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| 題 名 | 運用擬真模擬情境探討PGY醫師CICARE醫病溝通教學之成效=The Effect of CICARE Concept for Simulative Doctor-Patient Communication Training |
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| 作 者 | 鍾焜明; 郭妍伶; 王淑慎; 葉正發; 陳志成; 陳欽明; 周偉倪; | 書刊名 | 台灣急重症醫學雜誌 |
| 卷 期 | 8:4 2023.12[民112.12] |
| 頁 次 | 頁87-95 |
| 分類號 | 410.3 |
| 關鍵詞 | 擬真情境演練; 醫病溝通; 同理心; 醫療專業術語; CICARE; Teaching simulation; Medical communication; Empathy; Medical terminology; |
| 語 文 | 中文(Chinese) |
| 中文摘要 | 目的:根據美國 UCLA 附設醫院的關懷病人方案 CICARE 設計一個臨床案例,在情境中放入病人家屬和醫師的對話,將 CICARE 各個細項的溝通技巧是否做到放入評分項目中,發展出「CICARE 擬真病情溝通評分表」。以擬真情境演練的教學方式探討 CICARE 關懷病人理念在教學上的效果,期待年輕醫師的醫病溝通能力能更加提昇。 方法:進行信效度檢核「CICARE擬真病情溝通評分表」後,以111年度PGY1醫師45位為施測對象進行前後測,學員直接與標準化病人依臨床案例內容進行擬真模擬演練。3位臨床教師使用「CICARE擬真病情溝通評分表」給予評分及即時回饋。 結果:3 位評分者間的分數有很高的評分一致性信度。前測結果看到關懷安撫及同理病人以及針對進階治療做進一步說明及確認的部分,這兩題的分數較低。後測成績則有明顯的進步。 結論:CICARE 擬真病情溝通教學成效良好。安撫病人或家屬情緒,特別是同理心的運用對於年輕醫師而言是困難的,沒有受過訓練的話面對情緒激動的病人或家屬時會不知所措。醫療專業術語的進一步反問及說明也是容易被忽略的,導致溝通效果不佳。今後可以更多著重在這兩個方面的教學。 |
| 英文摘要 | Purpose: In order to enhance physician’s communication skills, we designed a clinical learning module and scoring method according to CICARE concept, the patient care program of UCLA affiliated hospitals in the United States, to see if this learning method can boost efficient dialogue between the patient and the physician. We put the communication skills of each CICARE item into a scoring item and developed the "CICARE Communication Simulation Scoring Scale". The teaching method of simulation scenario exercise was used to explore the effect of CICARE patient care concept in teaching, and it was expected that junior physician’s medical and communication skills could be further improved. Methods: The reliability and validity check " CICARE Communication Simulation Scoring Scale " was carried out, and 45 PGY1 physicians in 2022 were used as the test objects, and the trainees directly conducted simulation scenario exercises with standardized patients according to clinical cases in the form of role-playing. Three clinical teachers used the CICARE Communication Simulation Score Scale to give scoring and real-time feedback. Results: There is a high degree of confidence in the consistency of scores between the 3 raters. The pre-test results showed lower scores for caring and reassuring patients and showing empathy, as well as for further explanation and confirmation of advanced treatment. There was a marked improvement in post-test results. Conclusion: Practicing communication skills in simulation emphasizing on the CICARE concept has affirmative results in enhancing positive patient communication. It is difficult and sometimes traumatizing for young, inexperienced physicians to face emotional and irrational patients and family, but practicing communication in a simulation with focus on empathy provides a safe teaching and learning environment. In the future, more emphasis could be placed on reassuring and empathizing with patients or family members and emphasizing on how to verbally communicate important information in ways patient understands. |
本系統中英文摘要資訊取自各篇刊載內容。