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Thompson T, Grove L, Brown J, Buchan J, Kerry AL, Burge S. COGConnect: A new visual resource for teaching and learning effective consulting. PATIENT EDUCATION AND COUNSELING 2021; 104:2126-2132. [PMID: 33422369 DOI: 10.1016/j.pec.2020.12.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 11/22/2020] [Accepted: 12/16/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Consultation skills are essential to clinical practice and, when effective, can facilitate diagnoses and improve patient satisfaction. Various models exist to facilitate consultation teaching. These can be prescriptive, a challenge to apply in clinical settings and are often designed for primary care. In redesigning our entire curriculum, we sought to create a new visual, digital, resource for consultation teaching, aligned with statements from the UK Council for Clinical Communication (UKCCC), and suitable for the evolving expectations of patients, clinicians and the UK NHS, in 21st century medicine. METHODS We conducted a literature review encompassing teaching methods, NHS Priorities, patients' priorities, lifestyle interventions and practitioner resilience. COGConnect was designed iteratively through consultation with a graphic designer, health psychologists, a range of clinicians, and a consultation expert, and has evolved through extensive use in our new "effective consulting" course in primary and secondary care. RESULTS COGConnect is deliberately visual, iterative, bi-directional and multi-phasic. The central image of COGConnect is two persons in connection; the floating cogs suggesting an encounter of different agents who must adapt their cog-connection in terms of speed, direction and dimension. Around this image we place five core values. The consultation phases are represented by ten colourful cogs, with important additions including 'formulating', 'activating' and 'integrating'. CONCLUSION COGConnect builds on the strengths of existing frameworks and provides a strong visual resource suitable for digital learning. It offers greater emphasis on explicit clinical reasoning, activation of patient self-care and learning from the interaction. Having become the de facto resource for consultation skills training across primary and secondary care in our institution, the next phase is to develop the COGConnect.info website and a programme of formal evaluation.
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Affiliation(s)
- Trevor Thompson
- Centre for Academic Primary Care, School of Population Health Sciences, University of Bristol, Bristol, BS8 2PS, UK.
| | - Lizzie Grove
- Centre for Academic Primary Care, School of Population Health Sciences, University of Bristol, Bristol, BS8 2PS, UK
| | - Juliet Brown
- Centre for Academic Primary Care, School of Population Health Sciences, University of Bristol, Bristol, BS8 2PS, UK
| | - Jess Buchan
- Centre for Academic Primary Care, School of Population Health Sciences, University of Bristol, Bristol, BS8 2PS, UK
| | - Anthony L Kerry
- Department of Respiratory Medicine, Western Hospital NHS Foundation Trust, Swindon, SN3 6BB, UK
| | - Sarah Burge
- Bristol Medical School, University of Bristol, 69 St Michael's Hill, Bristol, BS2 8DZ, UK
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Mazzi MA, Rimondini M, van der Zee E, Boerma W, Zimmermann C, Bensing J. Which patient and doctor behaviours make a medical consultation more effective from a patient point of view. Results from a European multicentre study in 31 countries. PATIENT EDUCATION AND COUNSELING 2018; 101:1795-1803. [PMID: 29891103 DOI: 10.1016/j.pec.2018.05.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 05/07/2018] [Accepted: 05/25/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To assess European patients' preferences regarding seven aspects of doctor-patient communication. METHODS 6049 patients from 31 European countries evaluated 21 doctor and 12 patient behaviours, through a patient-generated questionnaire (PCVq). Multilevel models explored the effects of patient characteristics, contextual and cultural dimensions on preferences. RESULTS Patients attributed more responsibility to doctors, by giving greater importance to doctor than to patient factors, in particular to Treating the patient as a partner and as a person and Continuity of care. Gender, age, education, the presence of chronic illness and two of Hofstede's cultural dimensions, Individualism and Indulgence, showed differential evaluations among patients. Women gave greater importance to all seven communication aspects, older patients to being prepared for the consultation, lower educated patients to Treating patient as a person and Thoughtful planning. Patients from countries with an indulgent background rated all seven communication aspects of greater importance. A more individualistic orientation was related to lower importance regarding the four doctor's factors and the patient factor Open and Honest. CONCLUSIONS Treating the patient as a person and providing continuity of care emerged as universal values. PRACTICE IMPLICATIONS The findings should represent a landmark for the adaptation of patient-generated communication guidelines and programs in Europe.
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Affiliation(s)
- Maria Angela Mazzi
- University of Verona, Department of Neurosciences, Biomedicine and Movement Sciences, Italy.
| | - Michela Rimondini
- University of Verona, Department of Neurosciences, Biomedicine and Movement Sciences, Italy
| | | | - Wienke Boerma
- NIVEL, Netherlands Institute for Health Services Research, The Netherlands
| | - Christa Zimmermann
- University of Verona, Department of Neurosciences, Biomedicine and Movement Sciences, Italy
| | - Jozien Bensing
- NIVEL, Netherlands Institute for Health Services Research, The Netherlands
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Denniston C, Molloy E, Nestel D, Woodward-Kron R, Keating JL. Learning outcomes for communication skills across the health professions: a systematic literature review and qualitative synthesis. BMJ Open 2017; 7:e014570. [PMID: 28389493 PMCID: PMC5558817 DOI: 10.1136/bmjopen-2016-014570] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE The aim of this study was to identify and analyse communication skills learning outcomes via a systematic review and present results in a synthesised list. Summarised results inform educators and researchers in communication skills teaching and learning across health professions. DESIGN Systematic review and qualitative synthesis. METHODS A systematic search of five databases (MEDLINE, PsycINFO, ERIC, CINAHL plus and Scopus), from first records until August 2016, identified published learning outcomes for communication skills in health professions education. Extracted data were analysed through an iterative process of qualitative synthesis. This process was guided by principles of person centredness and an a priori decision guide. RESULTS 168 papers met the eligibility criteria; 1669 individual learning outcomes were extracted and refined using qualitative synthesis. A final refined set of 205 learning outcomes were constructed and are presented in 4 domains that include: (1) knowledge (eg, describe the importance of communication in healthcare), (2) content skills (eg, explore a healthcare seeker's motivation for seeking healthcare),( 3) process skills (eg, respond promptly to a communication partner's questions) and (4) perceptual skills (eg, reflect on own ways of expressing emotion). CONCLUSIONS This study provides a list of 205 communication skills learning outcomes that provide a foundation for further research and educational design in communication education across the health professions. Areas for future investigation include greater patient involvement in communication skills education design and further identification of learning outcomes that target knowledge and perceptual skills. This work may also prompt educators to be cognisant of the quality and scope of the learning outcomes they design and their application as goals for learning.
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Affiliation(s)
- Charlotte Denniston
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Elizabeth Molloy
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
- Department of Medical Education, University of Melbourne, Melbourne, Victoria, Australia
| | - Debra Nestel
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
- Department of Surgery (Austin), University of Melbourne, Melbourne, Victoria, Australia
| | - Robyn Woodward-Kron
- Department of Medical Education, University of Melbourne, Melbourne, Victoria, Australia
| | - Jennifer L Keating
- Department of Physiotherapy, Monash University, Melbourne, Victoria, Australia
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Kennedy AB, Cambron JA, Sharpe PA, Travillian RS, Saunders RP. Clarifying Definitions for the Massage Therapy Profession: the Results of the Best Practices Symposium. Int J Ther Massage Bodywork 2016; 9:15-26. [PMID: 27648109 PMCID: PMC5017817 DOI: 10.3822/ijtmb.v9i3.312] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Massage therapists are at times unclear about the definition of massage therapy, which creates challenges for the profession. It is important to investigate the current definitions and to consider the field as a whole in order to move toward clarity on what constitutes the constructs within the profession. PURPOSE To determine how a sample of experts understand and describe the field of massage therapy as a step toward clarifying definitions for massage and massage therapy, and framing the process of massage therapy practice. SETTING A two-day symposium held in 2010 with the purpose of gathering knowledge to inform and aid in the creation of massage therapy best practice guidelines for stress and low back pain. PARTICIPANTS Thirty-two experts in the field of massage therapy from the United States, Europe, and Canada. DESIGN Qualitative analysis of secondary cross-sectional data using a grounded theory approach. RESULTS Three over-arching themes were identified: 1) What is massage?; 2) The multidimensional nature of massage therapy; and 3) The influencing factors on massage therapy practice. DISCUSSION The data offered clarifying definitions for massage and massage therapy, as well as a framework for the context for massage therapy practice. These clarifications can serve as initial steps toward the ultimate goal of creating new theory for the field of massage therapy, which can then be applied in practice, education, research, and policy. CONCLUSIONS Foundational research into how experts in the profession understand and describe the field of massage therapy is limited. Understanding the potential differences between the terms massage and massage therapy could contribute to a transformation in the profession in the areas of education, practice, research, policy and/or regulation. Additionally, framing the context for massage therapy practice invites future discussions to further clarify practice issues.
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Affiliation(s)
- Ann B. Kennedy
- University of South Carolina School of Medicine Greenville, Human Performance Lab, Greenville, SC, USA
| | - Jerrilyn A. Cambron
- Department of Research at the National University of Health Sciences, Lombard, IL, USA
| | | | | | - Ruth P. Saunders
- University of South Carolina Department of Health Promotion, Education, and Behavior, Columbia, SC, USA
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Abstract
OBJECTIVES As communication is a central part of every interpersonal meeting within healthcare and research reveals several benefits of effective communication, we need to teach students and practitioners how to communicate with patients and with colleagues. This paper reflects on what and how to teach. METHODS In the previous century two major changes occurred: clinical relationship between doctor and patient became important and patients became partners in care. Clinicians experienced that outcome and especially compliance was influenced by the relational aspect and in particular by the communicative skills of the physician. This paper reflects on teaching and defines problems. It gives some implications for the future. RESULTS Although communication skills training is reinforced in most curricula all over the word, huge implementation problems arise; most of the time a coherent framework is lacking, training is limited in time, not integrated in the curriculum and scarcely contextualized, often no formal training nor teaching strategies are defined. Moreover evidence on communication skills training is scarce or contradictory. CONCLUSIONS Knowing when, what, how can be seen as an essential part of skills training. But students need to be taught to reflect on every behavior during every medical consultation. PRACTICE IMPLICATIONS Three major implications can be helpful to overcome the problems in communication training. First research and education on healthcare issues need to go hand in hand. Second, students as well as healthcare professionals need a toolkit of basic skills to give them the opportunity not only to tackle basic and serious problems, but to incorporate these skills and to be able to use them in a personal and creative way. Third, personal reflection on own communicative actions and dealing with interdisciplinary topics is a core business of medical communication and training.
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Affiliation(s)
- Myriam Deveugele
- Department of Family Medicine and Primary Health Care, Ghent University, Campus UZ - 6K3 De Pintelaan 185, B 9000 Gent, Belgium.
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Milnes S, Orford NR, Berkeley L, Lambert N, Simpson N, Elderkin T, Corke C, Bailey M. A prospective observational study of prevalence and outcomes of patients with Gold Standard Framework criteria in a tertiary regional Australian Hospital. BMJ Support Palliat Care 2015; 9:92-99. [DOI: 10.1136/bmjspcare-2015-000864] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Revised: 07/07/2015] [Accepted: 09/06/2015] [Indexed: 11/03/2022]
Abstract
ObjectivesReport the use of an objective tool, UK Gold Standards Framework (GSF) criteria, to describe the prevalence, recognition and outcomes of patients with palliative care needs in an Australian acute health setting. The rationale for this is to enable hospital doctors to identify patients who should have a patient-centred discussion about goals of care in hospital.DesignProspective, observational, cohort study.ParticipantsAdult in-patients during two separate 24 h periods.Main outcome measuresPrevalence of in-patients with GSF criteria, documentation of treatment limitations, hospital and 1 year survival, admission and discharge destination and multivariate regression analysis of factors associated with the presence of hospital treatment limitations and 1 year survival.ResultsOf 626 in-patients reviewed, 171 (27.3%) had at least one GSF criterion, with documentation of a treatment limitation discussion in 60 (30.5%) of those patients who had GSF criteria. Hospital mortality was 9.9%, 1 year mortality 50.3% and 3-year mortality 70.2% in patients with GSF criteria. One-year mortality was highest in patients with GSF cancer (73%), renal failure (67%) and heart failure (60%) criteria. Multivariate analysis revealed age, hospital length of stay and presence of the GSF chronic obstructive pulmonary disease criteria were independently associated with the likelihood of an in-hospital treatment limitation. Non-survivors at 3 years were more likely to have a GSF cancer (25% vs 6%, p=0.004), neurological (10% vs 3%, p=0.04), or frailty (45% vs 3%, p=0.04) criteria. After multivariate logistic regression GSF cancer criteria, renal failure criteria and the presence of two or more GSF clinical criteria were independently associated with increased risk of death at 3 years. Patients returning home to live reduced from 69% (preadmission) to 27% after discharge.ConclusionsThe use of an objective clinical tool identifies a high prevalence of patients with palliative care needs in the acute tertiary Australian hospital setting, with a high 1 year mortality and poor return to independence in this population. The low rate of documentation of discussions about treatment limitations in this population suggests palliative care needs are not recognised and discussed in the majority of patients.Trial registration number11/121.
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Giroldi E, Veldhuijzen W, de Leve T, van der Weijden T, Bueving H, van der Vleuten C. 'I still have no idea why this patient was here': An exploration of the difficulties GP trainees experience when gathering information. PATIENT EDUCATION AND COUNSELING 2015; 98:837-42. [PMID: 25858631 DOI: 10.1016/j.pec.2015.03.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 03/09/2015] [Accepted: 03/21/2015] [Indexed: 05/28/2023]
Abstract
OBJECTIVE Collecting information during patient encounters is essential for the delivery of patient-centered care. To obtain insight into areas that require more attention in medical communication training, this study explores what difficulties GP trainees encounter when gathering information. METHODS In this phenomenological study, we observed a morning clinic of 15 GP trainees. To explore trainees' experiences with information-gathering, we held brief interviews after every consultation and a lengthier interview directly after the morning clinic. The resulting data were analyzed using template analysis. RESULTS From trainees' reflections, we distilled five difficulties that trainees experience when gathering information: (1) Goal conflicts; (2) Ineffectiveness of trained communication skills in specific situations; (3) Trainees' distress hampers open communication; (4) Untrustworthy information; (5) Tunnel vision. CONCLUSION Information-gathering is difficult for GP trainees. Current generic communication skills training does not seem to support trainees sufficiently to handle effectively the challenges they encounter during consultations. PRACTICE IMPLICATIONS Medical communication training needs to support trainees in handling their goal-conflicts and feelings that hamper information-gathering, while also providing them with communication strategies adapted to handling specific challenging situations.
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Affiliation(s)
- Esther Giroldi
- Department of Family Medicine, Maastricht University, School for Public Health and Primary Care (CAPHRI), Maastricht, The Netherlands; Department of Educational Development and Research, Maastricht University, School of Health Professions Education (SHE), Maastricht, The Netherlands.
| | - Wemke Veldhuijzen
- Department of Family Medicine, Maastricht University, School for Public Health and Primary Care (CAPHRI), Maastricht, The Netherlands; Department of Educational Development and Research, Maastricht University, School of Health Professions Education (SHE), Maastricht, The Netherlands.
| | - Tijme de Leve
- Department of Family Medicine, Maastricht University, School for Public Health and Primary Care (CAPHRI), Maastricht, The Netherlands.
| | - Trudy van der Weijden
- Department of Family Medicine, Maastricht University, School for Public Health and Primary Care (CAPHRI), Maastricht, The Netherlands.
| | - Herman Bueving
- Department of General Practice, Erasmus University Medical Centre, Rotterdam, The Netherlands.
| | - Cees van der Vleuten
- Department of Educational Development and Research, Maastricht University, School of Health Professions Education (SHE), Maastricht, The Netherlands.
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Onyura B, Légaré F, Baker L, Reeves S, Rosenfield J, Kitto S, Hodges B, Silver I, Curran V, Armson H, Leslie K. Affordances of knowledge translation in medical education: a qualitative exploration of empirical knowledge use among medical educators. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2015; 90:518-24. [PMID: 25470312 DOI: 10.1097/acm.0000000000000590] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
PURPOSE Little is known about knowledge translation processes within medical education. Specifically, there is scant research on how and whether faculty incorporate empirical medical education knowledge into their educational practices. The authors use the conceptual framework of affordances to examine factors within the medical education practice environment that influence faculty utilization of empirical knowledge. METHOD In 2012, the authors, using a purposive sampling strategy, recruited medical education leaders in undergraduate medical education from a Canadian university. Recruits all had direct teaching and curricular development roles in either preclinical or clinical courses across the four years of the undergraduate curriculum. Data were collected through individual semistructured interviews on participants' use of empirical evidence, as well as the factors that influence integration of empirical knowledge into practice. Data were analyzed using thematic analysis. RESULTS Fifteen medical educators participated. The authors identified both constraining and facilitating affordances of empirical medical education knowledge use. Constraining affordances included poor quality and availability of evidence, inadequate knowledge delivery approaches, work and role overload, faculty and student change resistance, and resource limitations. Facilitating affordances included faculty development, peer recommendations, and local involvement in medical education knowledge creation. CONCLUSIONS Affordances of the medical education practice environment influence empirical knowledge use. Developing strategies for effective knowledge translation thus requires careful assessment of contextual factors that can enable, constrain, or inhibit evidence use. Empirical knowledge use is most likely to occur among medical educators who are afforded rich, facilitative opportunities for participation in creating, seeking, and implementing knowledge.
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Affiliation(s)
- Betty Onyura
- Dr. Onyura is research and evaluation consultant, Centre for Faculty Development, Li Ka Shing International Healthcare Education Centre, St. Michael's Hospital, Toronto, Ontario, Canada. Dr. Le´gare´ is Canada Research Chair in Implementation of Shared Decision Making in Primary Care and professor, Department of Family Medicine and Emergency Medicine, Laval University, Québec, Québec, Canada. Ms. Baker is research and education consultant, Centre for Faculty Development, Li Ka Shing International Healthcare Education Centre, St. Michael's Hospital, Toronto, Ontario, Canada. Dr. Reeves is professor of interprofessional research, Faculty of Health, Social Care and Education, Kingston University and St. Georges, University of London, London, United Kingdom. Dr. Rosenfield is professor, Faculty of Medicine, and vice dean of undergraduate medical education, University of Toronto, Toronto, Ontario, Canada. Dr. Kitto is a medical sociologist and assistant professor, Department of Surgery, University of Toronto, Toronto, Ontario, Canada. Dr. Hodges is professor, Faculty of Medicine and Faculty of Education, University of Toronto, and vice president of education, University Health Network, Toronto, Ontario, Canada. Dr. Silver is professor, Faculty of Medicine, University of Toronto, and vice president of education, Centre for Addiction and Mental Health, Toronto, Ontario, Canada. Dr. Curran is professor, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland, Canada. Dr. Armson is director of research, Foundation of Medical Practice Education, and professor, University of Calgary, Calgary, Alberta, Canada. Dr. Leslie is director, Centre for Faculty Development, Li Ka Shing International Healthcare Education Centre, St. Michael's Hospital, and associate professor, Department of Pediatrics, University of Toronto, Faculty of Medicine, Toronto, Ontario, Canada
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Veldhuijzen W. Reaction to Jonathan Silverman. PATIENT EDUCATION AND COUNSELING 2014; 94:444. [PMID: 24308900 DOI: 10.1016/j.pec.2013.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Accepted: 11/06/2013] [Indexed: 06/02/2023]
Affiliation(s)
- Wemke Veldhuijzen
- Maastricht University, General Practice, Maastricht, The Netherlands.
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Silverman J, Kurtz S, Draper J. A response to: Veldhuijzen et al., Communication guidelines as a learning tool: an exploration of user preferences in general practice [Patient Educ Couns 2013; 90(2): 213]. PATIENT EDUCATION AND COUNSELING 2013; 93:666. [PMID: 23890579 DOI: 10.1016/j.pec.2013.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Revised: 06/10/2013] [Accepted: 06/12/2013] [Indexed: 06/02/2023]
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Essers G, Kramer A, Andriesse B, van Weel C, van der Vleuten C, van Dulmen S. Context factors in general practitioner-patient encounters and their impact on assessing communication skills--an exploratory study. BMC FAMILY PRACTICE 2013; 14:65. [PMID: 23697479 PMCID: PMC3688246 DOI: 10.1186/1471-2296-14-65] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Accepted: 05/15/2013] [Indexed: 01/26/2023]
Abstract
Background Assessment of medical communication performance usually focuses on rating generically applicable, well-defined communication skills. However, in daily practice, communication is determined by (specific) context factors, such as acquaintance with the patient, or the presented problem. Merely valuing the presence of generic skills may not do justice to the doctor’s proficiency. Our aim was to perform an exploratory study on how assessment of general practitioner (GP) communication performance changes if context factors are explicitly taken into account. Methods We used a mixed method design to explore how ratings would change. A random sample of 40 everyday GP consultations was used to see if previously identified context factors could be observed again. The sample was rated twice using a widely used assessment instrument (the MAAS-Global), first in the standard way and secondly after context factors were explicitly taken into account, by using a context-specific rating protocol to assess communication performance in the workplace. In between first and second rating, the presence of context factors was established. Item score differences were calculated using paired sample t-tests. Results In 38 out of 40 consultations, context factors prompted application of the context-specific rating protocol. Mean overall score on the 7-point MAAS-Global scale increased from 2.98 in standard to 3.66 in the context-specific rating (p < 0.00); the effect size for the total mean score was 0.84. In earlier research the minimum standard score for adequate communication was set at 3.17. Conclusions Applying the protocol, the mean overall score rose above the level set in an earlier study for the MAAS-Global scores to represent ‘adequate GP communication behaviour’. Our findings indicate that incorporating context factors in communication assessment thus makes a meaningful difference and shows that context factors should be considered as ‘signal’ instead of ‘noise’ in GP communication assessment. Explicating context factors leads to a more deliberate and transparent rating of GP communication performance.
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Affiliation(s)
- Geurt Essers
- Department of Primary & Community Care, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
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Hulsman RL, Visser A. Seven challenges in communication training: learning from research. PATIENT EDUCATION AND COUNSELING 2013; 90:145-146. [PMID: 23312421 DOI: 10.1016/j.pec.2012.12.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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