肿瘤专业研究生医患沟通能力培训模式及效果分析

Doctor-patient communication training mode for oncology medical postgraduates and its effect

目的评估肿瘤专业研究生医患沟通能力,探讨肿瘤专业研究生医患沟通能力培训模式及效果。方法选取2014年10月至2016年3月在北京中医药大学第一临床医学院实习的肿瘤专业硕士研究生16名为研究对象,其中研究生一年级组及二年级组各8名。设计针对肿瘤专业研究生医患沟通培训体系。授课老师为肿瘤专科高级职称医师,并有中国医师协会认证的"中国医师人文医学执业技能师资"资质,进行沟通技能培训15学时。沟通技能教学内容主要包括医患沟通基础知识及核心技能、如何问诊及采集全面信息、如何讲解病情及诊治方案、舒缓医学与生命教育、心理学。分别评估培训前及培训后两组医患沟通能力。数据采用SPSS 12.0软件进行统计分析,行配对资料t检验和Wilcoxon秩和检验。结果全体肿瘤学研究生培训前SEGUE评分(67.12±7.62)分,应用课题组构建的医患沟通培训体系培训15个学时后,SEGUE评分提升至(83.62±7.01)分,差异有统计学意义(P<0.000 1)。按年级分组,培训前一年级组SEGUE评分(65.50±8.60)分,二年级组SEGUE评分(68.75±6.67)分,两组间差异无统计学意义(P>0.05)。培训后再次进行评估,一年级组SEGUE评分(82.75±7.78)分,二年级组SEGUE评分(82.14±11.77)分,两组间比较差异无统计学意义(P>0.05),自身前后对照均较培训前明显提高,差异有统计学意义(P<0.01)。结论肿瘤专业研究生沟通技能并未随临床实习轮转而明显改善,仍有较大提升空间;本研究设计的医患沟通培养模式教学效果良好,可显著提高肿瘤专业研究生医患沟通能力。

Objective To evaluate the communicative ability of doctor-patient education for postgraduates majoring in oncology,and to discuss the training mode and effect.Methods Totally 16 oncology medical postgraduates in the First Clinical College of Beijing University of Traditional Chinese Medicine between October 2014 and March 2016 were selected and were divided into two groups including grade 1 and grade 2.The training system of doctor-patient communication for postgraduate students of oncology was designed.The lecturers were senior doctors with specialties in cancer,and had the qualification of 'Chinese physician practicing skills teacher for humanities and medicine',which was certified by the Chinese medical doctor association,and had 15 hours of communication skills training.Communication skills teaching contents included basic knowledge and core skills of doctor-patient communication,how to ask and collect comprehensive information,how to explain the disease and treatment programs,palliative medicine and life education,psychology.Doctor-patient communication ability of two groups were evaluated before and after the training.SPSS 12.0 was applied to do statistical analysis,t test and Wilcoxon were used.Results SEGUE score(67.12±7.62) before the training for all oncology postgraduates was increased to 83.62±7.01 after the training of 15 hours of doctor-patient communication training system constructed by the research group.The difference was statistically significant(P<0.000 1).The SEGUE score in the first grade group(65.50±8.60) and the SEGUE score in the second grade group(68.75±6.67) were not significantly different between the two groups(P>0.05).After the training,the SEGUE score in the first grade group(82.75±7.78) and the SEGUE score in the second grade group(82.14±11.77) were not significantly different between the two groups(P>0.05),after the training,the SEGUE scores in both groups were significantly improved,the difference was statistically significant(P<0.01).Conclusion The communicative skills of postgraduates in oncology have not improved significantly with the rotation of clinical practice.There is still a lot of room for improvement.The training mode of doctor-patient communication in this study has a good teaching effect and can significantly improve the ability of doctor-patient communication in postgraduates.