以極有限資源在醫學系三年級進行基礎臨床溝通技巧教學

Using Very Limited Resources to Teach Basic Clinical Communication Skills in Medical School

10.6145/jme.200903_13(1).0006

陳祖裕(Cho-Yu Chan)；鄭浩民(Hao-Min Cheng)；黃金洲(Chin-Chou Huang)；巫春蓮(Chun-Lien Wu)；楊惠文(Hui-Wen Yang)；程雅琳(Ya-Lin Chen)；陳震寰(Chen-Huan Chen)

溝通技巧 ； 回饋 ； 自我反省 ； communication skills ； feedback ； reflection

Journal of Medical Education

13卷1期（2009 / 03 / 01）

49 - 59

繁體中文

自2004年9月開始，我們在醫學系三年級推動一項臨床溝通技巧的課程。其中基礎臨床溝通技巧的課程內容包括：⑴講授：疾病診斷原則、問診內容，以及臨床溝通技巧的理念及方法；⑵影片教學；⑶利用標準化病人作問診演練。問診技巧是以Calgary-Cambridge observation guide為架構，而問診演練特別著重演練者的自我反省(reflection)及其他學生及教師的描述性回饋(feedback)。由於資源有限，課程的執行乃秉持下列策略：⑴以影片教學彌補演練次數的不足；⑵以時間分割彌補教師人力的不足；⑶巧用心思使能儘量提供重複體驗的機會。在經過5年的執行和改進，大部分的學生在學期結束的評估都有令人滿意的表現，證實本課程具有不錯的教學效能。這項課程將會繼續執行，並且不斷改進。

In September, 2004, we implemented a new communication skills course for third-year medical students. The contents of this basic communication skills course included lectures on the principles of diagnosis, the fundamental elements of taking a history, and basic principles and methods of communication. The course also included videotape teaching and the use of standardized patients (SP) to practice interviewing skills. The Calgary-Cambridge observation guide was the reference used for teaching the interviewing process. In addition, reflection and feedback were especially emphasized. Since our resources were limited, we used the following strategies to design the course: (1) teaching video-tapes to make up for insufficient SP practice; (2) separation of practice sessions to compensate for the lack of teachers; (3) creation of opportunities for cognition and practice. [Dear Author: Strategy #2 is not very clear. The English is ok now, but the strategy is not explained very well.] After five years of revision, we found that most students had satisfactory performance in related knowledge and skills on the final examination, which is evidence of the effectiveness of this basic communications skill course. This course will be continued with ongoing improvements.

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