情景模拟教学法在提升中医助理全科医生医患沟通的应用研究

The Application Research of Situational Simulation Teaching Method in Improving the Doctor-Patient Communication of Traditional Chinese Medicine Assistant General Practitioners

摘要: 本研究探讨情景模拟教学法对中医助理全科医生(简称“助培生”)医患沟通态度、医患沟通能力及临床共情能力的影响。选取2023级、2024级共40名助培生作为研究对象，随机分为实验组与对照组，各20人。对照组实施传统教学法，实验组在传统教学基础上融入系统化情景模拟教学。在干预前及干预后，分别采用医学生沟通技能态度量表(CSAS)、医学生医患沟通行为量表(自评)、杰弗逊共情量表(医学生版)及两组的出科成绩、教师评价及患者评价。结果发现，干预后实验组在CSAS的积极态度分量表得分、医患沟通行为量表得分、共情能力得分、带教满意度及出科成绩、教师和患者评价方面均显著高于对照组(P < 0.05)，而CSAS的消极态度分量表得分显著低于对照组(P < 0.05)。结论：情景模拟教学法能有效提升中医助培生的医患沟通技能与临床共情能力，改善其学习态度，并获得更优的教学效果与临床评价，是培养高素质基层中医全科人才的有效教学方法之一。

Abstract: This study explores the impact of situational simulation teaching method on the attitude of traditional Chinese medicine assistant general practitioners (referred as “training students”) towards their attitude of doctor-patient communication, doctor-patient communication skills, and clinical empathy. Forty training students from the 2023 and 2024 cohorts were selected as research subjects and randomly divided into an experimental group and a control group, each with 20 students. The control group implemented traditional teaching, while the experimental group integrated systematic situational simulation teaching on the basis of traditional teaching. Before and after the intervention, the Student Communication Skills Attitude Scale (CSAS), Doctor-Patient Communication Behavior Scale (self-evaluation), the Jefferson Empathy Scale (student version), and the results of the two groups’ rotation, teacher evaluation, patient evaluation were used. The results showed that after the intervention, the experimental group had significantly higher scores in the positive attitude subscale of CSAS, doctor-patient communication behavior scale, empathy ability, teaching satisfaction, and rotation results, teacher and patient evaluations than the control group (P < 0.05), while the score in the negative attitude scale of CSAS was significantly lower than that of the control group (P < 0.05). Conclusion: Situational simulation teaching method can effectively improve the patient communication skills and clinical empathy ability of traditional Chinese medicine assistant general practitioners, improve their learning attitude, and obtain better teaching results and clinical evaluation, which is one of the effective methods to cultivate high-quality basic traditional Chinese medicine general practitioners.