Communication Skills Program Design and Implementation for Residency Training at Internal Medicine Department of Ege University Faculty of Medicine

Abstract

Introduction: The importance of communication skills in residency training is emphasized by different residency training organizations. In this research, after planning and implementing a communication skills training programme, assistant doctors’ knowledge and skill levels were evaluated, and assistant doctors’ opinions about programme were taken. Material and Method: This is an experimental type research using one group final test design. This research was conducted with second and third year assistant doctors at Internal Medicine Department of Ege University Faculty of Medicine. The curriculum was designed following an extensive needs assessment, and the training program was delivered in four sessions, each 2 hours long. A final written test and Objective Structured Clinical Examination (OSCE) were used to assess assistant doctors’ achievement. “Session evaluation form” and “programme evaluation form” were used to evaluate programme. Findings: Mean of the written test was found 43.10±10.30. Mean scores of the assistant doctors’ and cappa values on the stations of “Medical Interview Skills”, “Breaking Bad News” and “Communication with difficult patient” were 66, 0.79; 84, 0.63; 83, 0.59 respectively. In terms of session evalutaions, the highest means were found on the items of “explaining of the session’s goal and objectives”, “presentation of trainer”, “preparing of trainer”, “relevancy with the content and training methods” and “encouraging active participation”; the lowest means were found on the items of “session time”, “physical sources of training environment”. Assistant doctors stated that the programme was constructive and beneficial on the aspects of the content, instructional method, instructional material, and gaining skills; and unfavorable on the aspect of meaning of theoretical knowledge and time poverty for training. Results: According to the result of this research, after improving of the programme, it could be used in the residency training.

Keywords

• Communication skills, residency training, curriculum design, assessment, OSCE

EGE ÜNİVERSİTESİ TIP FAKÜLTESİ İÇ HASTALIKLARI ANABİLİM DALI ASİSTAN EĞİTİMİ İÇİN İLETİŞİM BECERİLERİ PROGRAM TASARIMI VE UYGULAMASI

Abstract

Giriş ve Amaç: Tıpta uzmanlık eğitiminde iletişim becerilerinin önemi, çeşitli uzmanlık eğitimi kurulusları tarafından ifade edilmektedir. Bu araştırmada, iletişim becerileri programı tasarlanıp uygulandıktan sonra asistanların bilgi ve beceri düzeylerinin değerlendirilerek, program hakkındaki görüşlerinin sunulması hedeflenmiştir. Gereç ve Yöntem: Tek grup son test deseninin kullanıldığı deneysel tipteki araştırma, EÜTF İç Hastalıkları AD ikinci ve üçüncü yıl asistanları ile yürütülmüştür. Kapsamlı bir ihtiyaç analizini takiben program tasarımı yapılmış ve eğitim 2 saatlik 4 oturumda gerçekleştirilmiştir. Asistanların basarı düzeyini ölçmek için basarı testi ve Objektif Yapılandırılmış Klinik Sınav (OYKS) uygulanmıştır. Programı değerlendirmek için oturum ve program değerlendirme formları kullanılmıştır. Bulgular: Başarı testi puan ortalaması 100 üzerinden 43.10±10.30’ dur. İstasyonlardan alınan ortalama puanlar ve gözlemciler arası tutarlılık için bakılan kappa değerleri; “Tıbbi görüşme becerileri” için 66 ve 0.79, “Kötü haber verme” için 84 ve 0.63, “Zor hasta ile görüşme” için 83 ve 0.59’dur. Eğitim oturumlarının genel değerlendirmesinde en yüksek ortalamalar amaç ve hedeflerin belirtilmesi, eğiticinin sunumu, eğiticinin hazırlığı, eğitim yöntemlerinin içerikle uyumlu olması ve aktif katılıma cesaretlendirmesi; en düşük ortalamalar ise oturum zamanı, eğitim ortamının fiziksel olanaklar açısından değerlendirilmesine verilmiştir. Asistanlar, programı içerik, yöntem, araç-gereç, eğitici ve beceri kazandırma açısından olumlu; teorik bilginin anlaşılma zorluğunu ve eğitim için zaman yetersizliğini olumsuz olarak bildirmişlerdir. Sonuç: Bu program geliştirildikten sonra uzmanlık eğitiminde kullanılabilir.

Keywords

• İletişim becerileri, uzmanlık eğitimi, eğitim programı tasarımı, değerlendirme

References

1. Zeldow PB, Makoul G. Communicating with patients. In: Wedding D., Stuber ML(Ed.). Behavior&Medicine. 4th Edition. Hogrefe&Huber Publishers; 2006.
2. Harms C, Young JR, Amsler F, Zettler C, Scheidegger D, Kindler CH. Improving anaestetists’ communication skills. Anaesthesia 2004; 59: 166-172.
3. Erden M. Eğitimde program değerlendirme. Anı Yayıncılık, 1998.
4. Kern DE, Thomas PA, Howard DM, Bass EB. Curriculum development for medical education, a six- step approach. The Johns Hopkins University Press, 1999.
5. Hulsman RL, Ros WJ, Winnubst JAM, Bensing JM. Teaching clinically experienced physicians communication skills: A review of evaluation studies. Medical Education 1999; 33: 655-668.
6. Biggs JSG. A good guide for postgraduate educators: Lessons learned in Britain. Medical Teacher 1998; 20 (3): 200-202.
7. Cupp LC. Communication skills training in otolaryngology head and neck surgery residencies. California, La Verne Publications, 2003.
8. Norling GR. Developing and testing a theoretical model of rapport-building: Implications for medical education and physician-patient communication. Unpublished doctoral dissertation, University of Kentucky, 2003. http://www.lib.umi.com/dissertations/preview_all/3078401 adresinden 16.07.2004 tarihinde ulaşılmıştır.

9. Hesketh EA, Allan MS, Harden RM, Macpherson SG. New doctors’ perceptions of their educational development during their first year of postgraduate training. Medical Teacher 2003; 25 (1): 67-76.
10. Kurtz S, Laidlaw T, Makoul G, Schnabl G. Medical education initiatives in communication skills. Cancer Prevention & Control 1999; 3 (1): 37-45.
11. Duffy FD, Gordon GH, Whelan G, Cole-Kelly K, Frankel R. Assessing competence in communication and interpersonal skills: The Kalamazoo II Report. Academic Medicine 2004; 79: 495-507.
12. Humphris GM, Kaney S. Examiner fatigue in communication skills objective structured clinical examinations. Medical Education 2001; 35: 444-449.
13. O’Connor HM, McGraw RC. Clinical skills training: Developing objective assessment instruments. Medical Education 1997; 3: 1359-363.
14. Gorter S, Rethans JJ, Scherhier A, Heijde D, Houben H, Vleuten C, Linden S. Developing case specific checklists for standardized patient based assessment in internal medicine: A review of the literature. Academic Medicine 2000; 75: 1130-1137.
15. Chan CSY, Wun YT, Cheung A, Dickinson JA, Chan KW, Lee HC, Yung YM. Communication skill of general practitioners: Any room for improvement? How much can it be improved? Medical Education 2003; 37: 514-526.
16. Haes JCJM, Oort F, Oosterveld P, Cate O. Assessment of medical students’ communicative behaviour and attitudes: Estimating the reliability of the use of the Amsterdam attitudes and communication scale through generalisability coefficients. Patient Education and Counseling 2001; 45: 35-42.
17. Noble L. Communication skills training: Pragmatism versus proof. Medical Education 2002; 36: 108-109.
18. Ağargün MY. Psikofarmakolojik araştırmalarda temel istatistik. Bulletin of Clinical Psychopharmacology 1999; 9 (4): 173-180.