivation of Doctor-Patients Communication Ability of Residents Doctors

目的探讨情景模拟教学与案例教学相结合的教学法在住院医师医患沟通能力培训中的应用效果。方法对某院低年住院医师进行医患沟通能力的培训。所有住院医师随机分为对照组40人及观察组40人。对照组采用传统的讲述式教学方法;观察组采用情景模拟教学与案例教学相结合的教学方法。应用利物浦医师沟通能力评价量表(LCSAS)中文修订版评估比较两组自身在培训前及培训后的差异,以及两组在培训后的差异;进行患者的满意度评估,并比较结果;并调查住院医师对情景模拟教学与案例教学结合的教学法在培训住院医师医患沟通能力中应用的认可程度。结果培训前两组住院医师得分分别为9.26±3.02,9.31±3.25,两组比较差异无统计学意义(P=0.9)。对照组在采用传统的讲述式教学方法培训医患沟通技巧后,LCSAS量表得分为12.81±5.18,较未培训前得分有所提高,且差异有统计学意义(P<0.05);观察组在采用情景模拟教学与案例教学相结合的方法培训医患沟通技巧后,LCSAS量表得分为(27.26±3.75),较未培训前得分明显提高,差异有统计学意义(P<0.01);且观察组与对照组在采用不同的培训方法后比较两组得分,观察组得分明显高于对照组(27.26±3.75vs12.81±5.18),且差异有统计学意义(P<0.01)。患者满意度调查结果显示,在医师语言和蔼、能表现同情心、患者能得到尊重及综合沟通能力方面,观察组的患者满意度明显高于对照组,且差异有统计学意义(P<0.05);调查问卷显示,100%的住院医师对情景模拟教学与案例教学相结合的方法进行医患沟通能力培训的教学方法表示认可,并认为该教学方法可以提高医患沟通能力。结论情景模拟教学联合案例教学法可以有效的提高低年住院医师的医患沟通能力,降低医疗纠纷风险。

Objective To investigate the application on teaching methods of scenario simulation case of the doctor-patient communication skills in resident doctors. Methods The trainee were junior resident doctors selected from Xuanwu Hospital of Capital Medical University. All residents were randomly divided into control group（N=40）and the observation group（N=40）. The control group used the traditional lecture-style teaching methods. The observation group used scenario simulation teaching methods of teaching and case teaching method. To apply the Chinese Version of Liverpool Communication Skills Assessment Scale（LCSAS） to evaluate the communication skills of residents, compare the differences between the two groups in front of their own training and post-training, as well as the differences in the two groups after training. Assessing the degree of satisfaction of patients and compare the results;and to investigate the extent of recognition of residency scenario simulation teaching and case teaching method in teaching doctor-patient communication skills training in residency applications. Results The scores before training of two groups were 9.26±3.02,9.31±3.25, the difference was not statistically significant（P = 0.9）. In the control group, after using the traditional method of teaching about the doctor-patient communication skills training, LCSAS Scale score were 12.81±5.18, the score is improved compared with before training, and the difference was statistically significant（P〈0.05）.After the observation group using scenario simulation teaching and case teaching method of combining patient communication skills training,LCSAS Scale score were（27.26±3.75）, the score significantly improved the training than before, and the difference was statistically significant（P〈0.01）.Comparing of observation group and control group scores after the different training methods,observation group scored significantly higher than control group（27.26±3.75vs12.81±5.18）,and the difference was statistically significant（P〈0.01）.Patient satisfaction survey results show that,in the language of physicians kind,showing compassion,the patient can be respected and integrated communication capabilities,the observation group was significantly higher than control group scores,and the difference was statistically significant（P〈0.05）;Survey showed that 100% of the residents acknowledged the scenario simulation teaching and case teaching method combining physician-patient communication skills training teaching methods,and which can improved doctorpatient communication skills.Conclusions Scenario simulation teaching method combined with case teaching method could improve the doctor-patient communication skills of junior resident doctors,and also reduce the risk of medical disputes.