目的 探讨多种教学方式对提高临床医学专业学生医患沟通能力的培训效果。方法 采用前瞻性自身对照研究。2017年1月至2017年12月,选取2017年1月至2017年6月在中山大学附属第三医院精神科实习的中山大学2012级五年制临床医学专业135名学生为研究对象,入科前进行医学生沟通技能态度量表和医学生医患沟通行为量表评定,入科后采用实习小讲课、互动教学(2周实习期内进行)和新媒体教学(持续6个月)等多种教学方式进行医患沟通能力系统培训,所有培训结束后,再次进行医患沟通能力的评估,由学生选出最有效的教学方式。结果 系统培训后,学生各方面的医患沟通能力都得到了提高,培训前后的消极态度[(35.22±4.35)分比(28.40±3.54)分]和积极态度[(53.20±5.35)分比(60.84±2.72)分]的评分差异均具有统计学意义(均P<0.05);培训前后医学生医患沟通行为量表的评分[(151.78±5.33)分比(166.27±4.36)分]差异具有统计学意义(P<0.05);系统培训前,男生医患沟通的积极态度评分差于女生[(51.41±4.88)分比(54.91±5.33)分],消极态度评分高于女生[(36.68±4.80)分比(33.83±3.42)分];系统培训后,男生的支持关注评分低于女生[(16.86±1.52)分比(17.83±1.27)分],其差异均具有统计学意义(P<0.05)。学生评选出的最有效的教学方式首先是模拟教学[46.7%(63/135)],其次是微信[28.9%(39/135)]。结论 多种教学方式有助于提高医学生的医患沟通能力和水平;不同性别学生沟通能力和对教学方式的喜好不同;互动教学中的模拟教学、新媒体教学中的微信平台是比较有效的教学方式,值得进一步研究和完善。

Objective To explore the application of various teaching methods in improving the doctor-patient communication skills of medical students. Methods It was a prospective self-control study. From January 2017 to December 2017, Before entered into psychiatry department of the Third Affiliated Hospital of Sun Yat-sen University, medical students were evaluated for “the Communication Skills Attitude Scale”and “the Medical Students' Doctor-Patient Communication Behavior Scale”, within the following six months a variety of ways of communication skills training,including internship lectures, interactive teaching and new media teaching,scale assessment again after 6 months. The most effective teaching methods were chosen by students. Results After training, the communication skill of medical students in all aspects was improved, the negative attitude was reduced (35.22±4.35 vs 28.40±3.54), the positive attitude was increased (53.20±5.35 vs 60.84±2.72), the difference was statistically significant (P<0.05); the medical students' communication behavior scale before and after training (151.78±5.33 vs 166.27±4.36), the difference was statistically significant (P<0.05).Before training, male students' positive attitude score towards doctor-patient communication were worse than female students (51.41±4.88 vs 54.91±5.33), while malestudents' negative attitude score was higher than female students(36.68±4.80 vs 33.83±3.42).After training, the support score of male students were worse than female students(16.86±1.52 vs 17.83±1.27), and the differences were statistically significant (P<0.05). The most effective training method favored student was simulation teaching 46.7% (63/135), followed by WeChat 28.9% (39/135). Conclusions Various teaching methods can improve doctor-patient relationship, students of different genders have different communication abilities and preferences for teaching methods. Among them, simulation teaching in interactive teaching and WeChat platform as the new media teaching facilites are relatively effective, which are worthy of further improvement.