Enlightenment of Foreign Doctor-patient Communication Models to Relevant Trainings for General Practitioners in China

doi:10.12114/j.issn.1007-9572.2021.00.185

Abstract

Abstract: Skills for communicating with patients are one kind of core ability that general practitioners（GPs） must possess，ensuring the improvement of services quality provided by GPs. The systematic，simple and practical doctor-patient communication models developed by foreign countries based on a large amount of research experience have been widely used in medical education，and proved to be crucial for improving doctors' skills for communicating with patients.In contrast，in China，GPs show relatively poor abilities in communicating with patients，which may be caused by insufficient awareness of training this ability in medical students influenced by the traditional biomedical model，and unsatisfied quality of such trainings due to lack of relevant teaching materials for medical students with different majors at different learning stages，and lack of relevant theoretical studies. As systematic，simple，and practical curriculum is the key to ensure the quality of training GPs' skills for communicating with patients，we detailedly analyzed the recommended major doctor-patient communication models in foreign countries（patient-centered communication，Calgary-Cambridge Guide，SEGUE Framework，Four Habits Model，Kalamazoo Essential Elements communication Checklist-Adapted），aiming at providing a reference for developing course contents of doctor-patient communication skills for GPs in China.

Key words: General practitioners, Doctor-patient communication, Communication skills, Training, Model

摘要： 沟通能力是全科医生必备的核心能力之一，是提高医疗服务质量的保障。国外在积累大量研究经验基础上，制定了系统、简单、实操性强的医患沟通模式，在医学教育中被广泛应用，被证明对提高医生沟通技能有着至关重要的作用。而我国由于受生物医学传统模式的影响，对医学生医患沟通能力的培养存在认识不足，缺乏适应不同阶段、专业方向的医患沟通教育教材，缺乏相关理论研究等问题，制约了沟通技能培训的质量，导致全科医生沟通能力相对薄弱。拥有系统、简单、实操性强的沟通培训模式是保证全科医生医患沟通能力培养质量的关键环节。本文重点分析国外推荐使用的主要医患沟通模式（以患者为中心的沟通模式、卡尔加里-剑桥指南、SEGUE框架、“四习惯”、卡拉马祖共识声明基本元素沟通清单），以期为制定符合我国全科医生医患沟通技能培训内容提供参考和借鉴。

关键词: 全科医生, 医患沟通, 沟通技能, 培训, 模式

DENG Lili,LIAO Xiaoyang,WU Jia, et al. Enlightenment of Foreign Doctor-patient Communication Models to Relevant Trainings for General Practitioners in China　[J]. Chinese General Practice, 2021, 24(13): 1684-1689. DOI: 10.12114/j.issn.1007-9572.2021.00.185.
邓黎黎,廖晓阳,伍佳等. 国外医患沟通模式对我国全科医生沟通技能培训的启示[J]. 中国全科医学, 2021, 24(13): 1684-1689. DOI: 10.12114/j.issn.1007-9572.2021.00.185.

References

［1］Global minimum essential requirements in medical education［J］．Medical Teacher，2002，24（2）：130．DOI：10.1080/01421590220120731．
［2］ROCHFORT A．1-Patient empowerment for patient self-management Wonca Europe 20th anniversary project 2015［M］．The World Book of Family Medicine - European Edition 2015.
［3］LIU Y，HUANG Y，GAO H，et al．Communication skills training：adapting to the trends and moving forward［J］．Bioscience Trends，2017，11（2）：142-147．DOI：10.5582/bst.2017.01095．
［4］KURTZ S M，SILVERMAN J D．The Calgary-Cambridge Referenced Observation Guides：an aid to defining the curriculum and organizing the teaching in communication training programmes［J］．Med Educ，1996，30（2）：83-89．DOI：10.1111/j.1365-2923.1996.tb00724.x.
［5］RAFIDAH A Y．Notes for the primary care teachers：teaching doctor-patient communication in family medicine［J］．Malays Fam Physician，2007，2（3）：120-122．
［6］LIU X C，ROHRER W，LUO A，et al．Doctor-patient communication skills training in mainland China：a systematic review of the literature［J］．Patient Education and Counseling，2015，98（1）：13-14．DOI：10.1016/j.pec.2014.09.012．
［7］陈国栋，刘江华，王梦瑶，等．医学生医患沟通教学改革的探索性研究［J］．医学与哲学，2017，38（3）：86-88．DOI：10.12014/j.issn.1002-0772.2017.03a.21.
CHEN G D，LIU J H，WANG M Y，et al．An investigation of educational reform of doctor-patient communication［J］．Medicine & Philosophy，2017，38（3）：86-88．DOI：10.12014/j.issn.1002-0772.2017.03a.21.
［8］田冬霞，刘俊荣．制约我国医学生医患沟通教育的四大瓶颈及其解决对策分析［J］．中国医学伦理学，2015，28（6）：940-943．DOI：CNKI:SUN:XNLX.0.2015-06-032.
TIAN D X，LIU J R．Four bottlenecks of doctor-patient communication education in Chinese medical students and the countermeasures［J］．Chinese Medical Ethics，2015，28（6）：940-943．DOI：CNKI:SUN:XNLX.0.2015-06-032.
［9］PUN J，CHAN E A，WANG S，et al．Health professional-patient communication practices in East Asia：an integrative review of an emerging field of research and practice in Hong Kong，South Korea，Japan，Taiwan，and Mainland China［J］．Patient Educ Couns，2018，101（7）：1193-1206．DOI：10.1016/j.pec.2018.01.018.
［10］侯胜田，张永康．主要医患沟通模式及6S延伸模式探讨［J］．医学与哲学，2014，35（1）：54-57．DOI：CNKI:SUN:YXZX.0.2014-01-016.
HOU S T，ZHANG Y K．Discussion on the main doctor-patient communication model and the six-stage extended model［J］．Medicine & Philosophy，2014，35（1）：54-57．DOI：CNKI:SUN:YXZX.0.2014-01-016．
［11］JANSEN K L，ROSENBAUM M E．The state of communication education in family medicine residencies［J］．Fam Med，2016，48（6）：445-451．
［12］BALINT E．The possibilities of patient-centered medicine［J］．J R Coll Gen Pract，1969，17（82）：269-276．
［13］MEAD N，BOWER P．Patient-centredness：a conceptual framework and review of the empirical literature［J］．Soc Sci Med，2000，51：1087-1110．DOI：10.1016/S0277-9536(00)00098-8.
［14］BROWN J B，STEWART M A，RYAN B L．Assessing communication between patients and physicians：the measure of patient-centered communication（MPCC）.Thames Valley Family Practice Research Unit and Centre for Studies in Family Medicine［Z］．2001.
［15］EPSTEIN R M，FRANKS P，FISCELLA K，et al．Measuring patient-centered communication in patient-physician consultations：theoretical and practical issues［J］．Soc Sci Med，2005，61（7）：1516-1528．DOI：10.1016/j.socscimed.2005.02.001．
［16］HASHIM M J．Patient-centered communication：basic skills［J］．Am Fam Physician，2017，95（1）：29-34．
［17］STEWART M，BELLE B J，WESTON W W，et al．Patient-centred medicine：transforming the clinical method［J］．Patient Education and Counseling，1998，34（1）：s44.
［18］HELITZER D L，LANOUE M，WILSON B，et al．A randomized controlled trial of communication training with primary care providers to improve patient-centeredness and health risk communication［J］．Patient Educ Couns，2011，82（1）：21-29．DOI：10.1016/j.pec.2010.01.021.
［19］LEE W W，ALKUREISHI M L，ISAACSON J H，et al．Impact of a brief faculty training to improve patient-centered communication while using electronic health records［J］．Patient Educ Couns，2018，101（12）：2156-2161．DOI：10.1016/j.pec.2018.06.020.
［20］ROTER D L，WEXLER R，NARAGON P，et al．The impact of patient and physician computer mediated communication skill training on reported communication and patient satisfaction［J］．Patient Educ Couns，2012，88（3）：406-413．DOI：10.1016/j.pec.2012.06.020.
［21］KURTZ S，SILVERMAN J，BENSON J，et al．Marrying content and process in clinical method teaching：enhancing the Calgary-Cambridge guides［J］．Acad Med，2003，78（8）：802-809．DOI：10.1097/00001888-200308000-00011．
［22］DRAPER J，SILVERMAN J，HIBBLE A，et al．The east anglia deanery communication skills teaching project-six years on［J］．Med Teach，2002，24（3）：294-298．DOI：10.1080/01421590220134132．
［23］SILVERMAN J．The Calgary-Cambridge guides：the "teenage years"［J］．The Clinical Teacher，2007，4（2）：87-93．DOI：10.1111/j.1743-498X.2007.00159_1.x．
［24］MEDICINE A，P-FEB V N．Contemporary issues in medicine-medical informatics and population health：report Ⅱ of the Medical School Objectives Project［J］．Academic Medicine Journal of the Association of American Medical Colleges，1999，74（2）：130-141.
［25］PAPAGEORGIOU A，MILES S，FROMAGE M，et al．Cross-sectional evaluation of a longitudinal consultation skills course at a new UK medical school［J］．BMC Med Educ，2011，11：55．DOI：10.1186/1472-6920-11-55．
［26］ISHIKAWA H，ETO M，KITAMURA K，et al．Resident physicians' attitudes and confidence in communicating with patients：a pilot study at a Japanese university hospital［J］．Patient Educ Couns，2014，96（3）：361-366．DOI：10.1016/j.pec.2014.05.012.
［27］MAKOUL G．The SEGUE Framework for teaching and assessing communication skills［J］．Patient Educ Couns，2001，45（1）：23-34．DOI：10.1016/s0738-3991(01)00136-7．
［28］FRANKEL R M，STEIN T．Getting the most out of the clinical encounter：the four habits model［J］．J Med Pract Manage，2001，16（4）：184-191．
［29］STEIN T，FRANKEL R M，KRUPAT E．Enhancing clinician communication skills in a large healthcare organization：a longitudinal case study［J］．Patient Educ Couns，2005，58：4-12．DOI：10.1016/j.pec.2005.01.014.
［30］MAKOUL G．Essential elements of communication in medical encounters：the Kalamazoo consensus statement［J］．Acad Med，2001，76（4）：390-393．DOI：10.1097/00001888-200104000-00021．
［31］DONG T，LAROCHELLE J S，DURNING S J，et al．Longitudinal effects of medical students' communication skills on future performance［J］．Mil Med，2015，180：24-30．DOI：10.7205/MILMED-D-14-00565．
［32］LANGBERG E M，DYHR L，DAVIDSEN A S．Development of the concept of patient-centredness：a systematic review［J］．Patient Educ Couns，2019，102（7）：1228-1236．DOI：10.1016/j.pec.2019.02.023．
［33］NAUGHTON C A．Patient-centered communication［J］.Pharmacy（Basel），2018，6（1）：18．DOI：10.3390/pharmacy6010018．
［34］JIANG S，STREET R L．The effects of patient-centered communication，social capital，and internet use on patient empowerment：a cross-sectional study in China［J］．Glob Health Promot，2019，26（4）：33-43．DOI：10.1177/1757975917749197．
［35］SKILLINGS J L，PORCERELLI J H，MARKOVA T．Contextualizing SEGUE：evaluating residents' communication skills within the framework of a structured medical interview［J］．J Grad Med Educ，2010，2（1）：102-107．DOI：10.4300/JGME-D-09-00030.1.
［36］JOYCE B L，STEENBERGH T，SCHER E．Use of the kalamazoo essential elements communication checklist（adapted） in an institutional interpersonal and communication skills curriculum［J］．J Grad Med Educ，2010，2（2）：165-169．DOI：10.4300/JGME-D-10-00024.1．

［37］KOSIK R O，FAN A P，REN Y，et al．Medical humanities education in China：an exploratory cross-sectional study［J］．The Lancet，2018，392：s47．DOI：10.1016/S0140-6736(18)32676-X．

［38］杨辉．巴林特小组［J］．中国全科医学，2007，10（13）：1077-1079．DOI：10.3969/j.issn.1007-9572.2007.13.013．

YANG H．Balint Groups［J］．Chinese General Practice，2007（13）：1077-1079．DOI：10.3969/j.issn.1007-9572.2007.13.013．

［39］赵建平．巴林特小组及其在中国的发展［J］．教育理论与实践，2012，32（12）：37-39．

ZHAO J P．The balint group and its development in China［J］．Theory and Practice of Education，2012，32（12）：37-39．

［40］张佳，方力争，苏琳，等．如何提升全科医师医患沟通的艺术性-全科医师巴林特小组活动实录［C］．// 浙江省医学会全科医学分会．2015 年浙江省全科医学学术年会论文汇编．2015．

［41］刘婵，许琰，罗荧荃，周昱．巴林特小组在全科医师规范化培训中的实践应用［J］．中国全科医学，2018，21（31）：3858-3862．DOI：10.12114/j.issn.1007-9572.2018.31.017．

LIU C，XU Y，LUO Y Q，et al．Application of Balint Group Activities in the National Standardized Training of General Practitioners［J］．Chinese General Practice，2018，21（31）：3858-3862．DOI：10.12114/j.issn.1007-9572.2018.31.017．

［42］FRASER R C．Assessment of consultation competence［M］．Macclesfield：Glaxo Medical Fellowship，1994：171-180．

［43］FRASER R C，LEE R S Y，YIU Y K．Regulatory assessment of the consultation competence of family physicians in Hong Kong［J］．Hong Kong Practitioner，2004，26（1）：5-15．

［44］FRASER R C，SARKHOU M E，MCKINLEY R K，et al．Regulatory end-point assessment of the consultation competence of family practice trainees in Kuwait［J］．Eur J Gen Pract，2006，12（3）：100-107．DOI：10.1080 /13814780600898353．

［45］JIWA M，HALKETT G，MENG X，et al．Rating general practitioner consultation performance in cancer care：does the specialty of assessors matter?A simulated patient study［J］．BMC Fam Pract，2014，15（1）：1-5．DOI：10.1186/1471-2296-15-152．

［46］贾鸿雁，葛彩英，刘新颖，等．以提高全科医师应诊能力为核心的方庄社区基地教学探索［J］．医学教育管理，2016，2（S1）：63-65．DOI：10.3969/j.issn.2096-045X.2016.S1.019．

［47］陈亮，张维维，夏秀萍，等．莱斯特评估包在全科医生门诊接诊能力培训中的应用效果分析［J］．中华全科医师杂志，2018，17（7）：557-559．DOI：10.3760/cma.j.issn.1671-7368.2018.07.016．

CHEN L，ZHANG W W，XIA X P，et al．Application of Leichester assessment package in consultation skill training for general practitioners at outpatient clinic［J］．Chinese Journal of General Practitioners，2018，17（7）：557-559．DOI：10.3760/cma.j.issn.1671-7368.2018.07.016．

［48］TONYA F，TENY R．The nurse leader handbook［M］．NewYork：Studer Group Fire Starter Publishing，2010：191-192．

［49］张丽芳，唐碧云，朱永满，等．AIDET沟通模式在术后镇痛随访中的应用［J］．中华护理杂志，2013，48（4）：302-303．DOI：10.3761/j.issn.0254-1769.2013.04.004．

ZHANG L F，TANG B Y，ZHU Y M，et al．The application of AIDET communication mode in the postoperative pain management［J］．Chinese Journal of Nursing，2013，48（4）：302-303．DOI：10.3761/j.issn.0254-1769.2013.04.004．

［50］刘春瑞，冯聪聪．AIDET 沟通模式在全科诊疗服务中的应用研究［J］．中外医学研究，2016，14（23）：159-160．DOI：10.14033/j.cnki.cfmr.2016.23.087．

［51］CHAN C S，WUN Y T，CHEUNG A，et al．Communication skill of general practitioners：any room for improvement?How much can it be improved?［J］．Med Educ．2003，37（6）：514-526．DOI：10.1046/j.1365-2923.2003.01533.x．

［52］裴林夕，郭东锋，钟俊华，等．家庭医生接诊服务中运用剑桥医患沟通模式的效果分析［J］．中华全科医师杂志，2013，12（12）：977-979．DOI：10.3760/cma.j.issn.1671-7368.2013.12.014．

PEI L X，GUO A F，ZHONG J H，et al．Implementation of Calgary-Cambridge consultation guide in family medicine practice［J］．Chinese Journal of General Practitioners，2013，12（12）：977-979．DOI：10.3760/cma.j.issn.1671-7368.2013.12.014.

［53］董天睿，黄求进，聂婉翎，等．Calgary-Cambridge 指南在护患沟通技能培训中的应用［J］．中华现代护理杂志，2014，20（26）：3379-3382．

DONG T R，HUANG Q J，NIE W L，et al．Application of the Calgary-Cambridge Guide in the training of nurse-patient relationship for practice nurses［J］．Chinese Journal of Modern Nursing，2014，20（26）：3379-3382．

［54］HAIG K M，SUTTON S， WHITTINGTON J．SBAR：a shared mental model for improving communication between clinicians［J］．Jt Comm J Qual Patient Saf，2006，32（3）：167-175．DOI：10.1016/s1553-7250（06）32022-3．

［55］HEALTHCARE S ．What is SBAR and What is SBAR communication?［EB/OL］．［2014-06-15］https://www.saferhealthcare.com /SBAR/what is SBAR/．

［56］FINNIGAN M A，MARSHALL S D，FLANAGAN B T．ISBAR for clear communication：one hospital's experience spreading the message［J］．Aust Health Rev．2010，34（4）：400-404．DOI：10.1071/AH09823．

［57］CAREY B，O'CARROLL-LOLAIT C，DONLON N E，et al．In-hospital paging systems：an effective method of communication between hospital staff in 2015［J］．Ir Med J，2015，108（9）：267-270．

［58］FORONDA C L，ALHUSEN J，BUDHATHOKI C，et al．A Mixed-methods，international，multisite study to develop and validate a measure of nurse-to-physician communication in simulation［J］．Nurs Educ Perspect．2015，36（6）：383-388．DOI：10.5480/15-1644．

［59］何正超，钟兰兰，陆群峰．SBAR 沟通模式在临床护理应用的研究进展［J］．护理研究，2017，31（3）：271-274．DOI：10.3969/j.issn.1009-6493.2017.03.006．

HE Z C，ZHONG L L，LU Q F．Research progress on application of SBAR communication model in clinical nursing［J］．Chinese Nursing Research，2017，31（3）：271-274．DOI：10.3969/j.issn.1009-6493.2017.03.006．

［60］曹萌，王涛，翟倩倩，等．ISBAR 沟通训练对全科规范化培训住院医师沟通与团队合作能力的影响研究［J］．中国全科医学，2020，23（16）：2062-2066．DOI：10.12114/j.issn.1007-9572.2019.00.700．

CAO M，WANG T，ZHAI Q Q，et al．Effect of ISBAR communication training model on communication skills and teamwork ability of general practitioners participating in standardized residency training［J］．Chinese General Practice，2020，23（16）：2062-2066．DOI：10.12114/j.issn.1007-9572.2019.00.700．

［61］赵铁夫，邹晓昭，周洪丹，等．北京市全科医生门诊医患沟通技能水平现状调查［J］．中国全科医学，2019，22（4）：413-416．DOI：10.12114/j.issn.1007-9572.2019.04.009．

ZHAO T F，ZOU X Z，ZHOU H D，et al．General practitioner-patient communications in outpatient clinic settings in Beijing［J］．Chinese General Practice，2019，22（4）：413-416．DOI：10.12114/j.issn.1007-9572.2019.04.009．

［62］HA J F，LONGNECKER N．Doctor-patient communication：a review［J］．Ochsner J．2010，10（1）：38-43．DOI：10.3329/jbcps.v32i2.26036．

［63］STEIN T．A decade of experience with a multiday residential communication skills intensive：has the outcome been worth the investment?［J］．Perm J，2007，11（4）：30-40．DOI：10．7812/tpp/07-069．

［64］李华英，邓敏，石冰．Calgary-Cambridge 会谈指南用于护生治疗性沟通教学实践［J］．护理学杂志，2014，29（24）：1-3．DOI：10.3870/hlxzz.2014.24.001．

LI H Y，DENG M，SHI B．Effect of applying Calgary Cambridge Guide in therapeutic communication training of nursing students［J］．Journal of Nursing Science，2014，29（24）：1-3．DOI：10.3870/hlxzz.2014.24.001．

［65］吴曦，陈剑春，刘建民．卡尔加里- 剑桥指南在医患沟通技能教学中的应用［J］．中国医学教育技术，2013，27（2）：218-221．DOI：10.3969/j.issn.1004-5287.2013.02．

WU X，CHEN J C，LIU J M．Application of Calgary-Cambridge Guide in doctor-patient communication skills teaching［J］．China Medical Education Technology，2013，27（2）：218-221．DOI：10.3969/j.issn.1004-5287.2013.02．

［66］国家卫生健康委员会．2019 中国卫生健康统计年鉴［M］．北京：中国协和医科大学出版社，2019．

［67］王冬阳，陈永年，方佩英，等．江苏省家庭医生签约服务工作现状及满意度研究［J］．中国全科医学，2018，21（19）：2297-2302．DOI：10.3969/j.issn.1007-9572.2018.00.19．

WANG D Y，CHEN Y N，FENG P Y，et al．Current status of family doctor contracted services and its satisfaction degree in Jiangsu Province［J］．Chinese General Practice，2018，21（19）：2297-2302．DOI：10.3969/j.issn.1007-9572.2018.00.19．

［68］郑艳玲，余芳，陈艳黎，等．我国全科医生职业倦怠状况及影响因素研究［J］．中国全科医学，2019，22（7）：764-769．DOI：10.12114/j.issn.1007-9572.2019.07.005．

ZHENG Y L，YU F，CHEN Y L，et al．Prevalence and Influencing Factors for Job Burnout among General Practitioners in China［J］．Chinese General Practice，2019，22（7）：764-769．DOI：10.12114/j.issn.1007-9572.2019.07.005．

［69］邱钰晖，何飞英．“互联网+”背景下医患沟通教育实践探索［J］．中国多媒体与网络教学学报（上旬刊），2019（6）：185-186．

［70］宗俐利．基于翻转课堂的教育传播学课程网络学习平台的设计与制作［D］．漳州：闽南师范大学，2016．

［71］张记刚．基于慕课+ 微信公众平台的混合式教学模式探索——以" 传播学理论" 课程为例［J］．新闻研究导刊，2018，9（16）：230-231．DOI：10.3969/j.issn.1674-8883.2018.16.154．

［72］高海英，袁媛，赵媛元，等．慕课教学在全科医学住院医师培训中的应用［J］．中国继续医学教育，2017，9（26）：5-7．DOI：10.3969/j.issn.1674-9308.2017.26.003．

［73］GAO H Y，YUAN Y，ZHAO Y Y，et al．Applicationg of moocteaching mode in medical residents in general medicine［J］．China Continuing Medical Education，2017，9（26）：5-7．DOI：10.3969/j.issn.1674-9308.2017.26.003．

［74］卢永平．移动互联网时代全科医生在线培训模式探讨［J］．中国高等医学教育，2017，（11）：30-31．DOI：10.3969/j.issn.1002-1701.2017.11.016.

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