TY - JOUR AU - White, Andrew A AU - King, Ann M AU - D ' addario, Angelo E AU - Brigham, Karen Berg AU - Dintzis, Suzanne AU - Fay, Emily E AU - Gallagher, Thomas H AU - Mazor, Kathleen M PY - 2022 DA - 2022/10/3 TI -使用基于视频的沟通评估应用程序实践并获得群众反馈对住院医生不良事件沟通技能的影响:张后审判乔-地中海JMIR建造SP - e40758六世- 8 - 4 KW -医疗错误披露KW -模拟研究KW -沟通评估KW -研究生医学教育KW -众包KW -以病人为中心的护理KW -医学教育KW -虚拟教育KW -虚拟沟通KW -医生沟通千瓦居民KW -虚拟学习KW -数字化学习KW -视频通信KW -医疗错误KW -数字响应AB -背景:美国住院医生需要实践和反馈，以满足研究生医学教育认证委员会的要求和患者在发生有害错误后进行有效沟通的期望。目前的教学方法严重依赖于讲座，很少向住院医生提供关于沟通技巧的个性化反馈，并且可能无法确保住院医生获得患者所需的技能。基于视频的沟通评估(VCA)应用程序是一种新颖的工具，用于模拟实践中的沟通场景，并获得关于医生沟通技能的众包评估和反馈。我们之前已经确定，众包外行可以通过VCA应用程序可靠地评估住院医生的错误披露技能。然而，它对错误披露培训的有效性尚未经过测试。目的:我们旨在评估使用VCA实践和反馈作为独立干预对住院医师错误披露技能发展的效果。方法:我们于2020年对美国一家学术医疗中心的病理学、妇产科和内科住院医师进行了一项前后研究。在基线时，每位居民完成了2例描述医疗错误的特定专业VCA病例。音频回答由至少8名众包外行使用6个项目(满分5分)对其进行评分。 At 4 weeks, residents received numerical and written feedback derived from layperson ratings and then completed 2 additional cases. Residents were randomly assigned cases at baseline and after feedback assessments to avoid ordinal effects. Ratings were aggregated to create overall assessment scores for each resident at baseline and after feedback. Residents completed a survey of demographic characteristics. We used a 2×3 split-plot ANOVA to test the effects of time (pre-post) and specialty on communication ratings. Results: In total, 48 residents completed 2 cases at time 1, received a feedback report at 4 weeks, and completed 2 more cases. The mean ratings of residents’ communication were higher at time 2 versus time 1 (3.75 vs 3.53; P<.001). Residents with prior error disclosure experience performed better at time 1 compared to those without such experience (ratings: mean 3.63 vs mean 3.46; P=.02). No differences in communication ratings based on specialty or years in training were detected. Residents’ communication was rated higher for angry cases versus sad cases (mean 3.69 vs mean 3.58; P=.01). Less than half of all residents (27/62, 44%) reported prior experience with disclosing medical harm to patients; experience differed significantly among specialties (P<.001) and was lowest for pathology (1/17, 6%). Conclusions: Residents at all training levels can potentially improve error disclosure skills with VCA practice and feedback. Error disclosure curricula should prepare residents for responding to various patient affects. Simulated error disclosure may particularly benefit trainees in diagnostic specialties, such as pathology, with infrequent real-life error disclosure practice opportunities. Future research should examine the effectiveness, feasibility, and acceptability of VCA within a longitudinal error disclosure curriculum. SN - 2369-3762 UR - https://mededu.www.mybigtv.com/2022/4/e40758 UR - https://doi.org/10.2196/40758 UR - http://www.ncbi.nlm.nih.gov/pubmed/36190751 DO - 10.2196/40758 ID - info:doi/10.2196/40758 ER -