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Makoul G, Noble L, Gulbrandsen P, van Dulmen S. Reinforcing the humanity in healthcare: The Glasgow Consensus Statement on effective communication in clinical encounters. PATIENT EDUCATION AND COUNSELING 2024; 122:108158. [PMID: 38330705 DOI: 10.1016/j.pec.2024.108158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 01/05/2024] [Accepted: 01/14/2024] [Indexed: 02/10/2024]
Abstract
Contemporary healthcare is characterized by multidisciplinary teamwork across a vast array of primary, secondary and tertiary services, augmented by progressively more technology and data. While these developments aim to improve care, they have also created obstacles and new challenges for both patients and health professionals. Indeed, the increasingly fragmented and transactional nature of clinical encounters can dehumanize the care experience across disciplines and specialties. Effective communication plays a pivotal role in reinforcing the humanity of healthcare through the delivery of person-centered care - compassionate, collaborative care that focuses on the needs of each patient as a whole person. After convening at the International Conference on Communication in Healthcare (Glasgow, 2022), an interdisciplinary group of researchers, educators and health professionals worked together to develop a framework for effective communication that both acknowledges critical challenges in contemporary health services and reinforces the humanity of healthcare. The Glasgow Consensus Statement is intended to function as a useful international touchstone for the training and practice of health professionals, fully recognizing and respecting that different countries are at different stages when it comes to teaching, assessment and policy. It also provides a vocabulary for monitoring the impact of system-level challenges. While effective communication may not change the structure of healthcare, it can improve the process if health professionals are supported in infusing the system with their own innate humanity and applying the framework offered within this consensus statement to reinforce the humanity in everyday practice.
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Affiliation(s)
- Gregory Makoul
- Department of Medicine, Yale School of Medicine, New Haven, USA; Human Understanding Institute, NRC Health, Lincoln, USA.
| | - Lorraine Noble
- UCL Medical School, University College London, London, UK; EACH: International Association for Communication in Healthcare, Salisbury, UK
| | - Pål Gulbrandsen
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Akershus University Hospital, Nordbyhagen, Norway
| | - Sandra van Dulmen
- NIVEL - Netherlands Institute for Health Services Research, Utrecht, Netherlands; Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, Netherlands; Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
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Mostafapour M, Fortier JH, Garber G. Exploring the dynamics of physician-patient relationships: Factors affecting patient satisfaction and complaints. J Healthc Risk Manag 2024; 43:16-25. [PMID: 38706117 DOI: 10.1002/jhrm.21567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 03/25/2024] [Indexed: 05/07/2024]
Abstract
This review identifes the factors influencing the relationship between physicians and patients that can lead to patients' dissatisfaction and medical complaints. Utilizing a systemic approach 92 studies were retrieved which included quantitative, qualitative, and mixed method studies. Through a thematic analysis of the literature, we identified three interrelated main themes that can influence the relationship between physicians and patients, patients' satisfaction, and the decision to file a medico-legal complaint. The main themes include patient and physician characteristics; the interpersonal relationship between physicians and patients; and the health care system and policies, with relevant subthemes. These themes are demonstrated in a descriptive model. The review suggests areas of focus for physicians who may wish to increase their awareness around the potential sources of relational problems with their patients. Identifying these issues may assist in improvements in the therapeutic relationship with patients, can reduce their medico-legal risk, and enhance the quality of their clinical practice. The findings can also be utilized to support andragogical principles for medical learners. The article can serve as a structured framework to identify potential problems and gaps to design and test effective interventions to mitigate these potential relational problems between physician-patient.
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Affiliation(s)
- Mehrnaz Mostafapour
- Department of Safe Medical Care Research, Canadian Medical Protective Association, Ottawa, Canada
| | - Jacqueline H Fortier
- Department of Safe Medical Care Research, Canadian Medical Protective Association, Ottawa, Canada
| | - Gary Garber
- Department of Safe Medical Care Research, Canadian Medical Protective Association, Ottawa, Canada
- Department of Medicine and the School of Epidemiology and Public Health at, University of Ottawa, Ottawa, Canada
- Department of Medicine, University of Toronto, Toronto, Canada
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Ong CX, Foo YY, Compton S. The impact of human cadaveric dissection on professional identity formation in medical students. BMC MEDICAL EDUCATION 2023; 23:970. [PMID: 38114993 PMCID: PMC10731900 DOI: 10.1186/s12909-023-04913-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 11/28/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND As technology advances, some schools are moving away from human cadaveric dissection to teach anatomy, leading to concern regarding the possible loss of a professional identity building experience. This study explored the role of dissection in students' professional identity formation. METHODS A mixed-methods study was conducted using survey methodology and semi-structured interviews of medical students at an American-style graduate-entry medical school in Singapore. The questionnaire adopted the conceptual framework of the Ring Theory of Personhood and the MacLeod-Clark Professional Identity Scale was used to measure professional identity, followed by semi-structured interviews of students using Braun and Clarke's six-phase reflexive thematic analysis. RESULTS Respondents did not differ substantively from non-respondents by age, nationality, or ethnicity, and year of entering medical school, however, they were slightly more female dominant. The number of hours of hands-on participation in dissection showed no significant relationship (r2 = 0.010; p = 0.424) with professional identity formation measured by the MacLeod-Clark Professional Identity Scale. Despite the survey results, semi-structured interviews revealed rich and nuanced findings suggesting the influence of dissection in participants' professional identity formation through deepening students' appreciation of humanistic values and enhancing their notions of patients' personhood. Notably, students without dissection experience did not express these sentiments and were orientated towards knowledge acquisition. CONCLUSION While our findings do not suggest that dissection strongly impacts students' professional identity formation, students shared thought-provoking experiences which suggest some level of its contribution. Careful consideration of this phenomenon should be exercised prior to removing dissection in favour of technological alternatives.
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Affiliation(s)
- Ci Xin Ong
- Duke-NUS Medical School, 8 College Rd, Singapore, 169857, Singapore.
| | - Yang Yann Foo
- Duke-NUS Medical School, 8 College Rd, Singapore, 169857, Singapore
| | - Scott Compton
- Duke-NUS Medical School, 8 College Rd, Singapore, 169857, Singapore
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Salim NA, Sallam M, Aldweik RH, Sawair FA, Sharaireh AM, Alabed A. Rating communication skills in dental practice: the impact of different sociodemographic factors. BMC MEDICAL EDUCATION 2023; 23:950. [PMID: 38087317 PMCID: PMC10717947 DOI: 10.1186/s12909-023-04958-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 12/08/2023] [Indexed: 12/18/2023]
Abstract
BACKGROUND Communication abilities are essential for the successful operation of a dental business and significantly influence outcomes, compliance, and patient satisfaction. AIMS AND METHODS The aim of our study was to evaluate the knowledge and practice of doctor-patient communication among Jordanian dentists. This evaluation was conducted through a survey based on the key components of the Calgary Cambridge Observation Guides. Additionally, the impact of several sociodemographic characteristics on communication abilities was investigated. This cross-sectional study was conducted from January to June 2022. The data collection tool was an online questionnaire developed by the researchers, consisting of three sections: self-reported demographic and professional data, the practice of doctor-patient communication, and knowledge of doctor-patient communication. RESULTS The study included 305 dentists, comprising 106 males and 199 females, with a mean age of 32.9 ± 9.0 years. The mean score for communication skills knowledge was 41.5, indicating a moderate level of communication skills knowledge. Female dentists demonstrated significantly higher communication scores compared to their male counterparts, and those working in the private sector scored significantly higher than those in the governmental sector or in both sectors (P ≤ 0.05). In general, older and more experienced dentists exhibited better communication skills. Educational level had a positive impact on certain communication skills items. 58.4% believed that communication skills can always be developed and improved through training sessions, while 48.9% reported never having attended such courses. 95.1% believed that training courses on communication skills are always necessary as part of the educational curriculum. The main obstacles that may deter dentists from considering communication skills courses were limited time (62.3%), course availability (37.7%), cost (28.2%), and perceived lack of importance (8.2%). CONCLUSION Among a sample of Jordanian dentists, there appears to be a discrepancy between knowledge and self-reported practices regarding communication abilities. In certain crucial, evidence-based areas of doctor-patient communication, there are fundamental deficiencies. Considering the significant role dentists play in oral health and prevention, communication skills should be a top educational priority for them.
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Affiliation(s)
- Nesreen A Salim
- Prosthodontic department, School of Dentistry, Consultant in fixed and removable prosthodontics, The University of Jordan, The University of Jordan Hospital, Amman, Jordan.
| | - Malik Sallam
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman, 11942, Jordan
- Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman, 11942, Jordan
| | - Ra'ed Hisham Aldweik
- Oral and Maxillofacial Surgery Resident, Jordan University Hospital, Amman, Jordan
| | - Faleh A Sawair
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontology, School of Dentistry, The University of Jordan, Jordan University Hospital, Amman, Jordan
| | - Aseel M Sharaireh
- Conservative department, School of Dentistry, The University Jordan, Amman, Jordan
| | - Aref Alabed
- Health administration and Management consultant, International Medical Training Academy, London, UK
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Chauhan A, Begum J, Saiyad S. Validated checklist for assessing communication skills in undergraduate medical students: bridging the gap for effective doctor-patient interactions. ADVANCES IN PHYSIOLOGY EDUCATION 2023; 47:871-879. [PMID: 37732370 DOI: 10.1152/advan.00140.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 09/12/2023] [Accepted: 09/14/2023] [Indexed: 09/22/2023]
Abstract
Communication skills are fundamental in healthcare, but assessing them among medical students presents challenges. In the Indian context, the lack of a specific assessment tool further compounds the issue. Thus this study aimed to develop and validate an observation-based communication skills checklist tailored to Phase I Bachelor of Medicine and Bachelor of Surgery (MBBS) students. The checklist was developed using both inductive and deductive approaches and underwent rigorous testing to ensure its reliability and validity. After piloting, the finalized version was administered to 84 Phase I MBBS students. Results indicated a critical content validity ratio of 0.78, face validity of 0.80, and an impressive Cronbach's alpha of 0.91, indicating good internal consistency and reliability of the checklist. The students scored over 80% in all checklist domains, except for empathy (73%) and support (74%), highlighting areas for potential improvement. Nonetheless, about 75% of students expressed satisfaction with the checklist's communication skills assessment. The feedback from faculty members was positive, as they found the checklist was easy to use, quick, and effective for evaluating communication skills. Consequently, the checklist's introduction has been well received by both students and faculty. In conclusion, the developed checklist proves to be an effective and valid instrument for assessing communication skills in Phase I MBBS students. By integrating this tool into observed station clinical examinations, medical educators can comprehensively evaluate students' communication behaviors. Moreover, the checklist serves as a valuable resource for bridging the gap between theoretical knowledge and practical application, enabling future physicians to excel in doctor-patient interactions, a crucial aspect of patient-centered care.NEW & NOTEWORTHY This article presents a highly unique and novel approach by introducing a structured checklist for communication skill assessment in medical students. Its rigorous validation process ensures reliability and effectiveness, while its adaptation to sociocultural norms highlights its relevance and applicability. The user-friendly design with a single-page layout and dichotomous scale further enhances its practicality in objective structured clinical examinations. The developed checklist equips educators with a valuable resource to assess and improve students' communication abilities.
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Affiliation(s)
- Archana Chauhan
- Department of Physiology, Dr. Yashwant Singh Parmar Government Medical College, Nahan, Sirmaur, India
| | - Jarina Begum
- Department of Community Medicine, Manipal Tata Medical College, Manipal Academy of Higher Education, Jamshedpur, Jharkhand, India
| | - Shaistha Saiyad
- Department of Physiology, Smt Nathiba Hargovandas Lakhmichand Municipal Medical College, Ahmedabad, Gujrat, India
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Hoonakker JD, Adeline-Duflot F, Orcel V, Grudzinski ML, Cognet M, Renard V. Use of visual aids in general practice consultations: A questionnaire-based survey. PEC INNOVATION 2023; 2:100159. [PMID: 37384162 PMCID: PMC10294083 DOI: 10.1016/j.pecinn.2023.100159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 04/21/2023] [Accepted: 04/24/2023] [Indexed: 06/30/2023]
Abstract
Objectives Visual aids (VAs) seem effective to improve doctor-patient communication. The objective was to describe how VAs are used in consultation and what French general practitioners (GPs) expect of them. Methods Cross-sectional study using a self-administered questionnaire among French GPs in 2019. Descriptive and multinominal logistic regression analyses were performed. Results Of the 376 respondents, 70% used VAs at least weekly and 34% daily; 94% considered VAs useful/very useful; 77% felt they did not use VAs enough. Sketches were the most used VAs and considered the most useful. Younger age was significantly associated with a higher rate of use of simple digital images. VAs were mainly used to describe anatomy and facilitate patient comprehension. Main reasons for not using VAs more often were time spent searching, lack of habit and poor quality of available VAs. Many GPs requested a database of good quality VAs. Conclusions GPs use VAs regularly in consultations but would like to use them more often. Informing GPs of the usefulness of VAs, training them to draw adapted sketches and creating a good quality databank are some possible strategies to increase the use of VAs. Innovation This study described in detail the use of VAs as tool for doctor-patient communication.
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Affiliation(s)
- Jean-Denis Hoonakker
- Department of General Practice, Faculty of Health, University Paris-Est Créteil, Créteil, France
- Multidisciplinary Health Centre of Pays de Nemours, Nemours, France
| | | | - Véronique Orcel
- Department of General Practice, Faculty of Health, University Paris-Est Créteil, Créteil, France
| | - Marie-Louise Grudzinski
- Department of General Practice, Faculty of Health, University Paris-Est Créteil, Créteil, France
| | - Mathilde Cognet
- Department of General Practice, Faculty of Health, University Paris-Est Créteil, Créteil, France
- University Multidisciplinary Health Centre of Sucy-en-Brie, Sucy-en-Brie, France
| | - Vincent Renard
- Department of General Practice, Faculty of Health, University Paris-Est Créteil, Créteil, France
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Taff H, Gilkerson L, Osta A, Seo-Lee A, Schwartz A, Chunara Z, McGinn L, Pillai N, Barnes MM. Strengthening Parent - Physician Communication: A Mixed Methods Study on Attuned Communication Training for Pediatric Residents. TEACHING AND LEARNING IN MEDICINE 2023; 35:577-588. [PMID: 35946430 DOI: 10.1080/10401334.2022.2107528] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 07/11/2022] [Indexed: 06/15/2023]
Abstract
Problem: High-quality communication improves patient satisfaction and clinical outcomes, yet formal communication training in residency is often minimal. Many studies on empathic communication show mixed results and are often hindered and skewed by brief study lengths, insufficiently and ambiguously defined concepts, and limited methods for objective measurements. Intervention: The FAN Curriculum is a unique communication curriculum, based on the conceptual frameworks of patient-centered communication, reflective practice, mindfulness, and attunement using the Facilitating Attuned Interactions (FAN) model. The first part of the FAN Curriculum was delivered as a 3-hour interactive workshop involving didactics, group discussion, and role play with pediatric residents. Residents then completed weekly self-reflections, a follow-up one-hour training to reinforce concepts, and five monthly mentor sessions, all emphasizing reflective practice. Context: This longitudinal, mixed-methods study examined the effects of the FAN Curriculum on residents' empathy levels and ability to communicate with parents in the clinical setting. The study was conducted at two urban, academic, medium-sized pediatric residency programs in Chicago between October 2016 and November 2017. First- and second-year pediatric residents whose continuity clinic site was located at their home institution participated. Residents received training in the use of the FAN Communication Tool using a delayed-start crossover study design. Impact: At five time points, residents and parents completed instruments validated for measuring physician empathy and mindfulness. Post-study interviews were conducted for one institution's residents and mentors and were evaluated using open and focused coding. Participants (n = 23) demonstrated a high degree of use of the FAN Communication Tool six months post-training and a significant rise in self-reported comfort with four of five FAN core processes. One parent-completed survey (Consultation and Relational Empathy, CARE) showed a statistically significant rise of 3.26% in resident relational empathy and collaboration after training (p = 0.02). In qualitative analysis of interviews, residents and mentors found the FAN Communication Tool beneficial, making clinic visits more efficient and collaborative. Both groups noted improvement in the residents' relationship-building skills; residents were able to use enhanced communication skills to better approach challenging encounters and work through parent concerns. Lessons Learned: Family-centered communication training can improve physician-perceived empathy and mindfulness. Effective communication for pediatric residents incorporates an empathic approach, and introduction to this formal curriculum supported their growth in connecting and engaging with children and parents. The FAN Curriculum may provide a useful method for improving resident communication skills with a positive impact on pediatricians' collaboration with patients and families.
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Affiliation(s)
- Heather Taff
- Department of Pediatrics, University of Illinois College of Medicine at Chicago, Chicago, Illinois, USA
- VNA Health Care, Aurora, Illinois, USA
| | | | - Amanda Osta
- Department of Pediatrics, University of Illinois College of Medicine at Chicago, Chicago, Illinois, USA
| | - Alisa Seo-Lee
- Department of Pediatrics, Cook County Health, Chicago, Illinois, USA
| | - Alan Schwartz
- Department of Pediatrics, University of Illinois College of Medicine at Chicago, Chicago, Illinois, USA
- Department of Medical Education, University of Illinois College of Medicine at Chicago, Chicago, Illinois, USA
| | - Zobia Chunara
- Department of Medical Education, University of Illinois College of Medicine at Chicago, Chicago, Illinois, USA
| | - Lander McGinn
- Department of Medical Education, University of Illinois College of Medicine at Chicago, Chicago, Illinois, USA
| | - Nikita Pillai
- Department of Medical Education, University of Illinois College of Medicine at Chicago, Chicago, Illinois, USA
| | - Michelle M Barnes
- Department of Pediatrics, University of Illinois College of Medicine at Chicago, Chicago, Illinois, USA
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Schweiberger K, Harris KW, Kavanaugh-McHugh A, Soudi A, Arnold RM, Merlin JS, Kasparian NA, Chang JC. "I Just Want You to Hear That Term": Characterizing Language Used in Fetal Cardiology Consultations. J Cardiovasc Dev Dis 2023; 10:394. [PMID: 37754823 PMCID: PMC10531623 DOI: 10.3390/jcdd10090394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 09/05/2023] [Accepted: 09/07/2023] [Indexed: 09/28/2023] Open
Abstract
The way clinicians communicate with parents during pregnancy about congenital heart disease (CHD) can significantly influence parental understanding of and psychological response to the diagnosis. A necessary first step to improving communication used in fetal cardiology consultations is to understand and describe the language currently used, which this paper aims to do. Nineteen initial fetal cardiology consultations with parents were audio-recorded, transcribed verbatim, and coded by two independent coders. A codebook was inductively developed and applied to all transcripts. The finalized coding was used to characterize fetal cardiologists' language. We identified four discourse styles employed in fetal cardiology consultations: small talk, medical, plain, and person-centered. Plain language was used to define and emphasize the meaning of medical language. Person-centered language was used to emphasize the baby as a whole person. Each consultation included all four discourse styles, with plain and medical used most frequently. Person-centered was used less frequently and mostly occurred near the end of the encounters; whether this is the ideal balance of discourse styles is unknown. Clinicians also used person-centered language (as opposed to disease-centered language), which is recommended by medical societies. Future studies should investigate the ideal balance of discourse styles and the effects of clinician discourse styles on family outcomes, including parents' decision-making, psychological adjustment, and quality of life.
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Affiliation(s)
- Kelsey Schweiberger
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA;
| | - Kelly W. Harris
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA;
| | - Ann Kavanaugh-McHugh
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN 37232, USA;
| | - Abdesalam Soudi
- Department of Linguistics, University of Pittsburgh, Pittsburgh, PA 15260, USA;
| | - Robert M. Arnold
- Section of Palliative Care and Medical Ethics, Department of General Internal Medicine, Palliative Research Center, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA; (R.M.A.); (J.S.M.)
| | - Jessica S. Merlin
- Section of Palliative Care and Medical Ethics, Department of General Internal Medicine, Palliative Research Center, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA; (R.M.A.); (J.S.M.)
| | - Nadine A. Kasparian
- The Heart Institute, Cincinnati Children’s Hospital, Cincinnati, OH 45229, USA;
- Department of Pediatrics, College of Medine, University of Cincinnati, Cincinnati, OH 45267, USA
- Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children’s Hospital, Cincinnati, OH 45229, USA
| | - Judy C. Chang
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA;
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Brennan N, Langdon N, Keates N, Mattick K, Gale T. Graduates' preparedness for the changing doctor-patient relationship: A qualitative study. MEDICAL EDUCATION 2023; 57:712-722. [PMID: 36646510 DOI: 10.1111/medu.15020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 01/06/2023] [Accepted: 01/11/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND A positive doctor-patient relationship is a crucial part of high-quality patient care. There is a general perception that it has been changing in recent years; however, there is a lack of evidence for this. Adapting to the changing doctor-patient relationship has been identified as an important skill doctors of the future must possess. This study explores (1) multiple stakeholder perspectives on how the doctor-patient relationship is changing and (2) in what ways medical graduates are prepared for working in this changing doctor-patient relationship. METHODS We conducted a national qualitative study involving semi-structured interviews with multiple stakeholders across the United Kingdom. Interviews lasting 45-60 minutes were conducted with 67 stakeholders including doctors in the first 2 years of practice (ECD's), patient representatives, supervisors, deans, medical educators and other health care professionals. The interviews were audiorecorded, transcribed, analysed, coded in NVivo and analysed thematically using a Thematic Framework Analysis approach. RESULTS The main ways the doctor-patient relationship was perceived to be changing related to increased shared decision making and patients having increasing access to information. Communication, patient-centred care and fostering empowerment, were the skills identified as being crucial for preparedness to work in the changing doctor-patient relationship. Graduates were reported to be typically well-prepared for the preconditions (communication and delivering patient-centred care) of patient empowerment, but that more work is needed to achieve true patient empowerment. CONCLUSION This study offers a conceptual advance by identifying how the doctor-patient relationship is changing particularly around the 'patient-as-knowledge-source' dimension. On the whole ECD's are well-prepared for working in the changing doctor-patient relationship with the exception of patient empowerment skills. Further research is now needed to provide an in-depth understanding of patient empowerment that is shared among key stakeholders (particularly the patient perspective) and to underpin the design of educational interventions appropriate to career stage.
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Affiliation(s)
- Nicola Brennan
- Collaboration for the Advancement of Medical Education Research, Peninsula Medical School, Faculty of Health, University of Plymouth, Plymouth, United Kingdom
| | - Nicola Langdon
- Collaboration for the Advancement of Medical Education Research, Peninsula Medical School, Faculty of Health, University of Plymouth, Plymouth, United Kingdom
| | | | - Karen Mattick
- Exeter Medical School, University of Exeter, Exeter, United Kingdom
| | - Thomas Gale
- Collaboration for the Advancement of Medical Education Research, Peninsula Medical School, Faculty of Health, University of Plymouth, Plymouth, United Kingdom
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Haiba AM, Haiba MM. Attitudes of medical students in Khartoum, Sudan towards the doctor-patient relationship: a cross-sectional study. PeerJ 2023; 11:e15434. [PMID: 37426412 PMCID: PMC10324596 DOI: 10.7717/peerj.15434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 04/26/2023] [Indexed: 07/11/2023] Open
Abstract
Background/Objectives The doctor-patient relationship is essential to the delivery of high-quality medical care. A strong doctor-patient relationship that improves patient outcomes and satisfaction depends on effective communication. The purpose of this study was to assess medical students' attitudes toward the doctor-patient relationship during their clinical years at the University of Khartoum. We also looked at how gender and study year affected patient-centeredness. Participants/Setting The study was conducted on medical students in their clinical years from December 2020 to March 2021. Students were selected from years 3 to 6. A total of 353 medical students constituted the study sample. Design The cross-sectional study utilized the Patient Practitioner Orientation Scale (PPOS) for the measurement of student attitudes towards the doctor-patient relationship. PPOS scores are calculated as a mean score that ranges from 1 (indicating doctor or disease-centered inclinations) to 6 (indicating patient-centered or egalitarian inclinations). Medical students' demographic data was collected, including their gender, age and study year. Results A total of 313 students completed the survey (response rate: 89%). The average total PPOS score and the scores for the caring and sharing subscales for the entire cohort were 4.08 ± 0.53, 4.43 ± 0.58, and 3.72 ± 0.72, respectively. Female gender was significantly associated with more patient-centered attitudes (p < 0.001). When compared to the start of their clinical curriculum, students' attitudes were significantly more patient-centered by the conclusion of their studies (p < 0.001). Conclusion A satisfactory level of patient-centeredness was demonstrated by medical students at the University of Khartoum, and gender had an impact on this quality. Additional consideration should be given to the finding that students' orientations were more patient-centered in the caring dimension and less so in the sharing one. Once addressed, improvements in that area could create an environment that enhances attitudes among students in the sharing domain, with great potential gains to patients.
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Affiliation(s)
- Aya M. Haiba
- Department of Community Medicine, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Marwan M. Haiba
- Faculty of Medicine, University of Ibn Sina, Khartoum, Sudan
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Pieterse AH, Gulbrandsen P, Ofstad EH, Menichetti J. What does shared decision making ask from doctors? Uncovering suppressed qualities that could improve person-centered care. PATIENT EDUCATION AND COUNSELING 2023; 114:107801. [PMID: 37230040 DOI: 10.1016/j.pec.2023.107801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 05/12/2023] [Accepted: 05/17/2023] [Indexed: 05/27/2023]
Abstract
OBJECTIVE Shared decision making (SDM) is infrequently seen in clinical practice despite four decades of efforts. We propose a need to explore what SDM asks from doctors in terms of enabling competencies and necessary, underlying qualities, and how these can be nurtured or suppressed in medical training. DISCUSSION Key SDM tasks call for doctors to understand communication and decision mechanisms to carry them out well, including reflecting on what they know and do not know, considering what to say and how, and listening unprejudiced to patients. Different doctor qualities can support accomplishing these tasks; humility, flexibility, honesty, fairness, self-regulation, curiosity, compassion, judgment, creativity, and courage, all relevant to deliberation and decision making. Patient deference to doctors, lack of supervised training opportunities with professional feedback, and high demands in the work environment may all inflate the risk of only superficially involving patients. CONCLUSIONS We have identified ten professional qualities and related competencies required for SDM, with each to be selected based on the specific situation. The competencies and qualities need to be preserved and nurtured during doctor identity building, to bridge the gap between knowledge, technical skills, and authentic efforts to achieve SDM.
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Affiliation(s)
- Arwen H Pieterse
- Department of Biomedical Data Sciences, Leiden University Medical Center, 2333 ZA Leiden, the Netherlands.
| | - Pål Gulbrandsen
- Institute of Clinical Medicine, University of Oslo, 0316 Oslo, Norway; Health Services Research Unit (HØKH), Akershus University Hospital, 1478 Lørenskog, Norway
| | - Eirik H Ofstad
- The Medical Clinic, Nordland Hospital Trust, 8005 Bodø, Norway
| | - Julia Menichetti
- Health Services Research Unit (HØKH), Akershus University Hospital, 1478 Lørenskog, Norway
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Verheijden M, Giroldi E, van den Eertwegh V, Luijkx M, van der Weijden T, de Bruin A, Timmerman A. Identifying characteristics of a skilled communicator in the clinical encounter. MEDICAL EDUCATION 2023; 57:418-429. [PMID: 36223270 DOI: 10.1111/medu.14953] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 09/21/2022] [Accepted: 10/08/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND In medical communication research, there has been a shift from 'communication skills' towards 'skilled communication', the latter implying the development of flexibility and creativity to tailor communication to authentic clinical situations. However, a lack of consensus currently exists what skilled communication entails. This study therefore aims to identify characteristics of a skilled communicator, hereby contributing to theory building in communication research and informing medical training. METHOD In 2020, six nominal group technique (NGT) sessions were conducted in the context of the general practitioner (GP) training programme engaging 34 stakeholders (i.e. GPs, GP residents, faculty members and researchers) based on their experience and expertise in doctor-patient communication. Participants in each NGT session rank-ordered a 'Top 7' of characteristics of a skilled communicator. The output of the NGT sessions was analysed using mixed methods, including descriptive statistics and thematic content analysis during an iterative process. RESULTS Rankings of the six sessions consisted of 191 items in total, which were organised into 41 clusters. Thematic content analysis of the identified 41 clusters revealed nine themes describing characteristics of a skilled communicator: (A) being sensitive and adapting to the patient; (B) being proficient in applying interpersonal communication; (C) self-awareness, learning ability and reflective capacity; (D) being genuinely interested; (E) being proficient in applying patient-centred communication; (F) goal-oriented communication; (G) being authentic; (H) active listening; and (I) collaborating with the patient. CONCLUSIONS We conceptualise a skilled communication approach based on the identified characteristics in the present study to support learning in medical training. In a conceptual model, two parallel processes are key in developing adaptive expertise in communication: (1) being sensitive and adapting communication to the patient and (2) monitoring communication performance in terms of self-awareness and reflective capacity. The identified characteristics and the conceptual model provide a base to develop a learner-centred programme, facilitating repeated practice and reflection. Further research should investigate how learners can be optimally supported in becoming skilled communicators during workplace learning.
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Affiliation(s)
- Michelle Verheijden
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
- Department of Educational Development and Research, School of Health Professions Educations (SHE), Maastricht University, Maastricht, The Netherlands
| | - Esther Giroldi
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
- Department of Educational Development and Research, School of Health Professions Educations (SHE), Maastricht University, Maastricht, The Netherlands
| | - Valerie van den Eertwegh
- Skillslab, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Marscha Luijkx
- Department of Family Medicine, School for Public Health and Primary Care, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Trudy van der Weijden
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Anique de Bruin
- Department of Educational Development and Research, School of Health Professions Educations (SHE), Maastricht University, Maastricht, The Netherlands
| | - Angelique Timmerman
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
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Novaes FPSS, Alves JG, Grosseman S. Communication in healthcare: experience of students and professionals from teaching- learning to practice in health. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2023; 14:23-35. [PMID: 37027508 PMCID: PMC10693394 DOI: 10.5116/ijme.6412.f49b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 03/16/2023] [Indexed: 06/19/2023]
Abstract
Objectives This study aimed to understand the teaching-learning experience in the Communication in Healthcare class among students, teaching assistants, and health professionals, as well as its applications to professional practice. Methods This is a qualitative study with a theoretical approach based on Gadamer's Philosophical Hermeneutics and a methodological framework based on Minayo and Bardin's thematic content analysis. Communication in Healthcare is an elective multiprofessional class, which lasts one semester and is offered regularly. All former students (n = 368) were invited to participate by email, and 30 participated in these focus groups (13 students, 8 teaching assistants, and 9 health professionals). The online focus groups took place on an online platform, and they were video-recorded and subsequently transcribed. Through cross-sectional and vertical analysis, the main themes were identified. Results The Communication in Healthcare class was an important step for personal, professional, and interprofessional formation and development of communication competence. The following dominant themes were identified: 1) motivation for signing up, 2) prior expectations, 3) meaning of the experience and shaping moments, 4) how the teaching-learning experience was retained and what was retained, 5) repercussions in relation to self, others, and professional life, and 6) reflections about the curriculum, interprofessional dialogue, and formation. Conclusions The teaching-learning experience was important for the formation of communicational competence. This research contributes to medical education and opens teaching-learning paths for communication skills, empathy, dialogue, and interprofessionalism. Future studies with a philosophical hermeneutic framework and online focus groups are indicated for the comprehension of educational interventions in health.
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Affiliation(s)
| | - João G.B. Alves
- Postgraduate Program, Instituto de Medicina Integral Professor Fernando Figueira (IMIP), Brazil
| | - Suely Grosseman
- Postgraduate Program in Medical Sciences, Federal University of Santa Catarina (UFSC), Brazil
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Adam P, Mauksch LB, Brandenburg DL, Danner C, Ross VR. Optimal training in communication model (OPTiCOM): A programmatic roadmap. PATIENT EDUCATION AND COUNSELING 2023; 107:107573. [PMID: 36410312 DOI: 10.1016/j.pec.2022.107573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 11/13/2022] [Accepted: 11/16/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVES Teaching primary care residents patient communication skills is essential, complex, and impeded by barriers. We find no models guiding faculty how to train residents in the workplace that integrate necessary system components, the science of physician-patient communication training and competency-based medical education. The aim of this project is to create such a model. METHODS We created OPTiCOM using four steps: (1) communication educator interviews, analysis and theme development; (2) initial model construction; (3) model refinement using expert feedback; (4) structured literature review to validate, refine and finalize the model. RESULTS Our model contains ten interdependent building blocks organized into four developmental tiers. The Foundational value tier has one building block Naming relationship as a core value. The Expertize and resources tier includes four building blocks addressing: Curricular expertize, Curricular content, Leadership, and Time. The four building blocks in the Application and development tier are Observation form, Faculty development, Technology, and Formative assessment. The Language and culture tier identifies the final building block, Culture promoting continuous improvement in teaching communication. CONCLUSIONS OPTiCOM organizes ten interdependent systems building blocks to maximize and sustain resident learning of communication skills. Practice Implications Residency faculty can use OPTiCOM for self-assessment, program creation and revision.
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Affiliation(s)
- Patricia Adam
- Department of Family Medicine and Community Health, University of Minnesota, Smiley's Clinic, 2020 East 28th Street, Minneapolis, MN 55407, USA.
| | - Larry B Mauksch
- Emeritus - Department of Family Medicine, University of Washington, Home, 6026 30th Ave NE, Seattle, WA 98115, USA.
| | - Dana L Brandenburg
- Department of Family Medicine and Community Health, University of Minnesota, Smiley's Clinic, 2020 East 28th Street, Minneapolis, MN 55407, USA.
| | - Christine Danner
- Department of Family Medicine and Community Health, University of Minnesota, Bethesda Clinic, 580 Rice St, St Paul, MN 55103, USA.
| | - Valerie R Ross
- University of Washington Department of Family Medicine, Family Medicine Residency Program, Box 356390, 331 N.E. Thornton Place, Seattle, WA 98125, USA.
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The Art and Science of Consultations in Bovine Medicine: Use of Modified Calgary – Cambridge Guides, Part 2. MACEDONIAN VETERINARY REVIEW 2023. [DOI: 10.2478/macvetrev-2023-0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Abstract
This article, part 2 of a 2-part series, describes the next two steps in the application of the Modified Calgary-Cambridge Guides (MCCG) to consultations in bovine medicine, ‘explanation and planning’, and ‘closing the consultation’, and introduces concepts that are associated with all the components of the guide, ‘building the relationship with the client’ and ‘providing structure to the consultation’. Part 1 introduced the aim and framework of the MCCG which enables the practitioner to gain an insight into the client’s understanding of the problem, including understanding aetiology, epidemiology and pathophysiology. Part 2 introduces the framework that provides the opportunity to understand the client’s expectations regarding the outcome, their motivation and willingness to adhere to recommendations. It also describes how to engage and acknowledge the client as an important part of the decision-making process, how to establish responsibilities of both the client and practitioner, and how to reach out to the client at the conclusion of the consultation to make certain that the client’s expectations were met.
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Hashimoto S, Kitakata H, Kohsaka S, Fujisawa D, Shiraishi Y, Nakano N, Sekine O, Kishino Y, Katsumata Y, Yuasa S, Fukuda K, Kohno T. Confidence in self-care after heart failure hospitalization. J Cardiol 2023; 81:42-48. [PMID: 36241046 DOI: 10.1016/j.jjcc.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 09/02/2022] [Accepted: 09/25/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Understanding patient perspectives of self-care is critical for improving multidisciplinary education programs and adherence to such programs. However, perspectives of self-care for patients with heart failure (HF) as well as the association between patient perspectives and patient-physician communication remain unclear. METHODS Confidence levels regarding self-care behaviors (eight lifestyle behaviors and four consulting behaviors) and self-monitoring were assessed using a self-administered questionnaire survey, which was directly distributed by dedicated physicians and nurses to consecutive patients hospitalized with HF in a tertiary-level hospital. Patient-physician communication was evaluated according to the quality of physician-provided information regarding "treatment and treatment choices" and "prognosis" using the Prognosis and Treatment Perception Questionnaire. Out of 202 patients, 187 (92.6 %) agreed to participate, and 176 completed the survey [valid response rate, 87.1 %; male, 67.0 %; median age, 73 (63-81) years]. Multivariate logistic regression analyses were conducted to predict low confidence in self-care (score in the lowest quartile). RESULTS High confidence (confident or completely confident >75 % of patients) was observed for all self-care behavior categories except low-salt diet (63.1 %), regular exercise (63.1 %), and flu vaccination (65.9 %). Lower confidence in self-care behavior was associated with low quality of patient-physician communication. With regard to self-monitoring, 62.5 % of patients were not confident in distinguishing worsening symptoms of HF from other diseases; non-confidence was also associated with low quality of patient-physician communication. CONCLUSIONS Hospitalized patients with HF had low confidence regarding regular exercise, salt restriction, and flu vaccination. The results also suggest patient-physician communication affects patient confidence.
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Affiliation(s)
- Shun Hashimoto
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Hiroki Kitakata
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Shun Kohsaka
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Daisuke Fujisawa
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Yasuyuki Shiraishi
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Naomi Nakano
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Otoya Sekine
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Yoshikazu Kishino
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Yoshinori Katsumata
- Institute for Integrated Sports Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Shinsuke Yuasa
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Keiichi Fukuda
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Takashi Kohno
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan; Department of Cardiovascular Medicine, Kyorin University Faculty of Medicine, Tokyo, Japan.
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Makowska M, Szczepek AJ, Nowosad I, Weissbrot-Koziarska A, Dec-Pietrowska J. Perception of Medical Humanities among Polish Medical Students: Qualitative Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:270. [PMID: 36612590 PMCID: PMC9819447 DOI: 10.3390/ijerph20010270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 12/19/2022] [Accepted: 12/22/2022] [Indexed: 06/17/2023]
Abstract
Medical humanities (MH) courses are a critical element of the medical curriculum influencing the establishment of a physician in the medical profession. However, the opinion about MH among medical students remains unknown. Interviews from seven focus groups were analysed. The students attended one of three Polish medical schools in Gdansk, Krakow, and Warsaw and were recruited to the discussion focused on the impact of drug manufacturers' presence at medical universities on socialization in the medical profession. Thematic analysis was conducted using the theoretical framework of social constructivism. The students' opinions about the MH classes arose during the analysis. In six groups, students thought that MH courses would be helpful in their future medical practice. However, in four groups, different opinion was expressed that MH courses were unnecessary or even "a waste of time". Factors discouraging students from the MH classes included poorly taught courses (monotonous, uninteresting, unrelated to medical practice, taught by unsuitable lecturers). Secondly, students thought that the time investment in the MH was too extensive. Furthermore, curriculum problems were identified, reflecting the incompatibility between the content of MH courses and teaching semesters. Lastly, some students stated that participation in MH courses should be elective and based on individual interests. Addressing problems recognized in this work could improve the training of future Polish physicians.
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Affiliation(s)
- Marta Makowska
- Department of Economic Psychology, Kozminski University, Jagiellońska 57, 03-301 Warszawa, Poland
| | - Agnieszka J. Szczepek
- Faculty of Medicine and Health Sciences, University of Zielona Góra, 65-046 Zielona Góra, Poland
- Department of Otorhinolaryngology, Head and Neck Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Inetta Nowosad
- Faculty of Social Sciences, University of Zielona Góra, 65-046 Zielona Góra, Poland
| | | | - Joanna Dec-Pietrowska
- Faculty of Medicine and Health Sciences, University of Zielona Góra, 65-046 Zielona Góra, Poland
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18
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Zeng W, Tan HC, Zheng HF, Lam ARL, Teo KK, Tan CS, Kovalik JP, Ghosh S, Xin XH. Satisfaction of patients with diabetic kidney disease with traditional chinese medicine physician visits. Heliyon 2022; 8:e12371. [PMID: 36590484 PMCID: PMC9800549 DOI: 10.1016/j.heliyon.2022.e12371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 10/30/2022] [Accepted: 12/07/2022] [Indexed: 12/23/2022] Open
Abstract
Background Patient-centred care is an important part of quality healthcare and patient satisfaction has been shown to be associated with improved clinical outcomes. We aim to explore the satisfaction of patients with diabetic kidney disease (DKD) with their visits to the TCM physician and its association with patients' socio-economic characteristics. Methods A questionnaire survey was conducted among patients aged >21 years with DKD. Participants' demographic, socioeconomic characteristics and satisfaction scores measured with the self-administered Medical Interview Satisfaction Scale (MISS) were collected after they visited the TCM physician. MISS is a 26-item questionnaire consisting of three domains - cognitive, affective and behavioural which was developed to assess patient satisfaction with medical consultation. Independent samples t-test and one-way analysis of variance (ANOVA) were used to analyse the data. Results 137 participants completed the questionnaires and were included in the analysis. The mean satisfaction score was 3.1 out of 5, with the cognitive domain being significantly higher compared to the affective and behavioural domains. The mean satisfaction score of the cognitive domain differed significantly among participants staying in different types of housing and those with previous TCM encounters. The mean satisfaction score of the behavioural domain differed significantly among participants of different ethnicities. The mean satisfaction scores of all the domains were also significantly different among participants with different duration of follow-up with their TCM physicians. Conclusion We found that ethnicity, types of housing, previous TCM experience and the duration of follow-up with the TCM physician may affect the satisfaction scores of patients with DKD.
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Affiliation(s)
- Wanling Zeng
- Department of Endocrinology, Singapore General Hospital, Singapore,Corresponding author:
| | - Hong Chang Tan
- Department of Endocrinology, Singapore General Hospital, Singapore
| | | | | | | | - Chieh Suai Tan
- Department of Renal Medicine, Singapore General Hospital, Singapore
| | - Jean-Paul Kovalik
- Cardiovascular and Metabolic Disease Program, Duke-NUS Medical School, Singapore
| | - Sujoy Ghosh
- Cardiovascular and Metabolic Disease Program, Duke-NUS Medical School, Singapore,Centre for Computational Biology, Duke-NUS Medical School, Singapore
| | - Xiao Hui Xin
- SingHealth Medicine ACP, Singapore General Hospital, Singapore
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Holtz B, Nelson V, Poropatich RK. Artificial Intelligence in Health: Enhancing a Return to Patient-Centered Communication. Telemed J E Health 2022. [DOI: 10.1089/tmj.2022.0413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Bree Holtz
- Department of Advertising and Public Relations, College of Communication Arts and Sciences, Michigan State University, East Lansing, Michigan, USA
| | - Victoria Nelson
- Department of Advertising and Public Relations, College of Communication Arts and Sciences, Michigan State University, East Lansing, Michigan, USA
| | - Ronald K. Poropatich
- Center for Military Medicine Research, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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20
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Desai MK, Kapadia JD. Medical Professionalism and Ethics. J Pharmacol Pharmacother 2022. [DOI: 10.1177/0976500x221111448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Frequent media reports of disputes between medical teachers, resident doctors, and patients have been disturbing thus indicating an increasing gap and decline in the values of the profession. The foundation of medical professionalism and ethics is trust, truth, human values, and strong societal commitment. Our professional responsibilities as medical educators have immediate and long-term impact on the quality of training, patient care, and overall image of the professional group in the society. Formal teaching and training in professionalism and medical ethics that emphasize humanistic aspects and standard of conduct, respectively, are equally essential as biomedical aspects. Interestingly, the principles of medical ethics and attributes of professionalism overlap. However, real-life experiences and complex clinical scenarios place medical educators at the crossroads that contradict their professional commitments resulting in ethical dilemmas. COVID-19 pandemic has further challenged the principles of medical professionalism, especially patient welfare, autonomy, and social justice to prioritize patient care and make tricky decisions based on insufficient resources including withholding and withdrawing potentially lifesaving treatments. Unfortunately, until now the teaching and training in medical professionalism and ethics have remained subtle and medical students learn by chance. The recent introduction of the AETCOM module and Code of Medical Ethics in the curriculum is a ray of hope to brighten the image of medical professionals.
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Affiliation(s)
- Mira K. Desai
- Department of Pharmacology, Nootan Medical College, Visnagar, Gujarat, India
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Vogel CE, Kiessling C, Fischer MR, Graupe T. Does a sense of gratitude protect against empathy loss in medical students? An exploratory study. GMS JOURNAL FOR MEDICAL EDUCATION 2022; 39:Doc32. [PMID: 36119146 PMCID: PMC9469569 DOI: 10.3205/zma001553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 03/01/2022] [Accepted: 05/05/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION The promotion of physicians' empathy (PE) skills in medical school plays a central role in physician-patient communication. However, a significant decline in empathy among medical students during their training has been repeatedly reported. Gratitude could be a possible protective factor for PE. However, as some students do not seem to be affected by this empathy loss, this study explores the relationship between gratitude and PE. METHODS Using validated questionnaires (JSPE-S, IRI and GQ-6), 88 medical students at LMU München evaluated their self-assessed PE and gratitude. In addition, they went through four OSCE stations focusing on general medicine, in which their empathy and communication skills were assessed by simulated patients (SP) and by an assessor using the Berlin Global Rating. Correlations were analysed using Pearson's correlation coefficient and gender differences were analysed using Mann-Whitney U-tests. RESULTS In the self-assessment, there was a significant, moderate correlation between students' attitude towards empathy (JSPE-S) and their gratitude (GQ-6) and a weak correlation between the IRI subscale "Empathy" and the GQ-6. In terms of the performance-based assessment, there were also weak correlations between PE or communication skills and gratitude. There were no gender-specific differences in the gratitude of the students. CONCLUSION We were able to demonstrate a correlational relationship between gratitude and empathy in medical students. Whether gratitude acts causally as a protective or supportive factor for empathy remains open. A causal relationship of gratitude to empathy should therefore be examined in a prospective study design.
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Affiliation(s)
- Claire Elisabeth Vogel
- Klinikum Landkreis Erding, Abteilung für Unfallchirurgie und Orthopädie, Erding, Germany
| | - Claudia Kiessling
- Private Universität Witten/Herdecke gGmbH, Lehrstuhl für die Ausbildung personaler und interpersonaler Kompetenzen im Gesundheitswesen, Witten, Germany
| | - Martin R. Fischer
- LMU Klinikum, LMU München, Institut für Didaktik und Ausbildungsforschung in der Medizin (DAM), München, Germany
| | - Tanja Graupe
- LMU Klinikum, LMU München, Institut für Didaktik und Ausbildungsforschung in der Medizin (DAM), München, Germany
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Medical Communication Perceived Self-Efficacy (ME-CO) Scale: Construction and Validation of a New Measuring Instrument from a Socio-Cognitive Perspective. Eur J Investig Health Psychol Educ 2022; 12:765-780. [PMID: 35877456 PMCID: PMC9323938 DOI: 10.3390/ejihpe12070056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/05/2022] [Accepted: 07/08/2022] [Indexed: 12/02/2022] Open
Abstract
The study presents the validation of a scale measuring physicians’ efficacy beliefs about their ability to manage issues related to communication with patients. Specifically, the tool focused on three fundamental phases of the clinical interview: collecting information, returning information to patients, and creating and maintaining a relationship with them. The research included two studies. Study 1 generated an item pool based on the literature review and developed a self-report questionnaire administered to a pilot sample of 150 physicians (MAge = 49.36; SD = 1.98). The responses were subjected to exploratory analysis. In total, 636 physicians (MAge = 47.99; SD = 8.68) took part in Study 2. Exploratory and confirmatory analyses yielded a final version of the tool consisting of an eight-factor structure with 31 items. Findings provided evidence of the robust psychometric properties of the scale and its usefulness in assessing physicians’ self-efficacy and defining effective interventions aimed at strengthening the doctors’ communication skills. The scale detected different aspects of physicians’ communication self-efficacy (asking questions, active listening, giving information, communicating an inauspicious diagnosis, non-verbal communication, recognition of patient’s clues and suggestions, information checking, and empathy).
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Bachmann C, Pettit J, Rosenbaum M. Developing communication curricula in healthcare education: An evidence-based guide. PATIENT EDUCATION AND COUNSELING 2022; 105:2320-2327. [PMID: 34887158 DOI: 10.1016/j.pec.2021.11.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 11/10/2021] [Accepted: 11/15/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To present a guide for communication curriculum development in healthcare professions for educators and curriculum planners. METHODS We collated a selection of theories, frameworks and approaches to communication curriculum development to provide a roadmap of the main factors to consider when developing or enhancing communication skills curricula. RESULTS We present an evidence-based guide for developing and enhancing communication curriculum that can be applied to undergraduate and postgraduate healthcare education. Recommended steps to consider during the communication curricula development process include thoughtful examination of current communication education, needs assessment, focused learning goals and objectives, incorporation of experiential educational strategies allowing for skills practice and feedback and use of formative and summative assessment methods. A longitudinal, developmental and helical implementation approach contributes to reinforcement and sustainment of learners' knowledge and skills. CONCLUSION AND PRACTICE IMPLICATIONS Drawing on best practices in developing communication curricula can be helpful in ensuring successful approaches to communication skills training for any level of learner or healthcare profession. This position paper provides a guide and identifies resources for new and established communication curriculum developers to reflect on strengths and opportunities in their own approaches to addressing the communication education needs of their learners.
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Affiliation(s)
- Cadja Bachmann
- Office of the Dean of Education, Medical Faculty, University of Rostock, Germany.
| | - Jeffrey Pettit
- Department of Family Medicine, Office of Consultation and Research in Medical Education, University of Iowa Carver College of Medicine, USA
| | - Marcy Rosenbaum
- Department of Family Medicine, Office of Consultation and Research in Medical Education, University of Iowa Carver College of Medicine, USA
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Kalia M, Rohilla R, Virk A, Goel NK. Introducing Communication Skills Training among Interns using Attitude, Ethics, and Communication Module. Indian J Community Med 2022; 47:352-355. [PMID: 36438520 PMCID: PMC9693931 DOI: 10.4103/ijcm.ijcm_953_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 09/09/2021] [Accepted: 10/21/2021] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Communication skills are the backbone for patient care services such as patient interviews, counseling the patient, and explaining treatment options. The present study was conceived to evaluate the communication training program and perceptions of medical interns and faculty regarding the same. METHODOLOGY Sixty medical interns were included in this cross-sectional study. Training on communication skills was imparted which was later assessed on the basis of Kalamazoo scale. Attitude of the interns regarding communication skill training was assessed using Rees and Sheard Scale. The attitude of faculty regarding introduction of communication skill was also assessed. RESULTS The mean score on Kalamazoo Consensus Scale was 19.65 ± 4.97 with a range of 10-29. Females had a higher score (21.09 ± 5.80) as compared to males (17.88 ± 3.21), but this was not statistically significant (P = 0.157). The mean score for positive and negative attitude scale was 59.15 ± 5.51 and 25.20 ± 9.60. CONCLUSION The ability to communicate effectively is a core competency expected of medical graduates and communication skills training of medical students and interns with the help of didactic lectures, role plays, and videos, etc., can go a long way in improving their communication skills.
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Affiliation(s)
- Meenu Kalia
- Department of Community Medicine, Government Medical College and Hospital, Chandigarh, India
| | - Ravi Rohilla
- Department of Community Medicine, Government Medical College and Hospital, Chandigarh, India
| | - Amrit Virk
- Department of Community Medicine, Adesh Medical College, Ambala, Haryana, India
| | - Naveen Krishan Goel
- Department of Community Medicine, Government Medical College and Hospital, Chandigarh, India
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Nordfalk JM, Menichetti J, Thomas O, Gulbrandsen P, Gerwing J. Three strategies when physicians provide complex information in interactions with patients: How to recognize and measure them. PATIENT EDUCATION AND COUNSELING 2022; 105:1552-1560. [PMID: 34711445 DOI: 10.1016/j.pec.2021.10.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 09/06/2021] [Accepted: 10/09/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To define and operationalize three taught strategies for providing information in interactions with patients using videos collected in a randomized controlled trial (RCT). METHODS This was a qualitative exploratory study embedded in a randomized controlled design, using microanalysis of face-to-face dialogue as an inductive video analysis method to operationalize physicians' use of three information-provision strategies. Data were 34 video-recorded simulated (but unscripted) interactions between 17 physicians and 34 multiple sclerosis patients collected before and after a brief course on information provision. We operationalized (1) mapping the patient's preferences and (2) checking the patient's understanding, and pauses indicative of (3) portioning information. RESULTS Results are detailed analytical definitions, criteria, and assessable, quantifiable outcomes for each of the three strategies. Patients responded to portioning pauses as expected: whereas 91% of these pauses elicited an immediate patient response, only 23% of non-portioning pauses did so. CONCLUSION Our methods revealed how to define and evaluate information sharing strategies physicians used within the contingencies of clinical interaction. PRACTICE IMPLICATIONS Findings provide applicable methods to teach, analyze, and evaluate information sharing strategies and indications for further training.
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Affiliation(s)
- J M Nordfalk
- Health Services Research Unit HØKH, Akershus University Hospital, Lørenskog, Norway; Department of Neurology, Akershus University Hospital, Lørenskog, Norway; University of Oslo, Norway.
| | - J Menichetti
- Health Services Research Unit HØKH, Akershus University Hospital, Lørenskog, Norway
| | - O Thomas
- Health Services Research Unit HØKH, Akershus University Hospital, Lørenskog, Norway
| | - P Gulbrandsen
- Health Services Research Unit HØKH, Akershus University Hospital, Lørenskog, Norway; Institute of Clinical Medicine, Campus Ahus, University of Oslo, Oslo, Norway
| | - J Gerwing
- Health Services Research Unit HØKH, Akershus University Hospital, Lørenskog, Norway
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Pérez-Martín AM, García Madrid MGDP, Ruiz-Moral R, Crespo-Cañizares A, Mena CGDL, Caballero-Martínez F. Ibero-American Consensus on Communication Skills for Nursing Degree students. Rev Lat Am Enfermagem 2022; 30:e3565. [PMID: 35613251 DOI: 10.1590/1518-8345.5653.3565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 01/10/2022] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE as a health care profession focused on caring for people, Nursing requires sound communication skills. Based on an international expert consensus, a proposal on learning outcomes in clinical communication for undergraduate Nursing education curricula in Spanish speaking countries is presented. METHOD a steering committee, consisting of 5 nurses and experts in communication in health care sciences, drew up the first list of communication skills specific to the Nursing degree. Their proposal was reviewed and improved by a committee of 7 international scientific advisers. 70 experts from 14 countries were selected using a snowball sampling procedure and invited to participate in a distance modified Delphi consensus process in two survey rounds. Statistical analysis was carried out to establish the final consensus level for each item. RESULTS a questionnaire with 68 learning outcomes in clinical communications was submitted for panel assessment. In the first Delphi round, the panel reached a statistical consensus on all the items assessed. There was no need for a second round to reconcile positions. CONCLUSION an academic proposal, approved by a high level of international consensus, is presented to guide and unify the learning outcomes on the clinical communication curriculum for undergraduate Nursing studies in Spanish speaking countries.
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Affiliation(s)
| | | | - Roger Ruiz-Moral
- Universidad Francisco de Vitoria, Facultad de Medicina, Madrid, Espanha
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George RE, Wells H, Cushing A. Experiences of simulated patients in providing feedback in communication skills teaching for undergraduate medical students. BMC MEDICAL EDUCATION 2022; 22:339. [PMID: 35505323 PMCID: PMC9066858 DOI: 10.1186/s12909-022-03415-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Accepted: 04/27/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Simulated Patients (SPs) are commonplace in the teaching of communication skills in medical education and can provide immediate feedback to students from the patient's perspective. The experiences of SPs and their perspective on providing feedback is an under-studied area. This study aims to explore SP experiences and views on feedback, factors influencing their feedback and implications for training. METHODS Using a constructivist grounded theory approach, we conducted six focus groups with 30 SPs. Participants included experienced simulated patients from a London-based actor agency, used in undergraduate teaching programmes of communication skills. Consistent with the principles of grounded theory, data was collected and analysed in an iterative process to identify themes. RESULTS Five over-arching themes were identified: 1.) Feedback processes, 2.) Challenges in providing feedback, 3.) Cumulative experiences, 4.) Web of interpersonal relationships and dynamics and 5.) Portraying the character and patient representations. DISCUSSION These SPs regarded the sharing of the emotions they experienced during the consultation as the focus of their feedback. Their preference was for giving a 'sandwich style' of feedback and 'out-of-role' approach. The relationship with facilitators and students and politeness conventions emerged as significant factors when providing feedback. Sensitivity to the social dynamics of groups and implicit facilitator expectations were challenges they experienced as was divergence in views of student performance. CONCLUSION This study explored SP experiences and perspectives on providing feedback. Findings reveal complex social and structural dynamics at play in providing feedback which have not been reported so far in the literature. It is recommended that these issues should be addressed in training of both SPs and facilitators, in addition to feedback guidelines.
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Affiliation(s)
- Riya Elizabeth George
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Robin Brook Centre, St Bartholomew's Hospital, London, EC1A 7BE, UK.
| | - Harvey Wells
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Robin Brook Centre, St Bartholomew's Hospital, London, EC1A 7BE, UK
| | - Annie Cushing
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Robin Brook Centre, St Bartholomew's Hospital, London, EC1A 7BE, UK
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Barks MC, Schindler EA, Ubel PA, Jiao MG, Pollak KI, Huffstetler HE, Lemmon ME. Assessment of parent understanding in conferences for critically ill neonates. PATIENT EDUCATION AND COUNSELING 2022; 105:599-605. [PMID: 34130892 PMCID: PMC8664893 DOI: 10.1016/j.pec.2021.06.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 06/08/2021] [Accepted: 06/09/2021] [Indexed: 05/31/2023]
Abstract
OBJECTIVES This study aimed to characterize the use and impact of assessments of understanding in parent-clinician communication for critically ill infants. METHODS We enrolled parents and clinicians participating in family conferences for infants with neurologic conditions. Family conferences were audio recorded as they occurred. We used a directed content analysis approach to identify clinician assessments of understanding and parent responses to those assessments. Assessments were classified based on an adapted framework; responses were characterized as "absent," "yes/no," or "elaborated." RESULTS Fifty conferences involving the care of 25 infants were analyzed; these contained 374 distinct assessments of understanding. Most (n = 209/374, 56%) assessments were partial (i.e. okay?); a minority (n = 60/374, 16%) were open-ended. When clinicians asked open-ended questions, parents elaborated in their answers most of the time (n = 55/60, 92%). Approximately three-quarter of partial assessments yielded no verbal response from parents. No conferences included a teach-back. CONCLUSIONS Although common, most clinician assessments of understanding were partial or close-ended and rarely resulted in elaborated responses from parents. Open-ended assessments are an effective, underutilized strategy to increase parent engagement and clinician awareness of information needs. PRACTICE IMPLICATIONS Clinicians hoping to facilitate parent engagement and question-asking should rely on open-ended statements to assess understanding.
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Affiliation(s)
- Mary C Barks
- Duke-Margolis Center for Health Policy, Duke University, Durham, NC, USA; Fuqua School of Business, Duke University, Durham, NC, USA.
| | - Emma A Schindler
- Duke-Margolis Center for Health Policy, Duke University, Durham, NC, USA
| | - Peter A Ubel
- Duke-Margolis Center for Health Policy, Duke University, Durham, NC, USA; Fuqua School of Business, Duke University, Durham, NC, USA; Sanford School of Public Policy, Duke University, Durham, NC, USA
| | - Megan G Jiao
- Duke-Margolis Center for Health Policy, Duke University, Durham, NC, USA; Fuqua School of Business, Duke University, Durham, NC, USA
| | - Kathryn I Pollak
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA; Duke Cancer Institute, Duke University School of Medicine, Durham, NC, USA
| | - Hanna E Huffstetler
- Duke-Margolis Center for Health Policy, Duke University, Durham, NC, USA; Fuqua School of Business, Duke University, Durham, NC, USA
| | - Monica E Lemmon
- Duke-Margolis Center for Health Policy, Duke University, Durham, NC, USA; Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA
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Moura D, Costa MJ, Pereira AT, Macedo A, Figueiredo-Braga M. Communication skills preparedness for practice: Is there a key ingredient in undergraduate curricula design? PATIENT EDUCATION AND COUNSELING 2022; 105:756-761. [PMID: 34244033 DOI: 10.1016/j.pec.2021.06.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 06/10/2021] [Accepted: 06/28/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To characterize medical interns' experience regarding communication skills education and to explore potential associations with preparedness for practice. METHODS Two hundred sixty-six medical interns answered an original questionnaire specifically developed to explore how well they feel their undergraduate training had prepared them in key aspects of medical communication. Instrument's psychometric properties were tested. Medical schools' curricula were considered and associations explored using non-parametric tests. RESULTS The questionnaire reliability was high, with Cronbach's alphas ranging from 0.89 to 0.94 on all the factors. Core communication skills were highly rated. Perceived preparedness was lower in aspects concerning dealing with emotion, breaking bad news and communicating with speech impaired patients. Better preparedness was associated with a longitudinal integration of communication skills throughout the curriculum, simulation with standardized patients and real patient interviewing with feedback on communication skills. CONCLUSIONS Integrated programs, standing on a strong experimental component, particularly combining patient-simulation strategies with continuous supervision and learner centred feedback, were associated with higher preparedness. These results support the expansion of an educational model based on simulation strategies and structured longitudinally throughout the undergraduate medical curriculum. PRACTICE IMPLICATIONS This study intends to inform educational background and to support further development of communication skills curricula.
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Affiliation(s)
- Diana Moura
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, University of Porto, Portugal; Institute of Psychological Medicine, Faculty of Medicine, University of Coimbra, Portugal.
| | - Manuel João Costa
- Life and Health Sciences Research Institute (ICVS) School of Medicine, University of Minho, Portugal
| | - Ana Telma Pereira
- Institute of Psychological Medicine, Faculty of Medicine, University of Coimbra, Portugal
| | - António Macedo
- Institute of Psychological Medicine, Faculty of Medicine, University of Coimbra, Portugal
| | - Margarida Figueiredo-Braga
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, University of Porto, Portugal; I3S - Instituto de Investigação e Inovação em Saúde, University of Porto, Portugal
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Gender Gap in Healthcare Worker—Patient Communication during the COVID-19 Pandemic: An Italian Observational Study. PSYCH 2022. [DOI: 10.3390/psych4010010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The value of the healthcare worker–patient communication has been well demonstrated and validated in several studies evidencing its relation to positive patient health outcomes, including better care response, simpler decision-making, better patient psychological well-being, and, therefore, considerable patient care satisfaction. The present study purposed to assess how patients perceived healthcare worker–patient communication during the COVID-19 pandemic and whether there were any gender-related differences among participants. From March 2020 to April 2020, an online questionnaire was administered to those who declared a patient’s condition in this period. The data considered included data on gender and a Quality of Communication questionnaire (QOC). A total of 120 patients were recruited online. Of these, 52 (43.33%) were females and 68 (56.67%) were males. Significant differences were recorded between females and males in the QOC questionnaire as regards Item no.2 (p = 0.033), Item no.6 (p = 0.007), Item no.11 (p = 0.013), Item no.12 (p = 0.003), Item no.13 (p = 0.002), Item no.15 (p = 0.008), and Item no.16 (p = 0.037), respectively. The potentially different elements between the two sexes considered were assessed in: Component 1: the need to be completely informed about their own health condition, and Component 2: the need to receive authentic and sincere communication from the healthcare worker involved. In light of the present findings, it has emerged that male patients seemed to be more active and positive in effective healthcare worker–patient communication.
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Chimmalgi M, Rajesh S, Anil Kumar KV, Asha UV, Jose J, Chandrakumari K. Problem-based learning using online platforms: An interactive alternative to mandatory e-learning during the COVID-19 pandemic. J ANAT SOC INDIA 2022. [DOI: 10.4103/jasi.jasi_13_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Pérez-Martín AM, García Madrid MGDP, Ruiz-Moral R, Crespo-Cañizares A, Mena CGDL, Caballero-Martínez F. Ibero-American Consensus on Communication Skills for Nursing Degree students. Rev Lat Am Enfermagem 2022. [PMID: 35613251 PMCID: PMC9132134 DOI: 10.1590/1518-8345.5653.3523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Objective: as a health care profession focused on caring for people, Nursing requires sound communication skills. Based on an international expert consensus, a proposal on learning outcomes in clinical communication for undergraduate Nursing education curricula in Spanish speaking countries is presented. Method: a steering committee, consisting of 5 nurses and experts in communication in health care sciences, drew up the first list of communication skills specific to the Nursing degree. Their proposal was reviewed and improved by a committee of 7 international scientific advisers. 70 experts from 14 countries were selected using a snowball sampling procedure and invited to participate in a distance modified Delphi consensus process in two survey rounds. Statistical analysis was carried out to establish the final consensus level for each item. Results: a questionnaire with 68 learning outcomes in clinical communications was submitted for panel assessment. In the first Delphi round, the panel reached a statistical consensus on all the items assessed. There was no need for a second round to reconcile positions. Conclusion: an academic proposal, approved by a high level of international consensus, is presented to guide and unify the learning outcomes on the clinical communication curriculum for undergraduate Nursing studies in Spanish speaking countries.
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Pérez-Martín AM, García Madrid MGDP, Ruiz-Moral R, Crespo-Cañizares A, Mena CGDL, Caballero-Martínez F. Consenso Iberoamericano sobre Habilidades de Comunicación para Estudiantes de Grado de Enfermería. Rev Lat Am Enfermagem 2022. [DOI: 10.1590/1518-8345.5653.3564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumen Objetivo: en su carácter de profesión de atención de la salud enfocada en cuidar a las personas, la Enfermería requiere habilidades de comunicación sólidas. Sobre la base de un consenso internacional de expertos, se presenta una propuesta sobre resultados de aprendizaje en la comunicación clínica para planes de estudio de las carreras de grado de Enfermería en países de habla hispana. Método: un comité orientador, compuesto por 5 enfermeros y expertos en comunicación en ciencias de atención de la salud, elaboró la primera lista de habilidades de comunicación específicas para la carrera de Enfermería. Un comité de 7 asesores científicos internacionales revisó y mejoró dicha propuesta. Se seleccionó a 70 expertos de 14 países a través del procedimiento de muestreo “bola de nieve”, y se los invitó a participar en un proceso de consenso Delphi modificado a distancia en dos rondas de encuesta. Se realizó un análisis estadístico para establecer el nivel de consenso final correspondiente a cada ítem. Resultados: se presentó un cuestionario con 68 resultados de aprendizaje en comunicaciones clínicas para que lo evaluara el panel. En la primera ronda Delphi, el panel llegó a un consenso estadístico en todos los ítems evaluados. No fue necesaria una segunda ronda para conciliar posiciones. Conclusión: se presenta una propuesta académica, aprobada con un elevado nivel de consenso internacional, a fin de orientar y unificar los resultados de aprendizaje en los planes de estudio sobre comunicación clínica para carreras de grado de Enfermería en países de habla hispana.
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Morelli E, Mulas O, Caocci G. Patient-Physician Communication in Acute Myeloid Leukemia and Myelodysplastic Syndrome. Clin Pract Epidemiol Ment Health 2021; 17:264-270. [PMID: 35444710 PMCID: PMC8985469 DOI: 10.2174/1745017902117010264] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 08/09/2021] [Accepted: 08/17/2021] [Indexed: 11/22/2022]
Abstract
Introduction: An effective communication is an integral part of the patient-physician relationship. Lack of a healthy patient-physician relationship leads to a lower level of patient satisfaction, scarce understanding of interventions and poor adherence to treatment regimes. Patients need to be involved in the therapeutic process and the assessment of risks and perspectives of the illness in order to better evaluate their options. Physicians, in turn, must convey and communicate information clearly in order to avoid misunderstandings and consequently poor medical care. The patient-physician relationship in cancer care is extremely delicate due to the complexity of the disease. In cancer diagnosis, the physician must adopt a communicative approach that considers the psychosocial factors, needs and patient’s preferences for information,which in turn all contribute to affect clinical outcomes.
Search Strategy and Methods :
This review was conducted using the Preferred Reporting Items for Systematic and Meta-analyses (PRISMA) statement. We included studies on the importance of physician-patient communication in Acute Myeloid Leukaemia and Myelodysplastic Syndrome care. We searched PubMed, Web of Sciences, Scopus, Google scholar for studies published from December 1
st
, 2020 up to March 1
st
, 2021. Using MeSH headings, we search for the terms “Physician and patient communication AND Acute Myeloid leukemia” or “Myelodysplastic syndrome” or “Doctor” or “Clinician”, as well as variations thereof .
Purpose of the Review
:
This review examines the progress in communication research between patient and physician and focuses on the impact of communication styles on patient-physician relationshipin hematologic cancers, including Acute Myeloid Leukaemia and Myelodysplastic Syndromes.
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Herrmann-Werner A, Loda T, Zipfel S, Holderried M, Holderried F, Erschens R. Evaluation of a Language Translation App in an Undergraduate Medical Communication Course: Proof-of-Concept and Usability Study. JMIR Mhealth Uhealth 2021; 9:e31559. [PMID: 34860678 PMCID: PMC8686471 DOI: 10.2196/31559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 08/11/2021] [Accepted: 08/25/2021] [Indexed: 11/13/2022] Open
Abstract
Background Language barriers in medical encounters pose risks for interactions with patients, their care, and their outcomes. Because human translators, the gold standard for mitigating language barriers, can be cost- and time-intensive, mechanical alternatives such as language translation apps (LTA) have gained in popularity. However, adequate training for physicians in using LTAs remains elusive. Objective A proof-of-concept pilot study was designed to evaluate the use of a speech-to-speech LTA in a specific simulated physician-patient situation, particularly its perceived usability, helpfulness, and meaningfulness, and to assess the teaching unit overall. Methods Students engaged in a 90-min simulation with a standardized patient (SP) and the LTA iTranslate Converse. Thereafter, they rated the LTA with six items—helpful, intuitive, informative, accurate, recommendable, and applicable—on a 7-point Likert scale ranging from 1 (don’t agree at all) to 7 (completely agree) and could provide free-text responses for four items: general impression of the LTA, the LTA’s benefits, the LTA’s risks, and suggestions for improvement. Students also assessed the teaching unit on a 6-point scale from 1 (excellent) to 6 (insufficient). Data were evaluated quantitatively with mean (SD) values and qualitatively in thematic content analysis. Results Of 111 students in the course, 76 (68.5%) participated (59.2% women, age 20.7 years, SD 3.3 years). Values for the LTA’s being helpful (mean 3.45, SD 1.79), recommendable (mean 3.33, SD 1.65) and applicable (mean 3.57, SD 1.85) were centered around the average of 3.5. The items intuitive (mean 4.57, SD 1.74) and informative (mean 4.53, SD 1.95) were above average. The only below-average item concerned its accuracy (mean 2.38, SD 1.36). Students rated the teaching unit as being excellent (mean 1.2, SD 0.54) but wanted practical training with an SP plus a simulated human translator first. Free-text responses revealed several concerns about translation errors that could jeopardize diagnostic decisions. Students feared that patient-physician communication mediated by the LTA could decrease empathy and raised concerns regarding data protection and technical reliability. Nevertheless, they appreciated the LTA’s cost-effectiveness and usefulness as the best option when the gold standard is unavailable. They also reported wanting more medical-specific vocabulary and images to convey all information necessary for medical communication. Conclusions This study revealed the feasibility of using a speech-to-speech LTA in an undergraduate medical course. Although human translators remain the gold standard, LTAs could be valuable alternatives. Students appreciated the simulated teaching and recognized the LTA’s potential benefits and risks for use in real-world clinical settings. To optimize patients’ and health care professionals’ experiences with LTAs, future investigations should examine specific design options for training interventions and consider the legal aspects of human-machine interaction in health care settings.
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Affiliation(s)
- Anne Herrmann-Werner
- Department of Internal Medicine VI/Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany.,Competence Centre for University Teaching in Medicine, Baden-Wuerttemberg, Faculty of Medicine, Eberhard-Karls University, Tuebingen, Germany
| | - Teresa Loda
- Department of Internal Medicine VI/Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
| | - Stephan Zipfel
- Department of Internal Medicine VI/Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany.,Deanery of Students' Affairs, Faculty of Medicine, Eberhard-Karls University, Tuebingen, Germany
| | - Martin Holderried
- Department of Strategic Medical Development and Quality Management, University of Tuebingen, Tuebingen, Germany.,Institute for Healthcare and Public Management, University of Hohenheim, Stuttgart, Germany
| | - Friederike Holderried
- eHealth Research-Group, Department of General, Visceral, and Transplant Surgery, University of Tuebingen, Tuebingen, Germany
| | - Rebecca Erschens
- Department of Internal Medicine VI/Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
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Ricci L, Villegente J, Loyal D, Ayav C, Kivits J, Rat AC. Tailored patient therapeutic educational interventions: A patient-centred communication model. Health Expect 2021; 25:276-289. [PMID: 34816546 PMCID: PMC8849242 DOI: 10.1111/hex.13377] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 09/02/2021] [Accepted: 10/17/2021] [Indexed: 11/07/2022] Open
Abstract
Background Tailoring therapeutic education consists of adapting the intervention to patients' needs with the expectation that this individualization will improve the results of the intervention. Communication is the basis for any individualization process. To our knowledge, there is no guide or structured advice to help healthcare providers (HCPs) tailor patient education interventions. Objectives We used a data‐driven qualitative analysis to (1) investigate the reasons why HCPs tailor their educational interventions and (2) identify how this tailoring is effectively conducted. The perspective aimed to better understand how to individualize therapeutic patient education and to disentangle the different elements to set up studies to investigate the mechanisms and effects of individualization. Design Individual semistructured interviews with 28 HCPs involved in patient education were conducted. The present study complied with the COREQ criteria. Results Why individualization is necessary: participants outlined that the person must be thought of as unique and that therapeutic education should be adapted to the patient's personality and cognitive abilities. The first step in the individualization process was formalized by an initial patient assessment. Several informal practices were identified: if needed, giving an individual time or involving a specific professional; eliciting individual objectives; reinforcing the relationship by avoiding asymmetrical posture; focusing on patients' concerns; leading sessions in pairs; and making the patient the actor of decisions. Conclusion From our thematic data analysis, a model for tailoring patient education interventions based on the Haes and Bensing medical communication framework is proposed. The present work paves the way for evaluation, then generation of recommendations and finally implementation of training for individualization in educational interventions. Short Informative Tailoring in therapeutic education consists of an adaptation to patients' needs. Communication is the basis for any individualization process. There is no model of patient‐centred communication in educational interventions. From semistructured interviews with HCPs, we propose a patient‐centred communication model for tailoring patient education intervention.
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Affiliation(s)
- Laetitia Ricci
- CHRU-Nancy, INSERM, Université de Lorraine, CIC 1433 Clinical Epidemiology, Nancy, France
| | - Julie Villegente
- CHRU-Nancy, INSERM, Université de Lorraine, CIC 1433 Clinical Epidemiology, Nancy, France.,Université de Reims Champagne-Ardenne, Reims, France
| | | | - Carole Ayav
- CHRU-Nancy, INSERM, Université de Lorraine, CIC 1433 Clinical Epidemiology, Nancy, France
| | | | - Anne-Christine Rat
- Université de Lorraine, APEMAC, Nancy, France.,University of Caen Normandie, Caen, France.,Rheumatology Department, University Hospital Center Caen, Caen, France
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Forsey J, Ng S, Rowland P, Freeman R, Li C, Woods NN. The Basic Science of Patient-Physician Communication: A Critical Scoping Review. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2021; 96:S109-S118. [PMID: 34348382 DOI: 10.1097/acm.0000000000004323] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PURPOSE Strong verbal communication skills are essential for physicians. Despite a wealth of medical education research exploring communication skills training, learners struggle to become strong communicators. Integrating basic science into the curriculum provides students with conceptual knowledge that improves learning outcomes and facilitates the development of adaptive expertise, but the conceptual knowledge, or "basic science," of patient-provider communication is currently unknown. This review sought to address that gap and identify conceptual knowledge that would support improved communication skills training for medical trainees. METHOD Combining the search methodology of Arksey and O'Malley with a critical analytical lens, the authors conducted a critical scoping review of literature in linguistics, cognitive psychology, and communications to determine: what is known about verbal communication at the level of word choice in physician-patient interactions? Studies were independently screened by 3 researchers during 2 rounds of review. Data extraction focused on theoretical contributions associated with language use and variation. Analysis linked patterns of language use to broader theoretical constructs across disciplines. RESULTS The initial search returned 15,851 unique studies, and 271 studies were included in the review. The dominant conceptual groupings reflected in the results were: (1) clear and explicit language, (2) patient participation and activation, (3) negotiating epistemic knowledge, (4) affiliative language and emotional bonds, (5) role and identity, and (6) managing transactional and relational goals. CONCLUSIONS This in-depth exploration supports and contextualizes theory-driven research of physician-patient communication. The findings may be used to support future communications research in this field and educational innovations based on a solid theoretical foundation.
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Affiliation(s)
- Jacquelin Forsey
- J. Forsey is a PhD candidate, Rehabilitation Sciences Institute, University of Toronto, and a fellow, Wilson Centre, Toronto, Ontario, Canada
| | - Stella Ng
- S. Ng is associate professor, Faculty of Medicine, University of Toronto, and director of research, Centre for Faculty Development, St. Michael's Hospital, Toronto, Ontario, Canada; ORCID: https://orcid.org/0000-0003-1433-6851
| | - Paula Rowland
- P. Rowland is assistant professor, Department of Occupational Therapy, University of Toronto, and scientist, Wilson Centre, Toronto, Ontario, Canada; ORCID: https://orcid.org/0000-0001-8054-7142
| | - Risa Freeman
- R. Freeman is vice chair of education and scholarship, Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Connie Li
- C. Li is a medical student, McMaster University, Hamilton, Ontario, Canada
| | - Nicole N Woods
- N.N. Woods is associate professor, Department of Family and Community Medicine, University of Toronto, and director, Institute for Education Research, UHN, Toronto, Ontario, Canada; ORCID: https://orcid.org/0000-0002-2976-1108
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Chhabra S, Girija S. Communicating bad news of COVID-19: An empirical study of patients' preferences in India. Health Mark Q 2021; 38:205-221. [PMID: 34652984 DOI: 10.1080/07359683.2021.1987017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The study aims to assess patients' preferences regarding physicians communicating bad news of COVID-19. Based on the data collected from 74 patients with COVID-19 in India, this study assesses "how" patients want bad news to be delivered. Key aspects of the physician-patient interaction were identified from the literature. Regression tests proved that three main constructs contribute significantly toward patient outcomes. Content of the message and facilitation were most crucial, however too much emotional support was not desirable by patients. Also, the patient's gender and educational background should be considered before breaking bad news . Thus, to increase patient compliance full disclosure and patient-centered methods of communication can be used.
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Affiliation(s)
| | - Smitha Girija
- Marketing at GITAM University, Visakhapatnam, Andhra Pradesh
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Kerr A, Kelleher C, Pawlikowska T, Strawbridge J. How can pharmacists develop patient-pharmacist communication skills? A realist synthesis. PATIENT EDUCATION AND COUNSELING 2021; 104:2467-2479. [PMID: 33726988 DOI: 10.1016/j.pec.2021.03.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 03/04/2021] [Accepted: 03/06/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To understand how pharmacists develop patient-pharmacist communication skills. METHODS A realist synthesis approach was used to understand how educational interventions work to improve patient-pharmacist communication. Initial programme theories were developed through a scoping search and stakeholder focus groups (faculty, students, patients and public). A systematic search was then conducted for evidence to test initial theories. Included papers were assessed for relevance and rigour. Extracted data was synthesised to refine the initial programme theories and develop modified programme theories. RESULTS Forty-seven papers were included in the final synthesis. Role-play with simulated patients and peers, video recording and lectures were the most widely reported interventions. Repeated practice, feedback, reflection and confidence were among the mechanisms by which interventions work. Modified programme theories relating to interactions of role-play, experiential learning, video recording, self-assessment and workshops were developed. CONCLUSIONS Outcomes of communication education interventions are influenced by the level of learner. Educational interventions that promote reflection are particularly useful. PRACTICAL IMPLICATIONS There are a wide range of theory-informed interventions, which should be used in a programmatic approach to communications education. A longitudinal programme of communication skills training, with intervention choice based on level of learning, is important.
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Affiliation(s)
- Aisling Kerr
- School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland.
| | - Caroline Kelleher
- Department of Psychology, Division of Population Health Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland.
| | - Teresa Pawlikowska
- Health Professions Education Centre (HPEC), RCSI University of Medicine and Health Sciences, Dublin, Ireland.
| | - Judith Strawbridge
- School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland.
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Lampert SL, Feldman ECH, Durkin LK, Davies WH, Greenley RN. Medication adherence among emerging adults: the influence of provider communication and patient personality. CHILDRENS HEALTH CARE 2021. [DOI: 10.1080/02739615.2021.1971986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Sara L. Lampert
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, USA
| | - Estée C. H Feldman
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, USA
| | - Lindsay K. Durkin
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, USA
| | - W. Hobart Davies
- Department of Psychology, University of Wisconsin Milwaukee, Milwaukee, USA
| | - Rachel Neff Greenley
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, USA
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Slevin P, Kessie T, Cullen J, Butler MW, Donnelly SC, Caulfield B. A qualitative study of clinician perceptions regarding the potential role for digital health interventions for the management of COPD. Health Informatics J 2021; 27:1460458221994888. [PMID: 33653189 DOI: 10.1177/1460458221994888] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Effective self-management of chronic obstructive pulmonary disease (COPD) can lead to increased patient control and reduced health care costs. However, both patients and healthcare professionals encounter significant challenges. Digital health interventions, such as smart oximeters and COPD self-management applications, promise to enhance the management of COPD, yet, there is little evidence to support their use and user-experience issues are still common. Understanding the needs of healthcare professionals is central for increasing adoption and engagement with digital health interventions but little is known about their perceptions of digital health interventions in COPD. This paper explored the perceptions of healthcare professionals regarding the potential role for DHI in the management of COPD. Snowball sampling was used to recruit the participants (n = 32). Each participant underwent a semi-structured interview. Using NVivo 12 software, thematic analysis was completed. Healthcare professionals perceive digital health interventions providing several potential benefits to the management of COPD including the capture of patient status indicators during the interappointment period, providing new patient data to support the consultation process and perceived digital health interventions as a potential means to improve patient engagement. The findings offer new insights regarding potential future use-cases for digital health interventions in COPD, which can help ease user-experience issues as they align with the needs of healthcare professionals.
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Affiliation(s)
| | | | - John Cullen
- Tallaght University Hospital, Ireland.,Trinity College Dublin, Ireland
| | - Marcus W Butler
- University College Dublin, Ireland.,St. Vincent's University Hospital, Ireland
| | - Seamas C Donnelly
- Tallaght University Hospital, Ireland.,Trinity College Dublin, Ireland
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Bachmann C, Kropf R, Biller S, Schnabel KP, Junod Perron N, Monti M, Berendonk C, Huwendiek S, Breckwoldt J. Development and national consensus finding on patient-centred high stakes communication skills assessments for the Swiss Federal Licensing Examination in Medicine. PATIENT EDUCATION AND COUNSELING 2021; 104:1765-1772. [PMID: 33358770 DOI: 10.1016/j.pec.2020.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 10/30/2020] [Accepted: 12/05/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To describe and evaluate a consensus finding and expert validation process for the development of patient-centred communication assessments for a national Licensing Exam in Medicine. METHODS A multi-professional team of clinicians and experts in communication, assessment and role-play developed communication assessments for the Swiss Federal Licensing Examination. The six-month process, informed by a preceding national needs-assessment, an expert symposium and a critical literature review covered the application of patient-centred communication frameworks, the development of assessment guides, concrete assessments and pilot-tests. The participants evaluated the process. RESULTS The multiple-step consensus process, based on expert validation of the medical and communication content, led to six high-stakes patient-centred communication OSCE-assessments. The process evaluation revealed areas of challenge such as calibrating rating-scales and case difficulty to the graduates' competencies and integrating differing opinions. Main success factors were attributed to the outcome-oriented process and the multi-professional exchange of expertise. A model for developing high stakes patient-centred communication OSCE-assessments was derived. CONCLUSIONS Consensus finding was facilitated by using well-established communication frameworks, by ensuring outcome-orientated knowledge exchange among multi-professional experts, and collaborative validation of content through experts. PRACTICE IMPLICATIONS We propose developing high-stakes communication assessments in a multi-professional expert consensus and provide a conceptual model.
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Affiliation(s)
- C Bachmann
- Institute for Medical Education, University of Bern, Switzerland; Office of Educational Affairs, Faculty of Medicine, University of Rostock, Ernst-Heydemann-Str. 8, 18057, Rostock, Germany.
| | - R Kropf
- Office of the Dean, Faculty of Medicine, University of Zurich, Switzerland
| | - S Biller
- Office of Student Affairs, Faculty of Medicine, University of Basel, Switzerland
| | - K P Schnabel
- Institute for Medical Education, University of Bern, Switzerland
| | - N Junod Perron
- Unit of Development and Research in Medical Education, Faculty of Medicine, University of Geneva, Switzerland
| | - M Monti
- Medical Education Unit, Faculty of Biology and Medicine, University of Lausanne, Switzerland
| | - C Berendonk
- Institute for Medical Education, University of Bern, Switzerland
| | - S Huwendiek
- Institute for Medical Education, University of Bern, Switzerland
| | - J Breckwoldt
- Office of the Dean, Faculty of Medicine, University of Zurich, Switzerland; Institute of Anaesthesiology University Hospital Zurich, Zurich, Switzerland
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Manalastas G, Noble LM, Viney R, Griffin AE. What does the structure of a medical consultation look like? A new method for visualising doctor-patient communication. PATIENT EDUCATION AND COUNSELING 2021; 104:1387-1397. [PMID: 33272747 DOI: 10.1016/j.pec.2020.11.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 11/15/2020] [Accepted: 11/20/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE This project developed an innovative methodology for visualising consultation structure by categorising doctor-patient talk into the phases proposed by an established educational model of clinical communication. METHOD Consultation phases were identified from verbatim transcripts using the tasks and process skills of the Calgary-Cambridge Guide to the Medical Interview. Seventy-eight simulated consultations from a 'History-taking' station of a postgraduate examination for physicians were analysed by two independent raters. Transcripts were converted into diagrams comprising up to six phases: Initiating, Gathering information, Summary, Explanation, Planning and Closing. RESULTS The dominant phases were Gathering information, Planning and Explanation (66 %, 10 % and 12 % of talk respectively). While consultations broadly followed the expected chronological sequence, less than a third (23/78) contained all six phases, with Closing and Summary most frequently absent. Half of consultations (40/78) did not include phases in the predicted order, with intertwined phases commonly observed. CONCLUSIONS In this standardised setting, doctors created variable consultation structures, typically omitting phases involving consolidation and agreement of plans going forward. PRACTICE IMPLICATIONS The method enables visualisation and comparison of consultation structure. The findings pose questions about the alignment of practice with educational guidance and the opportunities afforded to patients to actively engage in consultations.
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Affiliation(s)
| | | | - Rowena Viney
- UCL Medical School, University College London, London, UK.
| | - Ann E Griffin
- UCL Medical School, University College London, London, UK.
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Skelton JR. Language, Philosophy, and Medical Education. TEACHING AND LEARNING IN MEDICINE 2021; 33:210-216. [PMID: 33554658 DOI: 10.1080/10401334.2021.1877712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
ISSUE When medical schools began to recognize, a generation ago, that clinical "communication skills" could not be taken for granted among students, a process began of researching them, and introducing the results into curricula. This allowed for a discussion, for the first time, about how doctors should talk to patients, and manage interviews with them. However, there was a focus on a set of behavioral processes which were often unsophisticated with respect to the role of language in communication, or of language as a means of sustaining and describing ambiguity, or language as the primary impetus for educational reflection. EVIDENCE This paper looks at literature from language studies, the philosophy of language and the philosophy of education to establish the point that, where natural languages are concerned, it is possible and useful to talk of the purposes for which language is used. It is also important to recognize that the meaning of a particular language use is to a substantial extent defined by context: and that languages are excellent vehicles for maintaining and describing ambiguity, where it is impossible to reduce a state of affairs to the well-defined conclusion of empirical research. IMPLICATIONS In the light of this understanding, there is a need for "communication," and particularly the methodologies through which it is taught, to reflect these points. Simulation exercises, designed to develop clinical communication, should be clear that there is no single correct way of "talking to patients," no set of behavioral processes which is always effective. It is, in the end, the awareness and wisdom of the doctor, selecting from among a range of available approaches, which is at stake. In addition, methodologies should account for the recognition that awareness comes only from reflection, and that helping medical students and doctors alike to reflect is central to good practice.
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Affiliation(s)
- John R Skelton
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
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Kiessling C, Mennigen F, Schulte H, Schwarz L, Lutz G. Communicative competencies anchored longitudinally - the curriculum "personal and professional development" in the model study programme in undergraduate medical education at the University of Witten/Herdecke. GMS JOURNAL FOR MEDICAL EDUCATION 2021; 38:Doc57. [PMID: 33824893 PMCID: PMC7994876 DOI: 10.3205/zma001453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 07/16/2020] [Accepted: 08/13/2020] [Indexed: 06/12/2023]
Abstract
Background: In October 2018, the University of Witten/Herdecke (UW/H) launched the new reformed medical education programme called Medicine 2018+. A major innovation compared to the existing model programme was the introduction of thematic focuses. A longitudinal communication skills curriculum was integrated into the new thematic focus "professional and personal development - inner work" (IAP). With the start of the new programme, the IAP curriculum has been built step-by-step over time, i.e. the first four semesters have already been implemented, the following semesters are being planned. Project description: IAP aims to provide students with patient-centred medicine. Five areas of competence were defined: Doctor-patient communication, team competence, staying healthy, my paths to becoming a doctor, medicine and society. The focus of this article is on the communication curriculum. The first year of study focusses on the training of basic communication skills. In the 2nd year of study, students practice these basic skills in small groups with simulated patients (SP), whereby the emphasis in the 3rd semester is on history taking and in the 4th semester is on sharing information. In the 3rd semester, students complete a communication station in an OSCE. From the 5th semester onwards, the focus of training is on the consolidation of basic and advanced communication skills, which can be applied in clinical clerkships, and the reflection of clinical experiences. Key didactic elements are, in addition to teaching the theoretical basics, experience-based small group work with and without SP, feedback and reflection. The evaluation of the summer semester 2020 showed high agreement ratings of the students regarding the overall satisfaction with the individual courses (83-100% agreement). Discussion: The introduction of IAP has been very positively received by the students. Challenges are the adequate handling of the increasing student workload when planning new courses, the implementation of a longitudinal e-portfolio as well as the recruitment and training of clinical teachers and SPs. Conclusion: As the evaluation results of the summer semester 2020 show, the first steps of implementing a longitudinal communication curriculum at UW/H have been successful. Helpful strategies were the orientation on published examples from other faculties as well as regular feedback and discussions with students and teachers in order to adapt and integrate educational considerations into the existing model programme in Witten.
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Affiliation(s)
- Claudia Kiessling
- Universität Witten/Herdecke, Fakultät für Gesundheit, Lehrstuhl für die Ausbildung personaler und interpersonaler Kompetenzen im Gesundheitswesen, Witten, Germany
| | - Florian Mennigen
- Universität Witten/Herdecke, Fakultät für Gesundheit, Lehrstuhl für die Ausbildung personaler und interpersonaler Kompetenzen im Gesundheitswesen, Witten, Germany
| | - Heike Schulte
- Universität Witten/Herdecke, Fakultät für Gesundheit, Lehrstuhl für die Ausbildung personaler und interpersonaler Kompetenzen im Gesundheitswesen, Witten, Germany
| | - Laura Schwarz
- Universität Witten/Herdecke, Fakultät für Gesundheit, Lehrstuhl für die Ausbildung personaler und interpersonaler Kompetenzen im Gesundheitswesen, Witten, Germany
| | - Gabriele Lutz
- Universität Witten/Herdecke, Fakultät für Gesundheit, Department für Humanmedizin, Witten, Germany
- Gemeinschaftskrankenhaus Herdecke, Psychosomatische Abteilung, Herdecke, Germany
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Zhao Y, Segalowitz N, Voloshyn A, Chamoux E, Ryder AG. Language Barriers to Healthcare for Linguistic Minorities: The Case of Second Language-specific Health Communication Anxiety. HEALTH COMMUNICATION 2021; 36:334-346. [PMID: 31746231 DOI: 10.1080/10410236.2019.1692488] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
In this study we examined health communication anxiety (HCA) associated with language-discordant situations - that is, where people have to use their second language (L2) to communicate with health providers who are using their first language (L1). We adapted existing HCA scales in order to (1) assess L2 HCA in such situations separately for physical and mental/emotional health contexts and (2) control for potential confounds, such as HCA not related to L2 use and L2 communication anxiety not related to health, allowing us to obtain L2-specific measures of HCA. We examined the relationship between L2-specific HCA and willingness to use health services in language-discordant situations. English-speaking linguistic minority participants (N = 314) living in Québec, a predominantly French-speaking area of Canada, were recruited for online testing. The results revealed that, separately for both physical and mental/emotional health contexts, there were significant and meaningful L2-specific relations between HCA and willingness to use L2 health services - i.e., over and above general anxiety and discomfort about using an L2, and over and above general health communication anxiety. The effect was stronger for mental/emotional health contexts. The results are discussed in terms of their implications for understanding barriers to health services for linguistic minorities.
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Affiliation(s)
- Yue Zhao
- Psychology Department, Concordia University
| | - Norman Segalowitz
- Psychology Department, Concordia University
- School of Psychology and Counseling, Faculty of Health, Queensland University of Technology (QUT)
| | | | | | - Andrew G Ryder
- Psychology Department, Concordia University
- Culture and Mental Health Research Unit, Jewish General Hospital
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Gilligan C, Powell M, Lynagh MC, Ward BM, Lonsdale C, Harvey P, James EL, Rich D, Dewi SP, Nepal S, Croft HA, Silverman J. Interventions for improving medical students' interpersonal communication in medical consultations. Cochrane Database Syst Rev 2021; 2:CD012418. [PMID: 33559127 PMCID: PMC8094582 DOI: 10.1002/14651858.cd012418.pub2] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Communication is a common element in all medical consultations, affecting a range of outcomes for doctors and patients. The increasing demand for medical students to be trained to communicate effectively has seen the emergence of interpersonal communication skills as core graduate competencies in medical training around the world. Medical schools have adopted a range of approaches to develop and evaluate these competencies. OBJECTIVES To assess the effects of interventions for medical students that aim to improve interpersonal communication in medical consultations. SEARCH METHODS We searched five electronic databases: Cochrane Central Register of Controlled Trials, MEDLINE, Embase, PsycINFO, and ERIC (Educational Resource Information Centre) in September 2020, with no language, date, or publication status restrictions. We also screened reference lists of relevant articles and contacted authors of included studies. SELECTION CRITERIA We included randomised controlled trials (RCTs), cluster-RCTs (C-RCTs), and non-randomised controlled trials (quasi-RCTs) evaluating the effectiveness of interventions delivered to students in undergraduate or graduate-entry medical programmes. We included studies of interventions aiming to improve medical students' interpersonal communication during medical consultations. Included interventions targeted communication skills associated with empathy, relationship building, gathering information, and explanation and planning, as well as specific communication tasks such as listening, appropriate structure, and question style. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. Two review authors independently reviewed all search results, extracted data, assessed the risk of bias of included studies, and rated the quality of evidence using GRADE. MAIN RESULTS We found 91 publications relating to 76 separate studies (involving 10,124 students): 55 RCTs, 9 quasi-RCTs, 7 C-RCTs, and 5 quasi-C-RCTs. We performed meta-analysis according to comparison and outcome. Among both effectiveness and comparative effectiveness analyses, we separated outcomes reporting on overall communication skills, empathy, rapport or relationship building, patient perceptions/satisfaction, information gathering, and explanation and planning. Overall communication skills and empathy were further divided as examiner- or simulated patient-assessed. The overall quality of evidence ranged from moderate to very low, and there was high, unexplained heterogeneity. Overall, interventions had positive effects on most outcomes, but generally small effect sizes and evidence quality limit the conclusions that can be drawn. Communication skills interventions in comparison to usual curricula or control may improve both overall communication skills (standardised mean difference (SMD) 0.92, 95% confidence interval (CI) 0.53 to 1.31; 18 studies, 1356 participants; I² = 90%; low-quality evidence) and empathy (SMD 0.64, 95% CI 0.23 to 1.05; 6 studies, 831 participants; I² = 86%; low-quality evidence) when assessed by experts, but not by simulated patients. Students' skills in information gathering probably also improve with educational intervention (SMD 1.07, 95% CI 0.61 to 1.54; 5 studies, 405 participants; I² = 78%; moderate-quality evidence), but there may be little to no effect on students' rapport (SMD 0.18, 95% CI -0.15 to 0.51; 9 studies, 834 participants; I² = 81%; low-quality evidence), and effects on information giving skills are uncertain (very low-quality evidence). We are uncertain whether experiential interventions improve overall communication skills in comparison to didactic approaches (SMD 0.08, 95% CI -0.02 to 0.19; 4 studies, 1578 participants; I² = 4%; very low-quality evidence). Electronic learning approaches may have little to no effect on students' empathy scores (SMD -0.13, 95% CI -0.68 to 0.43; 3 studies, 421 participants; I² = 82%; low-quality evidence) or on rapport (SMD 0.02, 95% CI -0.33 to 0.38; 3 studies, 176 participants; I² = 19%; moderate-quality evidence) compared to face-to-face approaches. There may be small negative effects of electronic interventions on information giving skills (low-quality evidence), and effects on information gathering skills are uncertain (very low-quality evidence). Personalised/specific feedback probably improves overall communication skills to a small degree in comparison to generic or no feedback (SMD 0.58, 95% CI 0.29 to 0.87; 6 studies, 502 participants; I² = 56%; moderate-quality evidence). There may be small positive effects of personalised feedback on empathy and information gathering skills (low quality), but effects on rapport are uncertain (very low quality), and we found no evidence on information giving skills. We are uncertain whether role-play with simulated patients outperforms peer role-play in improving students' overall communication skills (SMD 0.17, 95% CI -0.33 to 0.67; 4 studies, 637 participants; I² = 87%; very low-quality evidence). There may be little to no difference between effects of simulated patient and peer role-play on students' empathy (low-quality evidence) with no evidence on other outcomes for this comparison. Descriptive syntheses of results that could not be included in meta-analyses across outcomes and comparisons were mixed, as were effects of different interventions and comparisons on specific communication skills assessed by the included trials. Quality of evidence was downgraded due to methodological limitations across several risk of bias domains, high unexplained heterogeneity, and imprecision of results. In general, results remain consistent in sensitivity analysis based on risk of bias and adjustment for clustering. No adverse effects were reported. AUTHORS' CONCLUSIONS: This review represents a substantial body of evidence from which to draw, but further research is needed to strengthen the quality of the evidence base, to consider the long-term effects of interventions on students' behaviour as they progress through training and into practice, and to assess effects of interventions on patient outcomes. Efforts to standardise assessment and evaluation of interpersonal skills will strengthen future research efforts.
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Affiliation(s)
- Conor Gilligan
- School of Medicine and Public Health, University of Newcastle, Hunter Medical Research Institute, Callaghan, Australia
| | - Martine Powell
- Centre for Investigative Interviewing, Griffith Criminology Institute, Griffith University, Brisbane, Australia
| | - Marita C Lynagh
- School of Medicine and Public Health, University of Newcastle, Hunter Medical Research Institute, Callaghan, Australia
| | | | - Chris Lonsdale
- Institute for Positive Psychology and Education, Australian Catholic University, Strathfield, Australia
| | - Pam Harvey
- School of Rural Health, Monash University, Bendigo, Australia
| | - Erica L James
- School of Medicine and Public Health, University of Newcastle, Hunter Medical Research Institute, Callaghan, Australia
| | - Dominique Rich
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
| | - Sari P Dewi
- School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
| | - Smriti Nepal
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Darlington, Australia
| | - Hayley A Croft
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, Australia
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Vazquez-Cancela O, Souto-Lopez L, Vazquez-Lago JM, Lopez A, Figueiras A. Factors determining antibiotic use in the general population: A qualitative study in Spain. PLoS One 2021; 16:e0246506. [PMID: 33539449 PMCID: PMC7861377 DOI: 10.1371/journal.pone.0246506] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 01/21/2021] [Indexed: 11/18/2022] Open
Abstract
Background Antibiotic resistance is an important Public Health problem and many studies link it to antibiotic misuse. The population plays a key role in such misuse. Objective The aim of this study was thus to explore the factors that might influence antibiotic use and resistance in the general population. Methods Qualitative research using the focus group (FG) method. Groups were formed by reference to the following criteria: age (over and under 65 years); place of origin; and educational/professional qualifications. FG sessions were recorded, transcribed and then separately analysed by two researchers working independently. Written informed consent was obtained from all participants. Results Eleven FGs were formed with a total of 75 participants. The principal factors identified as possible determinants of antibiotic misuse were: (i) lack of knowledge about antibiotics; (ii) doctor-patient relationship problems; (iii) problems of adherence; and, (iv) use without medical prescription. Antibiotic resistance is a phenomenon unknown to the population and is perceived as an individual problem, with the term “resistance” being confused with “tolerance”. None of the groups reported that information about resistance had been disseminated by the health care sector. Conclusions The public is unaware of the important role it plays in the advance of antimicrobial resistance. There is evidence of diverse factors, many of them modifiable, which might account for antibiotic misuse. Better understanding these factors could be useful in drawing up specific strategies aimed at improving antibiotic use.
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Affiliation(s)
- Olalla Vazquez-Cancela
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, A Coruña (Corunna), Spain
- University Hospital of Santiago de Compostela, Santiago de Compostela, A Coruña (Corunna), Spain
| | - Laura Souto-Lopez
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, A Coruña (Corunna), Spain
| | - Juan M. Vazquez-Lago
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, A Coruña (Corunna), Spain
- University Hospital of Santiago de Compostela, Santiago de Compostela, A Coruña (Corunna), Spain
- Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- * E-mail:
| | - Ana Lopez
- Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | - Adolfo Figueiras
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, A Coruña (Corunna), Spain
- Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain
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Communication Experiences in Primary Healthcare with Refugees and Asylum Seekers: A Literature Review and Narrative Synthesis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041469. [PMID: 33557234 PMCID: PMC7913992 DOI: 10.3390/ijerph18041469] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 01/28/2021] [Accepted: 01/29/2021] [Indexed: 12/03/2022]
Abstract
Refugee and asylum seeker population numbers are rising in Western countries. Understanding the communication experiences, within healthcare encounters, for this population is important for providing better care and health outcomes. This review summarizes the literature on health consultation communication experiences of refugees and asylum seekers living in Western countries. Seven electronic databases were searched from inception to 31 March 2019. Studies were included if they aimed to improve, assess or report on communication/interaction in the primary health care consultation setting with refugees or asylum seekers, and were conducted in Western countries. A narrative synthesis of the literature was undertaken. Thematic analysis of the 21 included articles, showed that refugees and asylum seekers experience a range of communication challenges and obstacles in primary care consultations. This included practical and relational challenges of organizing and using informal and formal interpreters and cultural understanding of illness and healthcare. Non-verbal and compassionate care aspects of communication emerged as an important factor in helping improve comfort and trust between healthcare providers (HCP) and refugees and asylum seekers during a healthcare encounter. Improvements at the systems level are needed to provide better access to professional interpreters, but also support compassionate and humanistic care by creating time for HCPs to build relationships and trust with patients.
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Bhatia JK, Chaturvedi A, Datta K, Ciraj A. Enhancing communication skills among residents in India: An interprofessional education approach. Med J Armed Forces India 2021; 77:S115-S121. [PMID: 33612941 PMCID: PMC7873706 DOI: 10.1016/j.mjafi.2020.12.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 12/30/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Interprofessional education (IPE) provides opportunities to postgraduates to develop communication skills which are vital for interactions with patients, their relatives, colleagues, paramedical and nursing staff. There is a need to develop an innovative IPE based module on communication skills for postgraduates stressing upon the existing lacunae and requirements detected by a validated assessment tool. We assessed the residents' appraisal of communication skills by a validated questionnaire to identify key areas to improve their communication skills and to determine perceptions of all the stakeholders i.e. faculty, nursing staff and paramedical staff. METHODS A descriptive correlational design using an online self-administered questionnaire on a sample of a total of 200 participants comprising residents, paramedical staff, nursing staff and faculty of tertiary care hospital. Study was approved by the Institutional Ethical Committee. Data was analysed by SPSS Version 22.0 used. (p value < 0.05 significant). RESULTS The participants included 113 residents, 17 paramedical staff, 33 Nursing staff and 37 faculty members. The present study found a significant difference of scores of means between the residents, faculty, paramedical staff and nursing staff p value < 0.05 except for alter centrism, interaction management and environmental control. The mean scores were also significantly different between the first, second and third year residents. CONCLUSION This study validates the need to enhance the communication skills of residents. The scores obtained will help us design and refine IPE module for the benefit of the residents.
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Affiliation(s)
| | - Abhishek Chaturvedi
- Senior Grade Lecturer (Biochemistry), Melaka Manipal Medical College (Manipal Campus), Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Karuna Datta
- Professor, Department of Sports Medicine, Convener MCIRC for MET & Coordinator, Department of Medical Education, Armed Forces Medical College, Pune, India
| | - A.M. Ciraj
- Professor & Course Director, MAHE FAIMER International Institute, Centre for Continuing Education & Professional Development, Manipal Academy of Higher Education, Manipal, Karnataka, India
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