Grandview/Southview医疗中心普外科住院医师沟通技巧

Wesley Johnson, Nhat-Anh Ngo, Michael Elrod
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引用次数: 1

摘要

背景:在整骨疗法项目向单一认证的研究生医学教育(GME)系统过渡的过程中,住院医生需要在毕业前证明一套由研究生医学教育认证委员会(ACGME)确定的核心能力。这些核心能力包括人际交往和沟通技巧以及专业精神。目的:使用经过验证的沟通评估工具(CAT)评估Grandview/Southview医疗中心(Dayton, OH)骨科普外科项目住院医师人际沟通技巧和专业精神的优缺点。方法:2014年11月至2018年6月,所有在卡萨诺普外科诊所就诊的患者在与住院医师会面后,由一名医疗助理填写一份CAT问卷。卡萨诺(Cassano)是一家以门诊为基础的机构,面向服务水平低下的当地社区,这里的病人首先由实习生看病,然后是4年或5年的住院医生,最后是主治医生。包括18岁及以上的患者;不能理解或阅读英语的患者被排除在外。收集患者的人口统计数据,包括年龄、性别、种族/民族以及以前与该住院医师的接触情况。每个居民的名字在CAT上被替换为数据分析的数字。本研究收集的常驻变量包括培训年份、性别和母语。结果:所有CAT项目的平均反应为4.5分(满分5分),表明对住院医生表现的反应在很大程度上是积极的。患者对14个CAT项目中的4个项目的反应只有极好、非常好或良好,没有一般或差的反应。4个项目只有1个一般或较差的回答。其余6项得到了超过1个一般或差的回应:“以一种让我感到舒适的方式向我打招呼”(第1名),“用我能理解的语言交谈”(第8名),“鼓励我问问题”(第10名),“尽可能多地让我参与决策”(第11名),“表现出关心和关心”(第13名),以及“花适当的时间和我在一起”(第14名)。结论:主治外科医生从医生的角度对住院医师的多个方面进行评估,但这种评估与患者的经验之间可能缺乏相关性,而这在骨科医学中是至关重要的。病人对CAT问卷的回答可以被项目主管用来识别里程碑/能力成就方面的不足,并根据ACGME标准促进住院医生个人和项目的改进。
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Communication Skills of Grandview/Southview Medical Center General Surgery Residents.

Context: In the transition of osteopathic programs to the single-accreditation graduate medical education (GME) system, residents are required to demonstrate skill in a set of core competencies identified by the Accreditation Council of Graduate Medical Education (ACGME) prior to graduation. Included in those core competencies are interpersonal and communication skills along with professionalism.

Objectives: To assess strengths and weaknesses of residents' interpersonal communication skills and professionalism in the Grandview/Southview Medical Center (Dayton, OH) osteopathic general surgery program using the validated Communication Assessment Tool (CAT).

Methods: From November 2014 to June 2018, all patients who presented for an appointment at the Cassano General Surgery Clinic were asked by a medical assistant to complete a CAT questionnaire following their encounter with a resident physician. Patients at Cassano, an outpatient office-based facility directed to the underserved local community, are seen first by an intern, then by a 4th or 5th year resident and later by an attending physician. Patients 18 years of age or older were included; patients were excluded if they were unable to understand or read English. Patient demographics were collected, including age, gender, race/ethnicity, and previous exposure to this resident physician. Each resident's name was replaced on the CAT with a number for data analysis. The resident variables collected for this study included year of training, gender, and native language.

Results: The mean response for all CAT items was 4.5 out of 5, indicating that responses to resident performance were largely positive. Patients responded to 4 of the 14 CAT items with only excellent, very good, or good responses and no fair or poor responses. Four items had only 1 fair or poor response. The remaining 6 items received more than 1 fair or poor response: "greeted me in a way that made me feel comfortable" (#1), "talked in terms I could understand" (#8), "encouraged me to ask questions" (#10), "involved me in decisions as much as I wanted" (#11), "showed care and concern" (#13), and "spent the right amount of time with me" (#14).

Conclusions: Attending surgeons evaluate residents in multiple areas from a doctor's perspective, but there is a potential lack of correlation between that evaluation and a patient's experience, which is paramount in osteopathic medicine. Patient responses to the CAT questionnaire can be used by program directors to identify deficiencies in milestone/competency achievement and facilitate improvement both individually and programmatically for residents according to ACGME standards.

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JOURNAL OF THE AMERICAN OSTEOPATHIC ASSOCIATION
JOURNAL OF THE AMERICAN OSTEOPATHIC ASSOCIATION MEDICINE, GENERAL & INTERNAL-
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期刊介绍: JAOA—The Journal of the American Osteopathic Association is the official scientific publication of the American Osteopathic Association, as well as the premier scholarly, peer-reviewed publication of the osteopathic medical profession. The JAOA"s mission is to advance medicine through the scholarly publication of peer-reviewed osteopathic medical research. The JAOA"s goals are: 1. To be the authoritative scholarly publication of the osteopathic medical profession 2. To advance the traditional tenets of osteopathic medicine while encouraging the development of emerging concepts relevant to the profession"s distinctiveness
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