关键词: 医患关系, 沟通能力, 促进技术, 课程培训, 交互式模拟训练

Abstract: Doctor-patient relationship is defined as the interpersonal interaction between doctors and patients in medical practice and its consequences. In recent years, the increasing number of medical disputes all over the country has brought the increasingly tensions, and domestic and foreign scholars have put forward a series of promoting techniques to improve the disharmonious doctor-patient relationship. Summing up these promoting technologies, we found that most of them focused on training the doctors' communication skills. However, with varying perspectives of researchers, their training methods and contents are different, which mainly include offline course training and online computer-based interactive simulation training. The offline course training is currently the main promotion technology of doctors' communication ability, and the Comskil model of communication skills training and the model of doctor communication ability in the workplace provide the theoretical and practice support for doctor’s general communication ability. The Comskil model of communication skills training has proposed 26 communication skills of six categories, it helps trainees to identify their strengths in communication skills after training, what improved and what needed to be improved, and so on. But this model takes a long time in training and lacks repeated practice, and it's difficult for doctors to transform their communication skill learned in simulated workplaces to the real workplaces. The model of doctor communication ability in the workplace can solve the transformation difficulty, and help trainees to learn appropriate communication skills in the real diagnosis and treatment process according to their own characteristics. However, this training model does not have any observation of what happens in the real workplace, and the final results feedback is only self-report of the trainees, so the results of feedback may be biased. On the basis of these two theoretical models, it forms the "tell bad news" communication training courses and the prescription-talk training courses in fields of special medical situation respectively. The "tell bad news" communication training courses proposed three stages of training, and the trainees were trained in the special medical situation of "telling the bad news". It uses a teaching model that combines theory and practice and trains doctors in the special situation of "telling bad news". On the one hand, it can help doctors to understand the patients' true thoughts more deeply from the patient's perspective; On the other hand, it can effectively improve doctors' communication skills and the quality of doctor-patient communication. The prescription-talk training course is to enhance the students' communication skills through developing a prescription dialogue guidelines. This course proposed a new approach for doctor-patient communication from the perspective of prescription dialogue, which lasts five times a week and consists of three phases. This dialogue guideline is widely used in prescription dialogues for doctors, which can enhance doctors' awareness of patients' participation and persistence in treatment, and provide suggestions for the reform of medical course. These two courses provide a new way for doctors to train their communication skills and a practical reference for other undeveloped medical special situations. Due to the limitations of offline training in training time and requirements for trainers, the use of computer simulations in the training of doctors' communication skills has been promoted, Thus, online computer-based interactive simulation training is formed. This training system has the advantages of repetitive learning and instant feedback on training results, and is also very flexible in training time. The greatest difficulty is to establish an effective and comprehensive simulation dialogue script and the guarantee of ecological training environment. With the development of science and technology, future research can incorporate more new technologies into online computer-based interactive simulation training to develop more ecological promotion technologies which not only contains the real situation of offline course training, but also produces the advantage of training time and effect feedback.

Key words: doctor-patient relationship , communication ability, promotion technology, course training, interactive simulation training