Chinese General Practice ›› 2024, Vol. 27 ›› Issue (13): 1561-1567.DOI: 10.12114/j.issn.1007-9572.2023.0215

Special Issue: 医患沟通最新文章合辑

• Chinese General Practice/Community Health Service Research • Previous Articles     Next Articles

The Role of a Ladderlike Communication Skill Course on Fostering Doctor-Patient Communication Competence of Students in Rural-oriented Free Tuition Medical Education Program

  

  1. 1. School of General Practice, Guangxi Medical University, Nanning 530021, China
    2. School of Humanities and Social Science, Guangxi Medical University, Nanning 530021, China
  • Received:2023-05-11 Revised:2023-08-17 Published:2024-05-05 Online:2024-03-06
  • Contact: SHEN Ying

阶梯式沟通技能课程对农村订单定向医学生医患沟通能力培养的作用研究

  

  1. 1.530021 广西壮族自治区南宁市,广西医科大学全科医学院
    2.530021 广西壮族自治区南宁市,广西医科大学人文社会科学学院
  • 通讯作者: 申颖
  • 作者简介:
    作者贡献:陈恩然、申颖建立队列,构建和实施阶梯式医患沟通技能课程;陈恩然、韦思羽进行数据收集和整理;陈恩然、韦宇宁进行统计学分析;陈恩然负责撰写论文;申颖负责研究构思与设计、论文终版修订,对论文整体负责。
  • 基金资助:
    广西自然科学基金资助项目(2020GXNSFAA238019); 广西医科大学教师教学能力发展项目(2022JFA04)

Abstract:

Background

The phase of undergraduate medical education is the starting point for fostering communication competence of students in Rural-oriented Free Tuition Medical Education Program (RTME), which lays the foundation both for communication competence training in the postgraduate education phase and performing effective communications with patients and their relatives, colleagues, and other health personnel in the career life of general practitioners (GPs). It is of great practical significance to explore how to improve quality of doctor-patient communication education in the stage of undergraduate medical education and develop doctor-patient communication competence of the RTME students.

Objective

To explore the role of the ladderlike communication skill course on fostering doctor-patient communication competence of students in rural-oriented free tuition medical education program.

Methods

A total of 259 RTME students of Grade 2019 were selected from Guangxi Medical University in September 2019 to establish Cohort 1, and 262 undergraduate medical students of Grade 2019 were selected to establish Cohort 2. From September 2019 to January 2022, the students in Cohort 1 were trained in a ladderlike communication skill course lasting for five consecutive semesters; from September 2021 to January 2022, the students in both cohorts were trained in a doctor-patient communication course. The final exam scores and process assessment scores of the two cohorts on the doctor-patient communication course were compared and the evaluation of teaching effectiveness and satisfaction of ladderlike communication skill course were investigated in the students in Cohort 1.

Results

The RTME students achieved significantly greater total scores for the final exam of the doctor-patient communication course, in which the RTME students performed better on the sections of case analysis and small essay, but worse on the single-choice question section compared to the undergraduate medical students (P<0.05). Similarly, the RTME students obtained higher scores on the process assessment of the doctor-patient communication course than undergraduate medical students, resulting from higher scores on the dimensions of information collection, information giving, negotiation and resolution, and nonverbal communication skills (P<0.05), and there was no statistically significant difference in the scores on the dimension of establishing first impression (P>0.05). Over 80% of RTME students felt satisfied or absolutely satisfied with the content, pedagogical measures, faculty, schedule and effects of the ladderlike communication skill course, and more than 60% believed it helped or absolutely helped promote learning interest, increase confidence to encounter difficult patients, and raise multiple competence, including empathy, doctor-patient communication, language expression, problem resolution, and team work.

Conclusion

The ladderlike communication skill course significantly elevates the effects of doctor-patient communication education in the phase of undergraduate medical education for the RTME students, facilitates the development of doctor-patient communication competence and other comprehensive competence. The ladderlike course mode is an effective measure fostering doctor-patient communication competence of medical students in medical education, and makes a useful reference for communication competence training for postgraduate education and continuing education of general practice.

Key words: Education, medical, undergraduate, General practice, Rural-oriented free tuition medical education program students, Doctor-patient communication, Communication skill, Ladderlike course

摘要: 背景 本科医学教育阶段是培养农村订单定向医学生沟通能力的起点,为毕业后教育阶段的沟通能力培训及之后的职业生涯中与患者及家属、同行、其他卫生行业人员有效沟通奠定了基础。探讨如何提高医学院校教育阶段医患沟通教育质量,并提升此阶段农村订单定向医学生医患沟通能力具有重要的现实意义。目的 探讨阶梯式沟通技能课程对农村订单定向医学生医患沟通能力培养的作用。方法 于2019年9月,选取广西医科大学2019级农村订单定向医学生259名建立队列1,选取同级临床医学专业本科生262名建立队列2。队列1学生于2019年9月—2022年1月接受长达5个学期的阶梯式沟通技能课程培训,两队列学生均于2021年9月—2022年1月学习《医患沟通学》课程。比较两个队列学生的《医患沟通学》课程期末考试成绩、过程性考核成绩,调查队列1学生对阶梯式沟通技能课程的教学效果评价和满意度。结果 农村订单定向医学生的《医患沟通学》期末考试总分及案例分析题、论述题得分高于临床医学专业本科生,单项选择题得分低于临床医学专业本科生(P<0.05)。农村订单定向医学生的《医患沟通学》课程过程性考试总分及信息收集、信息给予、协商解决、非语言沟通技巧使用维度得分高于临床医学专业本科生(P<0.05);建立第一印象维度得分与临床医学专业本科生比较,差异无统计学意义(P>0.05)。大于80.0%的农村订单定向医学生对阶梯式沟通技能课程的教学内容、教学方法、教学师资、课程编排、教学效果感到很满意/满意,>60.0%的农村订单定向医学生对阶梯式沟通技能课程在提升学习兴趣、增强接触困难患者信心、提高共情能力、提高医患沟通能力、提高语言表达能力、提高解决问题能力、提高团队协作意识方面表示很有帮助/有帮助。结论 阶梯式医患沟通技能课程可明显提高农村订单定向医学生本科医学教育阶段医患沟通教育效果,促进培养医患沟通能力及其他综合能力素养。阶梯式课程模式是医学院校教育中培养医学生医患沟通能力的有效手段,并为全科医学毕业后教育及继续教育阶段开展沟通能力培训提供有益参考。

关键词: 教育, 医学, 本科, 全科医学, 农村订单定向医学生, 医患沟通, 沟通技能, 阶梯式课程