儿科住院医师面对面医患沟通考核的实施与分析

Implementation and analysis of assessment for pediatric residents in face-to-face communications between doctors and patients

通过实施面对面人文沟通技能考核,发现儿科住院医师面对面沟通中存在的问题,为临床培训与教学改革提供依据。采用10 min口试场景模拟,考官扮演"家长",住院医师按要求完成规定的沟通内容。通过对2016年考生扣分项目情况分析,加强人文沟通培训。2017年考核结果显示"非语言沟通"和"沟通效果"2个维度得分高于2016年,具有显著性差异(P <0.01)。尤其是"应变能力""有效沟通成果"具有显著性差异(P <0.01)。在诊疗过程中,能够清晰有效地与家长进行面对面沟通不是一件容易的事,除语言表达外,还需要非语言方式的配合,如目光、表情、肢体动作等,所以沟通技巧训练是住院医师培训中非常重要的一部分。

Through the implementation of assessment for face-to-face communication skills,this article aims to identify the problems in doctor-patient communication among pediatric residents and provide the basis for clinical training and teaching reform.A 10-minute simulative scene for oral test was designed,where the examiner played the role of a parent and asked the resident to complete the prescribed communication.By analysis of test scores in 2016,the program decided to strengthen the humanities communication training.The results of 2017 showed that the scores of non-verbal communication and communication effect were significantly higher than those of 2016.In particular,the scores of"resilience"and"effective communication"had significant differences.It is not an easy task to communicate with the parents effectively and clearly in the process of diagnosis and treatment.In addition to language expression,nonverbal communications such as gaze,facial expressions and body movements are also required.Therefore,communication skill training is a very important part of residency training.