医療面接における医師・患者間コミュニケーションスキル評価尺度 : 文献レビューと尺度構成項目の分析 [in Japanese] A literature review of instruments measuring communication skills in medical education [in Japanese]
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目的 : 医療面接における医師・患者間コミュニケーションスキル評価尺度の概要と問題点を明らかにする．<br>方法 : 先行研究，2009年以降の文献レビューより欧米で広く使用される尺度を収集した．尺度の評価項目をthe Kalamazoo Consensus Statement（KCS）を参考に分類した．<br>結果 : 対象とした10尺度の全項目の83%がKCSの示す領域いずれかに分類された．<br>考察 : 医師・患者間コミュニケーションに必須のスキルについて一定の合意形成が示唆されたが，実証的根拠を示す研究がさらに必要である．理論的根拠に基づき構成され，使用する場面に適した信頼性の高い評価ツールの選択・開発が求められる．
Objectives: This study reviewed the literature on instruments measuring physician-patient communication skills in medical interviews. Our goal was to clarify the features of current instruments and problems in assessing physician-patient communication with them.<br>Methods: In 2012, we searched for published articles about instruments assessing physician-patient communication skills in the bibliographic databases PubMed, PsycINFO, and the Education Resources Information Center using the combination of search terms （"consultation skills" OR "doctor-patient communication" OR "physician-patient relations"） AND "medical education" AND （instruments OR measurement OR assessment）. Instruments designed for faculty observers and to be used in medical education were included in the study. To compare the instruments, we classified the items of each instrument on the basis of the framework of the Kalamazoo Consensus Statement （KCS）, an experts' consensus statement on 7 essential elements of physician-patient communication.<br>Results: Ten instruments were included in the study. Eighty-three percent of all 277 items of the instruments were classified to any of the 7 elements identified in the KCS. Most of the instruments included more than 6 elements identified in the KCS, and some of the instruments had been constructed on the basis of the KCS. However, the instruments varied considerably in essential communication skills to understand the patient's perspective, to share information, and to reach agreement on problems and plans.<br>Conclusions: Further study is needed to provide evidence for essential communication skills in physician-patient consultation. Because essential communication skills depend on the educational goals, culture, language, and other factors, ensuring the reliability and validity of tools administered to evaluate communication must be required.
- Igaku Kyoiku / Medical Education (Japan)
Igaku Kyoiku / Medical Education (Japan) 44(5), 335-344, 2013
Japan Society for Medical Education