提高妇产科住院医师大病沟通技巧：一项试点研究

IF 2.1 3区医学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES

Journal of Surgical Education Pub Date : 2025-07-17 DOI:10.1016/j.jsurg.2025.103619

Monica J. Janke , Laura Taylor , Michael P. Mendez , Anita M. Malone , Andrea McGowan , Yang Liu , Melissa W. Brackmann

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引用次数: 0

摘要

目的向患者及其家属传达重要消息是妇产科医生的一项重要技能。然而，在医疗培训中很少教授有效的沟通实践，对住院医师的培训策略也有限。我们的目标是在妇产科（OBGYN）住院医生中实施一项关于大病沟通的试点课程，并在课程前后评估自我感知的关键技能准备情况。我们根据国家认可的VitalTalk框架创建了一个针对妇产科的严重疾病沟通课程。课程包括1小时的教学和2小时的小组真人模拟。在课程前后对参与者进行了调查，以评估他们在传递严肃新闻和执行关键沟通技巧方面的准备情况，采用5分李克特量表。采用Wilcoxon符号秩检验分析前后反应。在美国中西部建立一个大型学术医疗中心。在2023-2024学年，25名acgme认证的妇产科住院医生参加了课程，并完成了课程前和课程后的调查评估。结果在课程结束后，住院医生在传递严肃新闻时明显感到更舒服，中位数评分从4.0 （IQR 2.0-4.0）增加到5.0 （IQR 4.0-5.0, p = 0.001）。居民对执行关键沟通技巧的准备程度的中位数评分在所有领域都有显著提高，包括：传达严肃新闻(p <；0.001)和预后(p <；0.001)，识别情绪和共情反应(p <；0.001)，领导家庭会议（p = 0.001），管理冲突(p <；0.001)，并对否认其疾病严重性的患者作出回应(p <；0.001)或希望接受未指示治疗的患者(p <；0.001)。结论实施以妇产科为重点的课程，提高住院医生对传递严重新闻的准备和舒适度是可行的。为住院医师提供富有同情心和有效的沟通技巧应该是妇产科住院医师培训的一部分。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Improving Serious Illness Communication Skills in Obstetrics and Gynecology Residents: A Pilot Study

OBJECTIVE

Delivering serious news to patients and their families is a crucial skill for obstetrician-gynecologists. However, effective communication practices are seldom taught during medical training and limited educational strategies exist for resident-level trainees. We aimed to implement a pilot course in serious illness communication for obstetrics and gynecology (OBGYN) residents and assess self-perceived preparedness in key skills before and after the course.

DESIGN

We created an OBGYN-specific serious illness communication course based on the nationally recognized VitalTalk framework. The course included a 1-hour didactic and a 2-hour small group live-action simulation. Participants were surveyed before and after the course to assess their comfort with delivering serious news and preparedness in performing key communication skills, using a 5-point Likert scale. Pre- and postcourse responses were analyzed using the Wilcoxon signed-rank test.

SETTING

A large academic medical center in the Midwest United States.

PARTICIPANTS

Twenty-five ACGME-accredited OBGYN residents during the 2023-2024 academic year participated in the course and completed pre- and postcourse survey assessments.

RESULTS

After course completion, residents felt significantly more comfortable with delivering serious news, with median ratings increasing from 4.0 (IQR 2.0-4.0) to 5.0 (IQR 4.0-5.0, p = 0.001). Residents’ median rating of preparedness to perform key communication skills significantly improved in all domains, including: conveying serious news (p < 0.001) and prognosis (p < 0.001), recognizing emotion and responding with empathy (p < 0.001), leading a family meeting (p = 0.001), managing conflict (p < 0.001), and responding to patients who deny the seriousness of their illness (p < 0.001) or who want treatments that are not indicated (p < 0.001).

CONCLUSIONS

Implementing an OBGYN-focused course that improves resident preparedness for and comfort with delivering serious news is feasible. Equipping residents with compassionate and effective communication skills should be integral to OBGYN residency training.

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来源期刊

Journal of Surgical Education EDUCATION, SCIENTIFIC DISCIPLINES-SURGERY

CiteScore

5.60

自引率

10.30%

发文量

261

审稿时长

48 days

期刊介绍： The Journal of Surgical Education (JSE) is dedicated to advancing the field of surgical education through original research. The journal publishes research articles in all surgical disciplines on topics relative to the education of surgical students, residents, and fellows, as well as practicing surgeons. Our readers look to JSE for timely, innovative research findings from the international surgical education community. As the official journal of the Association of Program Directors in Surgery (APDS), JSE publishes the proceedings of the annual APDS meeting held during Surgery Education Week.