摘要
背景全科医学专业研究生导师肩负着培养未来全科医学专业人才的重任,全科医学专业研究生导师自身的医患沟通能力对全科医学事业发展至关重要。目的分析全科医学专业硕士生导师在门诊接诊过程中的医患沟通能力现状。方法2022年4—6月,采用整群抽样法,选择来自首都医科大学的全科医学专业硕士生导师75名作为测评对象。测评人员作为同行者参与门诊患者就诊全过程,按照医患沟通技能评价量表(SEGUE)对全科医学专业硕士生导师在门诊接诊过程中的医患沟通能力进行测评。将全科医学专业硕士生导师SEGUE总得分及各维度得分与前期接受测评的三级医院专家门诊医生和社区卫生服务中心全科医生的测评结果进行比较,分析不同性别、任职方式,以及就职于不同级别医疗机构的全科医学专业硕士生导师SEGUE总得分及各维度得分的差异性,并比较全科医学专业硕士生导师与美国通科医生的SEGUE总得分。结果75名全科医学专业硕士生导师SEGUE总得分为12~24分,平均总得分为(17.8±2.6)分;在准备、信息收集、信息给予、理解患者和结束问诊维度上的平均得分分别为(3.9±0.9)、(6.5±1.7)、(3.1±1.1)、(2.6±0.9)、(1.7±0.5)分。全科医学专业硕士生导师、社区卫生服务中心全科医生在SEGUE准备和结束问诊维度上的得分高于三级医院专家门诊医生(P<0.05);就职于一级医院的全科医学专业硕士生导师SEGUE总得分及在准备维度上的得分高于就职于二级医院的全科医学专业硕士生导师(P<0.05),就职于一级医院的全科医学专业硕士生导师SEGUE总得分及在准备、信息收集维度上的得分高于就职于三级医院的全科医学专业硕士生导师(P<0.05);全科医学专业硕士生导师SEGUE总得分低于美国通科医生(P<0.05)。结论全科医学专业硕士生导师的临床沟通能力仍有较大提升空间,其临床沟通能力低于美国通科医生。全科医学院(系)的教学管理部门应重视对全科医学专业研究生导师医患沟通能力的培养,并让其通过言传身教提高全科医学专业研究生的人文医学执业技能水平。
Background Graduate supervisors in general practice are responsible for the important task of training future general practice professionals,so their abilities to communicate with patients are essential for the development of general practice.Objective To examine the abilities to communicate with patients in supervisors of master's students in general practice during outpatient encounters.Methods Seventy-five supervisors of master's students in general practice from Capital Medical University were selected by use of cluster sampling to receive a survey using a self-developed demographic questionnaire conducted from April to June 2022.Then their doctor-patient communication skills during outpatient encounters were assessed by relevant professionals who participated in the whole encounter process as accompaniers using the SEGUE Framework.The total score and dimension scores of SEGUE Framework of these supervisors were compared with those of outpatient specialists in tertiary hospitals and general practitioners(GPs)in community health centers(CHCs)in our previous studies,and were compared across these supervisors by sex,employment method and level of medical institutions.Then the total score of SEGUE Framework was compared between the supervisors and US GPs.Results The total score of SEGUE Framework attained by the supervisors ranged from 12 to 24 points,and the average score was(17.8±2.6).The average scores of five dimensions(set the stage,elicit information,give information,understand the patient's perspective,and end the encounter)obtained by them were(3.9±0.9),(6.5±1.7),(3.1±1.1),(2.6±0.9)and(1.7±0.5),respectively.These supervisors scored higher on dimensions of set the stage and end the encounter than GPs in CHCs and outpatient specialists in tertiary hospitals(P<0.05).Compared with their counterparts working in primary hospitals,supervisors working in secondary hospitals scored lower on the SEGUE Framework and set the stage dimension(P<0.05),and those working in tertiary hospitals scored lower on the SEGUE Framework and set the stage and elicit information dimensions(P<0.05).These supervisor scored lower on the SEGUE Framework than the US GPs(P<0.05).Conclusion There is still considerable room for improvement of the skills for communicating with patients in outpatient encounters in these supervisors.Their level of communication skills was still lower than that of US GPs.In view of this,the teaching management department responsible for general practice department(school)should pay attention to the training of the abilities of master supervisors to communicate with patients,thereby improving the level of medical humanities in practice in master's students in general practice by supervisors'words and deeds.
作者
赵铁夫
张彬
马涵英
韩红亚
马立萍
高绪霞
罗天翔
罗鸿池
ZHAO Tiefu;ZHANG Bin;MA Hanying;HAN Hongya;MA Liping;GAO Xuxia;LUO Tianxiang;LUO Hongchi(Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China)
出处
《中国全科医学》
北大核心
2023年第28期3539-3543,共5页
Chinese General Practice
基金
北京市哲学与社会科学基金资助项目(16JYB010)
首都医科大学2022教育教学改革研究课题(2022JYZ023)。
关键词
医患沟通
医生病人关系
全科医学
教育
医学
研究生
导师
门诊医疗
北京
Doctor-patient communication
Physician-patient relations
General practitice
Education,medical,graduate
Mentors
Ambulatory care
Beijing
