收稿日期: 2026-04-10
修回日期: 2026-07-17
录用日期: 2026-07-18
网络出版日期: 2026-08-31
Current situation and suggestions on medical communication for internal medicine residency programs
Received date: 2026-04-10
Revised date: 2026-07-17
Accepted date: 2026-07-18
Online published: 2026-08-31
调查教师与学员对儿科与成人内科住院医师规范化培训中的医患沟通培养（简称“二者”）模式差异的认知现状及培训需求，为构建专科化医患沟通培训体系提供依据。采用问卷调查法，于2025年7月至12月对瑞金医院的儿科与成人内科住培基地师生进行调研。问卷聚焦5个维度，采用Likert 5级量表与多项选择题相结合的形式。从师生角色、所属基地角度分析组间差异。本研究获得有效问卷86份（教师36份，学员50份）。96.5%受访者认同二者的核心模式与决策主体差异，但仅70.9%表示“已熟知二者的差异”。教师组对当前课程区分度的评价显著低于学员组（P<0.01）；成人内科师生对二者差异的熟知程度、教学实践情况的评分均显著低于儿内科基地（P<0.05）。“学员的临床实践机会”和“带教老师的经验传递”被认为是影响专科沟通差异认知的主要因素（均>70%）。受访者对学员高风险沟通的练习机会与处理能力的评价均较低（<4分）。受访者高度支持情景模拟（4.36±0.67分）等实践型教学方式，而对新技术赋能如人工智能（artificial intelligence，AI）决策教练、生物反馈持观望态度（4.05±0.86分，4.00±0.87分）。本研究发现通用型课程无法满足儿科与成人内科住院医师医患沟通能力培训的专科胜任力需求，应注重临床实践指导与反馈，引入情景模拟等新型教学模式，构建以专科差异为基石的分层分类培养体系。
马骏 , 许旭 , 马晓宇 , 陆文丽 , 徐静 , 余熠 . 内科住院医师规范化培训中医患沟通现状及建议[J]. 诊断学理论与实践, 2026 , 25(04) : 517 -522 . DOI: 10.16150/j.1671-2870.2026.04.017
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