نوع مقاله : مقاله پژوهشی
نویسندگان
1 دکتری تخصصی مدیریت خدمات بهداشتی و درمانی، مرکز تحقیقات بیماریهای غیرواگیر، دانشگاه علوم پزشکی سبزوار، سبزوار، ایران
2 استاد، گروه آموزش بهداشت و ارتقاء سلامت، دانشکده بهداشت، دانشگاه علوم پزشکی سبزوار، سبزوار، ایران
3 دانشجوی پزشکی، کمیته تحقیقات دانشجویی، دانشگاه علوم پزشکی سبزوار، سبزوار، ایران
4 کمیته تحقیقات دانشجویی، دانشگاه علوم پزشکی سبزوار، سبزوار، ایران
چکیده
زمینه و هدف: برقراری ارتباط مؤثر با بیماران یکی از مهارتهای ضروری برای دانشجویان پزشکی است. آموزشهای سنتی، فرصتهای محدودی برای یادگیری این مهارتها فراهم میکند. این پژوهش باهدف طراحی و اجرای برنامه بیمارستان خرس عروسکی بهعنوان ابزاری برای تقویت مهارتهای ارتباطی دانشجویان انجام شد.
مواد و روشها: این پژوهش با استفاده از روش اقدامپژوهی در دانشگاه علوم پزشکی سبزوار انجام شد. برنامه بیمارستان خرس عروسکی براساس مدل ADDIE طراحی و پیادهسازی شد. در مرحله تحلیل، نیازسنجی با استفاده از مصاحبههای نیمهساختاریافته انجام شد. در مرحله طراحی و توسعه، محتوای آموزشی ایجاد شد که شامل ۷ شایستگی کلیدی برای برقراری ارتباط با بیمار بود. برنامه با مشارکت ۳۰ دانشجوی پزشکی و حدود ۴۰۰ دانشآموز اجرا شد. از نرمافزارهای SPSS نسخه ۲۱ و Atlas.ti نسخه ۹ برای تحلیل نتایج استفاده شد.
یافتهها: بیش از ۶۰% دانشجویان تجربه کمی در ارتباط با کودکان در محیطدرمانی داشتند. دانشجویان شرکتکننده در برنامه اعلام کردند مهارتهای ارتباطی و میزان تمایل آنها به کار در حوزه درمان کودکان پس از اجرای برنامه افزایشیافته است. همچنین، پس از اجرای برنامه میزان ترس دانشآموزان از پزشک و بیمارستان کاهش یافت. حدود ۹۴% از دانشجویان و ۹۸% از دانشآموزان، میزان رضایت خود را از اجرای برنامه در سطح خوب و خیلی خوب اعلام کردند.
نتیجهگیری: برنامه بیمارستان خرس عروسکی میتواند موجب بهبود مهارتهای ارتباطی دانشجویان پزشکی در برخورد با کودکان بیمار و والدین آنها شود. استفاده از روشهای آموزشی تجربی و تعاملی میتواند به ارتقای شایستگیهای ارتباطی دانشجویان کمک کند.
تازه های تحقیق
https://scholar.google.com/citations?hl=en&user=HKaet2oAAAAJ
https://pubmed.ncbi.nlm.nih.gov/?term=Mahdi+Abbasi
https://scholar.google.com/citations?hl=en&user=t5wMgpQAAAAJ
https://pubmed.ncbi.nlm.nih.gov/?term=Masoumeh+Hashemian
https://scholar.google.com/scholar?hl=en&as_sdt=0,5&q=Negar+Shadab+mehr&btnG
https://pubmed.ncbi.nlm.nih.gov/?term=Negar+Shadabmehr
https://scholar.google.com/scholar?hl=en&as_sdt=0,5&q=zahra+moradi&btnG
https://pubmed.ncbi.nlm.nih.gov/?term=Zahra+Moradi
https://scholar.google.com/scholar?hl=en&as_sdt=0,5&q=mohammad+hossein+mohammadi+&btnG
https://pubmed.ncbi.nlm.nih.gov/?term=Mohammad+Hossein+Mohammadi
کلیدواژهها
موضوعات
عنوان مقاله [English]
Design, Implementation and Evaluation of the “Teddy Bear Hospital” Program: An Experiential Learning Model for Teaching Patient Communication Skills
نویسندگان [English]
- Mahdi Abbasi 1
- Masoumeh Hashemian 2
- Negar Shdab Mehr 3
- Zahra Moradi 4
- Mohammad Hossein Mohammadi 4
- Sana Jafarlou 4
1 Ph.D. of Healthcare management, Noncommunicable Diseases Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran
2 Professor, Department of Health Education and Health Promotion, School of Public Health, Sabzevar University of Medical Sciences, Sabzevar, Iran
3 Medical student, Student Research Committee, Sabzevar University of Medical Sciences, Sabzevar, Iran
4 Student Research Committee, Sabzevar University of Medical Sciences, Sabzevar, Iran
چکیده [English]
Background: Effective communication with patients is a core skill for medical students. Traditional teaching offers limited experiential learning opportunities. This study aimed to design and implement the “Teddy Bear Hospital” program to strengthen students’ communication skills.
Materials and Methods: This action research was conducted at Sabzevar University of Medical Sciences in Iran. The program was developed and implemented based on the ADDIE model. During the analysis phase, a needs assessment was conducted through semi-structured interviews. In the design and development phase, educational content was created encompassing seven core competencies for effective doctor–patient communication. Learning materials included simulated clinical scenarios, multimedia resources, educational pamphlets, and stakeholder guides. The program involved 30 medical students (including six trained facilitators) and approximately 400 elementary school children. Data were analyzed using SPSS 21 and Atlas.ti v9.
Results: More than 60% of students reported limited prior experience communicating with children in clinical settings. Participants indicated improvements in their communication skills and increased willingness to work in pediatric care after the program. Additionally, children’s fear of physicians and hospitals decreased following the intervention. Approximately 94% of students and 98% of children rated their satisfaction with the program as “good” or “very good”.
Conclusion: The “Teddy Bear Hospital” program can enhance medical students’ communication skills with pediatric patients and their parents while reducing children’s fear of hospitals and physicians. Implementing experiential and interactive educational approaches may contribute to the development of students’ professional and communicative competencies.
کلیدواژهها [English]
- Communication skills
- physician
- patient
- Teddy Bear Hospital
- Medical Students
- Van Weel C. Primary health care and family medicine at the core of health care: challenges and priorities in how to further strengthen their potential. Front Med (Lausanne). 2014;1:37-47. DOI: 10.3389/fmed.2014.00037.
- Turabian JL. Some basic concepts of family medicine explained by means of fables (Part 1 of 2): Uncertainty, complexity, community, and variability. Archives of Community and Family Medicine. 2018;1(1):1-7.
- Ha JF, Longnecker N. Doctor-patient communication: a review. Ochsner Journal. 2010;10(1):38-43. PMID: 21603354.
- Von Fragstein M, Silverman J, Cushing A, Quilligan S, Salisbury H, Wiskin C, Education UCfCCSTiUM. UK consensus statement on the content of communication curricula in undergraduate medical education. Medical education. 2008;42(11):1100-7. Doi:10.1111/j.1365-2923.2008.03137.x.
- Mercer SW, Maxwell M, Heaney D, Watt GC. The consultation and relational empathy (CARE) measure: development and preliminary validation and reliability of an empathy-based consultation process measure. Family practice. 2004;21(6):699-705. DOI: 10.1093/fampra/cmh621.
- Hojat M, Vergare MJ, Maxwell K, Brainard G, Herrine SK, Isenberg GA, et al. The devil is in the third year: a longitudinal study of erosion of empathy in medical school. Academic medicine. 2009;84(9):1182-91. DOI: 10.1097/ACM.0b013e3181b17e55.
- Neumann M, Edelhäuser F, Tauschel D, Fischer MR, Wirtz M, Woopen C, et al. Empathy decline and its reasons: a systematic review of studies with medical students and residents. Academic medicine. 2011;86(8):996-1009. DOI: 10.1097/ACM.0b013e318221bFAe.
- Wouda JC, van de Wiel HB. The communication competency of medical students, residents and consultants. Patient Education and Counseling. 2012;86(1):57-62. DOI: 10.1016/j.pec.2011.07.027.
- Roff S. Reconsidering the “decline” of medical student empathy as reported in studies using the Jefferson Scale of Physician Empathy-Student version (JSPE-S). Medical teacher. 2015;37(8):783-6. DOI: 10.3109/0142159X.2015.1021948.
- Dunham L, Dekhtyar M, Gruener G, CichoskiKelly E, Deitz J, Elliott D, et al. Medical student perceptions of the learning environment in medical school change as students transition to clinical training in undergraduate medical school. Teaching and learning in medicine. 2017;29(4):383-91. DOI: 10.1080/10401334.2017.1294788.
- O'Brien BC, Poncelet AN. Transition to clerkship courses: preparing students to enter the workplace. Academic Medicine. 2010;85(12):1862-9. DOI: 10.1097/ACM.0b013e3181f224e1.
- Rosenbaum ME, Axelson R. Curricular disconnects in learning communication skills: what and how students learn about communication during clinical clerkships. Patient education and counseling. 2013;91(1):85-90. DOI: 10.1016/j.pec.2012.12.003.
- Rosenbaum ME. Dis-integration of communication in healthcare education: Workplace learning challenges and opportunities. Patient education and counseling. 2017;100(11):2054-61. DOI: 10.1016/j.pec.2017.06.002.
- Perron NJ, Sommer J, Louis-Simonet M, Nendaz M. Teaching communication skills: beyond wishful thinking. Swiss medical weekly. 2015;145(0304):w14064-w. DOI: 10.4414/smw.2015.14064.
- Brock KE, Cohen HJ, Sourkes BM, Good JJ, Halamek LP. Training Pediatric Fellows in Palliative Care: A Pilot Comparison of Simulation Training and Didactic Education. J Palliat Med. 2017;20(10):1074-84. DOI: 10.1089/jpm.2016.0486.
- Nheu L, Uahwatanasakul W, Gray A. Medical students' experience of a Teddy Bear Hospital as part of a paediatric curriculum. Focus on Health Professional Education: A Multi-Professional Journal. 2018;19(3):40-51. Doi:10.3316/informit.099822531846764
- Kaufman J, Modak M, Moylan S. The Teddy Bear Hospital in Australia. Journal of Paediatrics & Child Health. 2012;48(6). DOI: 10.1111/jpc.12073.
- Kis H, Endres K, Karwowska A, Harrison M, Lau S, Lemire O, Zucker M. "Teddy Bear Hospital Project" school visits improve pre-clerkship students' comfort explaining medical concepts to children. Can Med Educ J. 2022;13(3):70-4. DOI: 10.36834/cmej.73534.
- Wong A, Geilani J. Teddy Bear Hospital (TBH): reducing children’s fear of doctors and the hospital environment. Sheffield: University of Sheffield; 2004.
- Thng JZH, Tan FYY, Aw MMHY, Hu S. Combination of teddy bear hospital and virtual reality training increases empathy of medical students. The Asia Pacific Scholar. 2022;7(3):33. Doi:10.29060/TAPS.2022-7-3/OA2739.
- Zimmermann PG, Santen L. Teddy says "Hi!": Teddy bear clinics revisited. J Emerg Nurs. 1997;23(1):41-4. DOI: 10.1016/S0099-1767(97)80082-6.
- Moch SD, Vandenbark RT, Pehler SR, Stombaugh A. Use of Action Research in Nursing Education. Nurs Res Pract. 2016;2016:8749167. DOI: 10.1155/2016/8749167.
- Stringer ET, Christensen LM, Baldwin SC. Integrating teaching, learning, and action research: Enhancing instruction in the K-12 classroom: Sage Publications; 2009.
- Muruganantham G. Developing Of E-Content Package By Using ADDIE Model. International Journal of Applied Research. 2015;1(3):52-4.
- Jia T, Lan Y, Pang J, Ma M, Ding Z, Wang Y, Jiang E. Development and Evaluation of an ICU Nurse Training Program on Oral Mucosal Pressure Injury Prevention and Management Using the ADDIE Model. Risk Manag Healthc Policy. 2025;18:363-72. DOI: 10.2147/RMHP.S375717.
- Makoul G. Essential elements of communication in medical encounters: the Kalamazoo consensus statement. Acad Med. 2001;76(4):390-3. DOI: 10.1097/00001888-200104000-00017.
- Ashraf H, Shabani Varaki K, Moallem SR, Miri Moghaddam MM, Jangjoo S, Emami N, Izanloo A. Teddy bear hospital, a pilot study in Mashhad, Iran. Razavi International Journal of Medicine. 2021;9(2):61-4. (Persian)
- Soheilipour F, Jaderi P, Nasr N. Reliability and Validity of the RMS Pictorial Scale in Comparison with Facial Image Scale and Venham Picture Test for Assessment of Child Anxiety. Journal of Isfahan Dental School. 2018;14(2):207-14. (Persian)
- Cardoso Pinto AM, Patel SB, Stephens M, Guha P, Baptista A, Smith S. Developing as health professionals through community volunteering: exploring the value of a partnership between medical students and primary schools online compared to in-person. BMC Med Educ. 2023;23(1):56. DOI: 10.1186/s12909-023-04092-w.
- Rashid AA, Cheong AT, Hisham R, Shamsuddin NH, Roslan D. Effectiveness of pretend medical play in improving children's health outcomes and well-being: a systematic review. BMJ Open. 2021;11(1):e041506. DOI: 10.1136/bmjopen-2020-041506.
- Leonhardt C, Margraf-Stiksrud J, Badners L, Szerencsi A, Maier RF. Does the 'Teddy Bear Hospital' enhance preschool children's knowledge? A pilot study with a pre/post-case control design in Germany. J Health Psychol. 2014;19(10):1250-60. DOI: 10.1177/1359105313500240.
- Dalley JS, McMurtry CM. Teddy and I get a check up: a pilot educational intervention teaching children coping strategies for managing procedure-related pain and fear. Pain Res Manag. 2015;2015:929753. Doi:10.1155/2015/929753.
- Medeiros GJM, Negrão BJ, Sales MRP, de Paula Goulart LR, Appenzeller S. Communication skills in pediatrics: perception of medical students. BMC Med Educ. 2024;24(1):1545.
- Keir A, Wilkinson D. Communication skills training in paediatrics. J Paediatr Child Health. 2013;49(8):624-8. DOI: 10.1186/s12909-024-03478-9.
- Mărginean CO, Meliţ LE, Chinceşan M, Mureşan S, Georgescu AM, Suciu N, et al. Communication skills in pediatrics - the relationship between pediatrician and child. Medicine (Baltimore). 2017;96(43):e8399. DOI: 10.1097/MD.0000000000008399
- Antila AK, Lindblom S, Louhiala P, Pyörälä E. Creating a safe space: medical students' perspectives on using actor simulations for learning communication skills. BMC Med Educ. 2024;24(1):1225. DOI: 10.1186/s12909-024-03456-4.
- Graungaard AH, Andersen JS. Meeting real patients: a qualitative study of medical students' experiences of early patient contact. Educ Prim Care. 2014;25(3):132-9. DOI: 10.1080/14739879.2014.931732.
- Dumbuya E. Experiential Curriculum Framework: From Primary to Tertiary Education. Available at SSRN 5018510. 2024. DOI: 10.2139/ssrn.5018510
)