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      Comunicación efectiva en salud: evaluación de una experiencia docente en estudiantes de medicina de Cuenca, Ecuador Translated title: Comunicació efectiva en salut: avaluació d'una experiència docent en estudiants de medicina de Cuenca, l'Equador Translated title: Effective communication in Health: evaluation of a teaching experience in Medicine School of Cuenca, Ecuador

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          Abstract

          Resumen Introducción: La comunicación dentro del ámbito médico es esencial para obtener buenos resultados en consulta; esta habilidad debe aprenderse a lo largo de la carrera y no suponer que es innata. Luego de una revisión sistemática de la metodología de enseñanza en Ecuador y el poco desarrollo que ha tenido dentro de las universidades, vemos la necesidad de realizar un estudio evaluando las habilidades comunicacionales de los estudiantes de medicina. Metodología: se incluyó cien estudiantes de sexto año que realizan el internado en el Hospital Vicente Corral Moscoso. Se valoró las entrevistas por observación directa utilizando una lista de verificación sustentada en la Guía Calgary-Cambridge. Se analizaron los datos buscando diferencia estadística. Resultados: No hubo diferencia estadística entre los grupos. El promedio obtenido por los evaluados fue de 13,96 de 23 habilidades. Se comparó por dos grupos: estudiantes que tenían formación en comunicación médica (19) y los que no tenían ninguna (81). Se encontró que los estudiantes con formación en comunicación desarrollan entrevistas con mayor empatía, escucha efectiva, respeto por las expectativas de los pacientes y capacidad de resumir los hallazgos en busca de resultados más eficaces. Conclusión: Se observan algunas diferencias entre ambos grupos comparables con estudios internacionales. Se recomienda a las escuelas establecer un currículo formal para el aprendizaje de la comunicación como habilidad efectiva en la formación médica. El objetivo es humanizar la comunicación y favorecer una mejor relación entre médico y paciente.

          Translated abstract

          Resum Introducció: La comunicació dins de l'àmbit mèdic és essencial per a obtenir bons resultats en consulta; aquesta habilitat ha d'aprendre's al llarg de la carrera i no suposar que és innata. Després d'una revisió sistemàtica de la metodologia d'ensenyament a l'Equador i el poc desenvolupament que ha tingut dins de les universitats, veiem la necessitat de realitzar un estudi avaluant les habilitats comunicacionals dels estudiants de medicina. Metodologia: Es va incloure cent estudiants de sisè any que realitzen l'internat a l'Hospital Vicente Corral Moscoso. Es va valorar les entrevistes per observació directa utilitzant una llista de verificació sustentada en la Guia Calgary-Cambridge. Es van analitzar les dades buscant diferència estadística. Resultats: No va haver-hi diferència estadística entre els grups. La mitjana obtinguda pels avaluats va ser de 13,96 de 23 habilitats. Es va comparar per dos grups: estudiants que tenien formació en comunicació mèdica (19) i els que no tenien cap (81). Es va trobar que els estudiants amb formació en comunicació desenvolupen entrevistes amb major empatia, escolta efectiva, respecte per les expectatives dels pacients i capacitat de resumir les troballes a la recerca de resultats més eficaços. Conclusió: S'observen algunes diferències entre tots dos grups comparables amb estudis internacionals. Es recomana a les escoles establir un currículum formal per a l'aprenentatge de la comunicació com a habilitat efectiva en la formació mèdica. L'objectiu és humanitzar la comunicació i afavorir una millor relació entre metge i pacient.

          Translated abstract

          Abstract Introduction: Communication within the medical field is essential to obtain good results from the consultation. This skill must be learned throughout the career and not assumed to be innate. After a systematic review of teaching methodology in Ecuador and the little development it has had within medical schools, we carried out an observational study evaluating communication skills of medical students. Methodology: One hundred final-year students working at the Vicente Corral Moscoso Hospital were included. Direct observation interviews were assessed using a checklist tool supported by the Calgary-Cambridge Guide. Data were analyzed looking for statistical significance. Results: There was no statistical significance between groups. Mean score was 13.96 out of 23 skills evaluated. Two groups were randomized: students who had training in medical communication (19) and those who had none (81). Students with communication training developed empathic interviews, effective listening, respect for patient expectations and were capable to summarize findings for effective communication outcomes. Conclusion: There are some differences between both groups comparable with international studies. Ecuadorian Medical Schools are encouraged to establish a formal curriculum in learning and training communication skills. The objective is to humanize communication and to promote better relationship between doctor and patient.

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          Physicians' communication and perceptions of patients: is it how they look, how they talk, or is it just the doctor?

          Although physicians' communication style and perceptions affect outcomes, few studies have examined how these perceptions relate to the way physicians communicate with patients. Moreover, while any number of factors may affect the communication process, few studies have analyzed these effects collectively in order to identify the most powerful influences on physician communication and perceptions. Adopting an ecological approach, this investigation examined: (a) the relationships of physicians' patient-centered communication (informative, supportive, partnership-building) and affect (positive, contentious) on their perceptions of the patient, and (b) the degree to which communication and perceptions were affected by the physicians' characteristics, patients' demographic characteristics, physician-patient concordance, and the patient's communication. Physicians (N=29) and patients (N=207) from 10 outpatient settings in the United States participated in the study. From audio-recordings of these visits, coders rated the physicians' communication and affect as well as the patients' participation and affect. Doctors were more patient-centered with patients they perceived as better communicators, more satisfied, and more likely to adhere. Physicians displayed more patient-centered communication and more favorably perceived patients who expressed positive affect, were more involved, and who were less contentious. Physicians were more contentious with black patients, whom they also perceived as less effective communicators and less satisfied. Finally, physicians who reported a patient-centered orientation to the doctor-patient relationship also were more patient-centered in their communication. The results suggest that reciprocity and mutual influence have a strong effect on these interactions in that more positive (or negative) communication from one participant leads to similar responses from the other. Physicians' encounters with black patients revealed communicative difficulties that may lower quality of care for these patients.
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            Effective training strategies for teaching communication skills to physicians: an overview of systematic reviews.

            Physicians need good communication skills to communicate effectively with patients. The objective of this review was to identify effective training strategies for teaching communication skills to qualified physicians. PubMED, PsycINFO, CINAHL, and COCHRANE were searched in October 2008 and in March 2009. Two authors independently selected relevant reviews and assessed their methodological quality with AMSTAR. Summary tables were constructed for data-synthesis, and results were linked to outcome measures. As a result, conclusions about the effectiveness of communication skills training strategies for physicians could be drawn. Twelve systematic reviews on communication skills training programmes for physicians were identified. Some focused on specific training strategies, whereas others emphasized a more general approach with mixed strategies. Training programmes were effective if they lasted for at least one day, were learner-centred, and focused on practising skills. The best training strategies within the programmes included role-play, feedback, and small group discussions. Training programmes should include active, practice-oriented strategies. Oral presentations on communication skills, modelling, and written information should only be used as supportive strategies. To be able to compare the effectiveness of training programmes more easily in the future, general agreement on outcome measures has to be established. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
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              Teaching communications skills to medical students: Introducing the fine art of medical practice

              Introduction: Like many other people based professions, communications skills are essential to medical practice also. Traditional medical teaching in India does not address communication skills which are most essential in dealing with patients. Communication skills can be taught to medical students to increase clinical competence. Objective: To teach basic communication and counseling skills to fourth-year undergraduate students to increase their clinical competence. Methodology: A total of 48, fourth-year MBBS students participated in the study. They were given training in basic communication and counseling skills and taught the patient interview technique according to Calgary–Cambridge guide format. Improvement in communication was assessed by change in pre- and post-training multiple choice questions, clinical patient examination, and Standardized Patient Satisfaction Questionnaire (SPSQ) scores. Results and Analysis: About 88% of the students in the sample were convinced of the importance of learning communication skills for effective practice. Almost 90% students were communicating better after training, as tested by improved SPSQ. As judged by Communication Skill Attitude Scale, student's positive attitude toward learning communication skill indicated that there is a necessity of communication skill training during undergraduate years. Conclusion: The ability to communicate effectively is a core competency for medical practitioners. Inculcating habits of good communications skill during formative years will help the medical students and future practitioners. Regular courses on effective communication should be included in the medical school curriculum.
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                Author and article information

                Journal
                bioetica
                Revista de Bioética y Derecho
                Rev. Bioética y Derecho
                Observatori de Bioètica i Dret - Cátedra UNESCO de Bioética (Barcelona, Barcelona, Spain )
                1886-5887
                2021
                : 52
                : 85-104
                Affiliations
                [2] Azuay orgnameUniversidad de Cuenca Ecuador
                [1] orgnameUniversidad de Barcelona España
                Article
                S1886-58872021000200006 S1886-5887(21)00005200006
                10.1344/rbd2021.52.34162
                a32b247e-b921-4500-88bb-131b673b6f0e

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 17 May 2021
                : 15 March 2021
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 32, Pages: 20
                Product

                SciELO Spain

                Categories
                Monográfico comunicación en el ámbito sanitario

                aprenentatge mèdic,comunicació efectiva,relació metge-pacient,Guia Calgary-Cambridge,Doctor patient relationship,Calgary-Cambridge guide,effective communication,medical learning,relación médico-paciente,Guía Calgary-Cambridge,comunicación efectiva,aprendizaje médico

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