问题:高质量的沟通提高了患者满意度和临床结果,然而,在住院医师方面的正式沟通培训往往很少。许多关于移情交流的研究显示出好坏参半的结果,并且经常被简短的研究长度所阻碍和扭曲,定义不充分和模糊的概念,和有限的客观测量方法。干预:FAN课程是一个独特的沟通课程,基于以患者为中心的沟通的概念框架,反思性实践,正念,并使用促进调谐交互(FAN)模型进行调谐。FAN课程的第一部分是一个3小时的互动工作坊,涉及教学法,小组讨论,和儿科住院医师的角色扮演。然后,居民们完成了每周的自我反思,一小时的后续培训,以加强概念,和五次每月的导师会议,都强调反思性实践。上下文:这个纵向,混合方法研究检查了FAN课程对居民的移情水平和在临床环境中与父母沟通能力的影响。这项研究是在两个城市进行的,学术,2016年10月至2017年11月期间在芝加哥的中型儿科住院医师计划。连续性诊所位于其家庭机构的第一年和第二年儿科居民参加了。居民接受了使用FAN通信工具的培训,该工具使用了延迟启动的交叉研究设计。影响:在五个时间点,住院医师和家长完成了经过验证的测量医生同理心和正念的仪器。对一个机构的居民和导师进行了研究后访谈,并使用开放和集中的编码进行了评估。参与者(n=23)在培训后六个月证明了对FAN交流工具的高度使用,并且在五个FAN核心流程中的四个中,自我报告的舒适度显着提高。一项家长完成的调查(咨询和关系移情,CARE)显示,培训后居民关系同理心和协作的统计学显着提高了3.26%(p=0.02)。在访谈的定性分析中,居民和导师发现风扇沟通工具有益,使诊所访问更有效和协作。两组均注意到居民关系建立技能的改善;居民能够利用增强的沟通技巧来更好地应对具有挑战性的遭遇,并通过父母的关注开展工作。经验教训:以家庭为中心的沟通培训可以提高医生感知的同理心和正念。儿科住院医师的有效沟通包含了一种移情的方法,正式课程的介绍支持了他们与孩子和父母的联系和互动。FAN课程可能为提高居民沟通技巧提供了一种有用的方法,对儿科医生与患者和家庭的合作产生积极影响。
Problem: High-quality communication improves patient satisfaction and clinical outcomes, yet formal communication training in residency is often minimal. Many studies on empathic communication show mixed results and are often hindered and skewed by brief
study lengths, insufficiently and ambiguously defined concepts, and limited methods for objective measurements. Intervention: The FAN Curriculum is a unique communication curriculum, based on the conceptual frameworks of patient-centered communication, reflective practice, mindfulness, and attunement using the Facilitating Attuned Interactions (FAN) model. The first part of the FAN Curriculum was delivered as a 3-hour interactive workshop involving didactics, group discussion, and role play with pediatric residents. Residents then completed weekly self-reflections, a follow-up one-hour training to reinforce concepts, and five monthly mentor sessions, all emphasizing reflective practice. Context: This longitudinal, mixed-methods
study examined the effects of the FAN Curriculum on residents\' empathy levels and ability to communicate with parents in the clinical setting. The
study was conducted at two urban, academic, medium-sized pediatric residency programs in Chicago between October 2016 and November 2017. First- and second-year pediatric residents whose continuity clinic site was located at their home institution participated. Residents received training in the use of the FAN Communication Tool using a delayed-start crossover
study design. Impact: At five time points, residents and parents completed instruments validated for measuring physician empathy and mindfulness. Post-
study interviews were conducted for one institution\'s residents and mentors and were evaluated using open and focused coding. Participants (n = 23) demonstrated a high degree of use of the FAN Communication Tool six months post-training and a significant rise in self-reported comfort with four of five FAN core processes. One parent-completed survey (Consultation and Relational Empathy, CARE) showed a statistically significant rise of 3.26% in resident relational empathy and collaboration after training (p = 0.02). In qualitative analysis of interviews, residents and mentors found the FAN Communication Tool beneficial, making clinic visits more efficient and collaborative. Both groups noted improvement in the residents\' relationship-building skills; residents were able to use enhanced communication skills to better approach challenging encounters and work through parent concerns. Lessons Learned: Family-centered communication training can improve physician-perceived empathy and mindfulness. Effective communication for pediatric residents incorporates an empathic approach, and introduction to this formal curriculum supported their growth in connecting and engaging with children and parents. The FAN Curriculum may provide a useful method for improving resident communication skills with a positive impact on pediatricians\' collaboration with patients and families.