The Effect of Teaching Patient-Physician Communication on the Competency of Undergraduate Medical Students

زمينه و هدف: عليرغم تاكيد فراوان بر مهارتهاي ارتباطي، آموزش آن در بالين به صورت مدون انجام نمي شود. اين مطالعه به منظور بررسي تاثير آموزش مهارت ارتباط با بيمار در دانشجويان پزشكي عمومي صورت گرفت. روش: در يك پايلوت كارآزمايي در عرصه 68 نفر از دانشجويان پزشكي عمومي دوره كارآموزي بخش داخلي به صورت غير تصادفي بين دو مركز آموزشي تقسيم شده و در گروه شاهد روش مرسوم آموزش و در گروه مورد، همان روش به همراه آموزش مهارت ارتباط با بيمار طي 2 كارگاه در پايان ماه اول و دوم دوره كارآموزي صورت گرفت. در پايان ماه سوم عملكرد دانشجويان بوسيله مشاهده مصاحبه با بيمارنما در يك آزمون سنجيده شد. (OSCE) باليني ساختارمند عيني 23 سال در مطالعه وارد / يافته ها: 68 دانشجو 48 درصد مونث با ميانگين سني 7 8 و در / 8 و گوش دادن فعال 62 / شدند. ميانگين نمره مهارت ارتباطي در گروه مورد 80 7 بود. اختلاف بين نمرات از نظر آماري معنادار بود. / 7 و 89 / گروه شاهد به ترتيب 89 .( p=0/ و 01 p=0/ (به ترتيب 008 نتيجه گيري: آموزش مهارتهاي ارتباطي در دانشجويان پزشكي عمومي در افزايش مهارت آنان در اين زمينه موثر است. آموزش اين مهارت در ابتداي دوره باليني و استمرار آن در طي اين دوره به ويژه از طريق آموزش الگو توصيه مي گردد.

Background: Patient-physician communication skill is one of the basic competencies needed for health care professionals and so is a basic part of medical core curriculum. Communication skills have been increasingly paid attention in medical education. This study was designed to evaluate the effect of teaching patientphysician communication skills on the competency of undergraduate medical students. Methods: A field trial on 68 undergraduate medical students with random allocation to case and control groups was carried out. Teaching communications skills were performed through role modeling in the control group. The same method along with workshops on communication skills were performed for the case group. Two sessions of communication skills’ workshop performed one month apart the Competency of all 68 students was examined by observation of their interview with simulated patients (SPs) through an objective structured clinical examination (OSCE) at the end of the 3rd month. Three stations examined communication skills using Calgary-Cambridge guide, modified ALOS global and patient physician relationship questionnaires distributed by ABMS and assessed the examinees through observation by professionals. Each station was ranked from 0 to 10. Data were analyzed by SPSS-11.5 software. Results: Students in case group obtained higher scores in communication skills but the difference was not statistically significant. However active listening(p=0.01) and patientphysicians communication skills (p=0.009)mean scores were significantly higher in Control group. Conclusion: It is likely that social interaction treats of internal validity has occurred. Diffusion of training material and Compensatory rivalry could have probably happened.