关键词: 教学, 医患沟通, 叙事医学, 平行病历, 全科医师, 患者满意度

Abstract: Objective To explore the effect of parallel medical record writing and sharing on improving general practice physicians′ communication skills and patient satisfaction. Methods From June 2024 to June 2025, 47 clinicians qualified for general practice resident standardized training and teaching from Beijing Anzhen Hospital, Capital Medical University were selected as subjects. After organizing guidance physicians to learn narrative medicine methods, complete parallel medical record writing and exchange, we evaluated their outpatient doctor-patient communication SEGUE scale scores and patient satisfaction before and after the intervention, and compared the scores with t-test. Fifteen doctors were enrolled in the study using purposive sampling. The one-on-one semi-structured in-depth interview method was adopted in this study. The interview data was processed through audio recording and text transcription, analysis unit construction, content coding, and theme extraction. Descriptive phenomenological analysis was finally applied to conduct logical analysis on the interview materials, so as to clarify doctors′ perceptions and opinions regarding narrative medicine training and parallel chart writing, as well as summarize the core themes derived from the interviews. Results After intervention, scores for the preparation stage (4.79±0.55 vs. 3.15±0.36), information collection (7.74±1.13 vs. 4.26±2.24), information provision (3.72±0.45 vs. 2.66±0.76), patient understanding (3.72±0.50 vs. 1.64±0.87), final inquiry (1.36±0.49 vs. 1.09±0.50), total SEGUE score (21.34±2.09 vs. 12.79±3.36), and patient satisfaction (8.17±0.64 vs. 7.64±0.71) were all higher than pre-intervention (all P<0.01). General practitioners scored higher than specialists in information provision (3.92±0.29 vs. 3.66±0.48), patient understanding (3.92±0.29 vs. 3.66±0.54), and patient satisfaction (8.58±0.79 vs. 8.03±0.51), all P<0.05. Doctors′ understanding and perspectives on narrative medicine training and parallel chart writing can be summarized into two main themes and four sub-themes: pre-training resistance (perceived as an additional burden, lack of perceived benefits) and narrative empowerment (deepened empathy, reaffirmation of initial medical motivations). Conclusions Doctors have gone through a process of moving from resistance to acceptance, and finally to active participation in narrative medicine training for parallel chart writing. Narrative medicine parallel medical record writing and sharing can improve general practice teachers′ communication skills and patient satisfaction, and the improvement effect for general practitioners is better than that for specialist physicians.

Key words: Teaching, Doctor-patient communication, Narrative medicine, Parallel medical records, General practitioners, Patient satisfaction