标准化病人在的美国住院医师伦理与沟通教育中的应用.pdf

　　第 21卷第 5期 2008年 10月 中国医学伦理学 Chinese Medical Ethics Vol. 21 No. 5 Oct. 2008 标准化病人在美国住院医师伦理与沟通教育中的应用 唐 　健 1 ,张金钟 2 (1　天津医科大学医学人文科学系 ,天津　300070; 2　天津中医药大学、天津医科大学 ,天津　300070) 〔摘要 〕标准化病人是美国当前住院医师培养中伦理与沟通教育的重要载体。介绍了美国住院医师伦理与沟通技能教学 设计与实施过程 ,以标准化病人的身份参与教学与评估工作的感触。就沟通教学中教师角色、设计理念、标准化病人设计的步 骤、教学氛围的建立等相关问题总结了一些经验 ,并对国内应用标准化病人于教学提出一些初步的设想。 〔关键词 〕伦理与沟通教学 ;标准化病人 ;医学教育 〔中图分类号 〕R - 052　　　〔文献标识码 〕A　　　〔文章编号 〕1001 - 8565 (2008) 05 - 0072 - 04 The Applica tion of Standard ized Pa tien ts in the Educa tion of Eth ics and Physic ian - Pa tien t Comm un ica tion Sk ills for Am er ican Residen t D octors. An O bserva tiona l Study TANG J ian 1 , ZHAN G J in - zhong 2 (1　D epartm en t of M ed ica l Hum anities, T ian jin M edica l U niversity, T ian jin 300070, Ch ina; 2　Tian jin U niversity of TCM and Tian jin M edica l U niversity, T ian jin 300070, Ch ina) Abstract: Standardized patients are now serving as an important vehicle in the education of ethics and physician - patient communication skills for American resident doctors. This observational study introduces the background, design and implement of the education of ethics and physician - patient communication skills, and describes the author’s personal experiences as an a trained standardized patient in the ethics and communication training workshop for American residents. Some experiences are concluded on related issues including expected roles of teachers, teaching philosophy, SPs design, supportive environment building, and some primary assumptions on applying SPs to Chinese medical education. Key words: Education of Ethics and Physician - Patient Communication Skills; Standardized Patients ( SPs) ; Medical Education 1　背景 2001年 ,美国住院医师教育评鉴委员会 (ACGME)提出 “效果工程 (Outcome Project) ”,要求其所属的会员医学院与教 学医院必须要对其住院医师的医学知识 (Medical knowledge)、 以实践为基础的学习与改进 ( Practice - based learning and imp rovement)、病人关怀 ( Patient - care)、基于医疗体系的执业 ( System - based p ractice)、人际与沟通技能 ( Interpersonal and communication skills)与专业精神 (p rofessionalism)等六项核心 能力进