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Barker LA, Moore JD, Cook HA. Generative Artificial Intelligence as a Tool for Teaching Communication in Nutrition and Dietetics Education-A Novel Education Innovation. Nutrients 2024; 16:914. [PMID: 38612948 PMCID: PMC11013049 DOI: 10.3390/nu16070914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 03/20/2024] [Accepted: 03/20/2024] [Indexed: 04/14/2024] Open
Abstract
Although effective communication is fundamental to nutrition and dietetics practice, providing novice practitioners with efficacious training remains a challenge. Traditionally, human simulated patients have been utilised in health professions training, however their use and development can be cost and time prohibitive. Presented here is a platform the authors have created that allows students to interact with virtual simulated patients to practise and develop their communication skills. Leveraging the structured incorporation of large language models, it is designed by pedagogical content experts and comprises individual cases based on curricula and student needs. It is targeted towards the practice of rapport building, asking of difficult questions, paraphrasing and mistake making, all of which are essential to learning. Students appreciate the individualised and immediate feedback based on validated communication tools that encourage self-reflection and improvement. Early trials have shown students are enthusiastic about this platform, however further investigations are required to determine its impact as an experiential communication skills tool. This platform harnesses the power of artificial intelligence to bridge the gap between theory and practice in communication skills training, requiring significantly reduced costs and resources than traditional simulated patient encounters.
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Affiliation(s)
- Lisa A. Barker
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, VIC 3168, Australia
| | - Joel D. Moore
- School of Social Sciences, Monash University, Melbourne, VIC 3800, Australia;
| | - Helmy A. Cook
- School of Medicine, Monash University, Clayton, VIC 3800, Australia;
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Williams N, Griffin G, Wall M, Watson S, Warland J, Bradfield Z. Patient evaluation of gynaecological information provision and preferences. J Adv Nurs 2024; 80:1188-1200. [PMID: 37731325 DOI: 10.1111/jan.15866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 08/03/2023] [Accepted: 08/30/2023] [Indexed: 09/22/2023]
Abstract
AIM To evaluate gynaecological patients' preferences and satisfaction regarding information provision, exploring enablers and barriers to information access. DESIGN A descriptive cross-sectional survey design was used. METHODS A total of 293 women accessing gynaecological services responded to the survey. Quantitative analysis included descriptive and inferential statistics. Content analysis was conducted on qualitative data. RESULTS Health professionals were the most common and preferred sources of gynaecological health information. Enablers to information provision included positive communication strategies by health professionals, participants having prior knowledge and doing their own research. Despite its widespread availability, only 24.2% of women preferred the internet as an information source. Poor communication and inadequate information provision were identified as barriers to information access. Statistically significant associations were identified between location of residence, education level, year of birth, diagnostic group and health information preferences. Recommendations from women included improved communication strategies, system changes and provision of individualized information. CONCLUSION Health professionals are central to women accessing information about gynaecological diagnoses. Areas for improvement include communication strategies, facilitating access to internet-based resources for information and consideration of women's preferences when providing health information. IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE Consumer co-design of gynaecological health information and communication training for health professionals is recommended. Improved communication and facilitated use of internet-based resources may improve women's understanding of information. IMPACT This study explored gynaecological patients' preferences and satisfaction regarding information provision, exploring enablers and barriers to information access. It was found that gynaecological patients preferred individualized information provided to them directly by health professionals and despite its widespread availability, the internet is an underutilized health information resource. These findings are applicable to health professionals and patients utilizing tertiary gynaecological health services in Australia but may be generalized if demographic data aligns with other jurisdictions. REPORTING METHOD The STROBE reporting method was used in the preparation of the manuscript. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Natalie Williams
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Australia
| | - Georgia Griffin
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Australia
| | - Megan Wall
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Australia
| | - Stuart Watson
- Women's Health, Genetics & Mental Health, King Edward Memorial Hospital, Subiaco, Australia
| | - Jane Warland
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Australia
- School of Nursing, Curtin University, Bentley, Australia
| | - Zoe Bradfield
- Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Subiaco, Australia
- School of Nursing, Curtin University, Bentley, Australia
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Pettinger C, Tripathi S, Shoker B, Hodge G. Collaborative leadership to support sustainability in practice for dietitians as allied health professionals. J Hum Nutr Diet 2023; 36:2323-2335. [PMID: 37489277 DOI: 10.1111/jhn.13211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 07/06/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND Allied health professionals (AHPs) have an important role to support the Greener National Health Service (NHS) agenda. Dietitians are AHPs who are already demonstrating strong influence on food sustainability advocacy. There is call for more collaboration across the health professions to optimise "green" leadership in the pursuit of planetary health. The present study aimed to investigate the perceived role of AHP leaders and future leaders around more sustainable healthcare practices. METHODS A mixed methods approach using audio-recorded semi-structured interviews with strategic AHP leaders (n = 11) and focus groups with student AHPs (n = 2). Standardised open-ended questions considered concepts of (i) leadership, (ii) green agenda, (iii) collaboration and (iv) sustainability. Purposive sampling used already established AHP networks. Thematic analysis systematically generated codes and themes with dietetic narratives drawn out specifically as exemplars. RESULTS The findings represent diverse AHP voices, with six of 14 AHPs analysed, including dietetic (future) leaders. Three key themes emerged: (1) collective vision of sustainable practice; (2) empowering, enabling and embedding; and (3) embracing collaborative change. Dietetic specific narratives included food waste, NHS food supply chain issues, and tensions between health and sustainability advice. CONCLUSIONS The present study shows that collaborative leadership is a core aspiration across AHP leaders and future leaders to inform the green agenda. Despite inherent challenges, participant perceptions illustrate how "change leadership" might be realised to support the net zero agenda within health and social care. Dietitians possess the relevant skills and competencies, and therefore have a fundamental role in evolving collaborative leadership and directing transformational change towards greener healthcare practices. Recommendations are made for future leaders to embrace this agenda to meet the ambitious net zero targets.
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Affiliation(s)
- Clare Pettinger
- School of Health Professions, Peninsula Allied Health Centre (PAHC), Faculty of Health, University of Plymouth, Plymouth, UK
| | - Smita Tripathi
- Plymouth Business School, Faculty of Arts, Humanities and Business, University of Plymouth, Plymouth, UK
| | - Benji Shoker
- Plymouth Business School, Faculty of Arts, Humanities and Business, University of Plymouth, Plymouth, UK
| | - Gary Hodge
- School of Nursing and Midwifery, Faculty of Health, University of Plymouth, Plymouth, UK
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Bylund CL, Vasquez TS, Peterson EB, Ansell M, Bylund KC, Ditton-Phare P, Hines A, Manna R, Singh Ospina N, Wells R, Rosenbaum ME. Effect of Experiential Communication Skills Education on Graduate Medical Education Trainees' Communication Behaviors: A Systematic Review. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2022; 97:1854-1866. [PMID: 35857395 PMCID: PMC9712157 DOI: 10.1097/acm.0000000000004883] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
PURPOSE A better understanding of how communication skills education impacts trainees' communication skills is important for continual improvement in graduate medical education (GME). Guided by the Kirkpatrick Model, this review focused on studies that measured communication skills in either simulated or clinical settings. The aim of this systematic review was to examine the effect of experiential communication skills education on GME trainees' communication behaviors. METHOD Five databases were searched for studies published between 2001 and 2021 using terms representing the concepts of medical trainees, communication, training, and skills and/or behaviors. Included studies had an intervention design, focused only on GME trainees as learners, used experiential methods, and had an outcome measure of communication skills behavior that was assessed by a simulated or standardized patient (SP), patient, family member, or outside observer. Studies were examined for differences in outcomes based on study design; simulated versus clinical evaluation setting; outside observer versus SP, patient, or family member evaluator; and length of training. RESULTS Seventy-seven studies were ultimately included. Overall, 54 (70%) studies reported some positive findings (i.e., change in behavior). There were 44 (57%) single-group pre-post studies, 13 (17%) nonrandomized control studies, and 20 (26%) randomized control studies. Positive findings were frequent in single-group designs (80%) and were likely in nonrandomized (62%) and randomized (55%) control trials. Positive findings were likely in studies evaluating communication behavior in simulated (67%) and clinical (78%) settings as well as in studies with outside observer (63%) and SP, patient, and family member (64%) evaluators. CONCLUSIONS This review demonstrates strong support that experiential communication skills education can impact GME trainees' communication behaviors. Marked heterogeneity in communication trainings and evaluation measures, even among subgroups, did not allow for meta-analysis or comparative efficacy evaluation of different studies. Future studies would benefit from homogeneity in curricular and evaluation measures.
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Affiliation(s)
- Carma L Bylund
- C.L. Bylund is professor, Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida
| | - Taylor S Vasquez
- T.S. Vasquez is a doctoral student, Department of Public Relations, College of Journalism and Communications, University of Florida, Gainesville, Florida
| | - Emily B Peterson
- E.B. Peterson is senior research analyst, University of Southern California, Los Angeles, California
| | - Margaret Ansell
- M. Ansell is associate university librarian and associate chair, Health Science Center Libraries, University of Florida, Gainesville, Florida
| | - Kevin C Bylund
- K.C. Bylund is associate professor, Department of Radiation Oncology, University of Rochester Medical Center, Rochester, New York
| | - Philippa Ditton-Phare
- P. Ditton-Phare is medical education support officer (psychiatry), Hunter New England Local Health District, Newcastle, New South Wales, Australia
| | - April Hines
- A. Hines is journalism and mass communications librarian, George A. Smathers Libraries, University of Florida, Gainesville, Florida
| | - Ruth Manna
- R. Manna is associate director, Patient Experience Partnerships, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Naykky Singh Ospina
- N. Singh Ospina is associate professor, Department of Medicine, College of Medicine, University of Florida, Gainesville, Florida
| | - Robert Wells
- R. Wells is science writer, Office of Research, University of Central Florida, Orlando, Florida
| | - Marcy E Rosenbaum
- M.E. Rosenbaum is professor, Department of Family Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa
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Fuchs JR, Tannous AM, Guiton G, Kaul P. An innovative approach to teaching cross-cultural communication among dental students. Br Dent J 2022; 233:879-884. [DOI: 10.1038/s41415-022-5211-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 07/07/2022] [Indexed: 11/27/2022]
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Bustamante-Helfrich B, Santa Maria E, Bradley J, Warden D, Sengupta A, Phillips-Madson R, Ungaretti T. Collaborative faculty development transforms evaluation at a school of osteopathic medicine: an exploratory grounded theory study. MEDEDPUBLISH 2022. [DOI: 10.12688/mep.18986.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Faculty development (FD) initiatives for medical educators must keep pace with educators’ expanding roles and responsibilities in the 21st century to effectively support and guide professional growth. Successful initiatives will be comprehensive and systematic, rather than episodic. Our research explores the impact of a collaborative, individualized, and focused FD program. The purpose of this pilot study is: (1) to describe the innovative design and implementation of the incipient FD program at University of the Incarnate Word School of Osteopathic Medicine (UIWSOM), San Antonio, Texas; and (2) to present insights from a preliminary process evaluation of the program’s initial launch to inform and facilitate broadscale implementation. Methods: We used a longitudinal, holistic approach to redesign the UIWSOM FD program to provide evidence-informed and experiential learning for faculty. We performed a process evaluation of the initial iteration of the FD program using an inductive qualitative research approach. We applied principles of constructivist grounded theory to analyze faculty’s responses collected during semi-structured interviews. Results: Three themes emerged from our analysis: communication, advocacy, and reciprocal learning. We found that effective communication, advocacy for faculty success, and reciprocal value between faculty and program developers undergirded the core concept of authentic engagement. Faculty’s perceptions of the quality of engagement of those implementing the program overshadowed the quality of the logistics. Conclusions: Our pilot study identified authentic engagement as critical to faculty’s positive experience of this new FD initiative. Practical implications for other health professions schools with similar FD initiatives include consideration of the relational aspects. Future studies should expand the process evaluation to determine key factors driving perceived program success for other skill domains and amongst clinical faculty, and include a long-range outcome evaluation of the fully implemented program.
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Perron NJ, Pype P, van Nuland M, Bujnowska-Fedak MM, Dohms M, Essers G, Joakimsen R, Tsimtsiou Z, Kiessling C. What do we know about written assessment of health professionals' communication skills? A scoping review. PATIENT EDUCATION AND COUNSELING 2022; 105:1188-1200. [PMID: 34602334 DOI: 10.1016/j.pec.2021.09.011] [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: 03/02/2021] [Revised: 08/26/2021] [Accepted: 09/06/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE The aim of this scoping review was to investigate the published literature on written assessment of communication skills in health professionals' education. METHODS Pubmed, Embase, Cinahl and Psychnfo were screened for the period 1/1995-7/2020. Selection was conducted by four pairs of reviewers. Four reviewers extracted and analyzed the data regarding study, instrument, item, and psychometric characteristics. RESULTS From 20,456 assessed abstracts, 74 articles were included which described 70 different instruments. Two thirds of the studies used written assessment to measure training effects, the others focused on the development/validation of the instrument. Instruments were usually developed by the authors, often with little mention of the test development criteria. The type of knowledge assessed was rarely specified. Most instruments included clinical vignettes. Instrument properties and psychometric characteristics were seldom reported. CONCLUSION There are a number of written assessments available in the literature. However, the reporting of the development and psychometric properties of these instruments is often incomplete. Practice implications written assessment of communication skills is widely used in health professions education. Improvement in the reporting of instrument development, items and psychometrics may help communication skills teachers better identify when, how and for whom written assessment of communication should be used.
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Affiliation(s)
- Noelle Junod Perron
- Unit of Development and Research in Medical Education, Geneva Faculty of Medicine and Institute of Primary Care, Geneva University Hospitals, Geneva, Switzerland.
| | - Peter Pype
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Marc van Nuland
- Academic Center for General Practice, Leuven University, Leuven, Belgium
| | | | | | - Geurt Essers
- Network of GP Training Programs in the Netherlands, Utrecht, The Netherlands
| | - Ragnar Joakimsen
- Department of Clinical Medicine, Faculty of Health Sciences, UIT The Artic University of Norway and Department of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
| | - Zoi Tsimtsiou
- Department of Hygiene, Social-Preventive Medicine and Medical Statistics, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Claudia Kiessling
- Personal and Interpersonal Development in Health Care Education, Witten/Herdecke University, Witten, Germany
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King G, Baldwin P, Servais M, Moodie S. Solution-Focused Coaching to Support Clinicians' Professional Development: An Analysis of Relational Strategies and Co-constructed Outcomes. Dev Neurorehabil 2022; 25:205-216. [PMID: 34860149 DOI: 10.1080/17518423.2021.2011458] [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] [Indexed: 10/19/2022]
Abstract
PURPOSE To explore solution-focused coaching (SFC) as a means to enhance pediatric rehabilitation practitioners' development of listening skills. METHODS Six clinicians each participated in two SFC sessions with an experienced coach who used a practice model developed for pediatric rehabilitation (SFC-peds). The transcribed interviews were analyzed by inductive content analysis to identify the coach's use of relational strategies and the nature of what was being co-constructed in the sessions. RESULTS The coach used six relational strategies (e.g., supporting reflective and critical thinking). Through dialogue and reflection, the coach and clinician co-constructed four important outcomes, including shared meaning, awareness and discovery of strengths and values, discovery of strategies and opportunities, and forward movement. CONCLUSIONS The study informs our understanding of the relational processes and benefits of SFC conversations. These conversations appear to provide an optimal learning space to enhance professional development, by facilitating the co-creation of meaning, awareness, and intentionality.
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Affiliation(s)
- Gillian King
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | | | - Michelle Servais
- Thames Valley Children's Centre, London, Canada.,School of Communication Sciences and Disorders, Western University, London, Canada
| | - Sheila Moodie
- School of Communication Sciences and Disorders, Western University, London, Canada
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Blake Gornall A, Hutchinson AM, Redley B. Clinician perspectives of pregnant women's participation in antiemetic decision-making: A qualitative study. Nurs Health Sci 2022; 24:54-64. [PMID: 35174947 DOI: 10.1111/nhs.12930] [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: 07/29/2021] [Revised: 01/30/2022] [Accepted: 02/07/2022] [Indexed: 11/30/2022]
Abstract
This study explored clinician perceptions of women's participation in decision-making about antiemetic treatments during pregnancy, and the suitability of the five Choosing Wisely questions to increase women's involvement. The qualitative interpretive descriptive design used semi-structured interviews to capture data. Participants were six obstetricians and six midwives experienced in providing care for pregnant women seeking support for nausea and vomiting at a single private, obstetrician-led maternity health service in Australia. Thematic analysis revealed four themes that captured clinician perspectives about women's participation in decision-making about antiemetic treatments: (i) information gathering; (ii) developing an understanding; (iii) using knowledge; and (iv) making decisions. Clinician attitudes and perspectives, as well as their self-reported styles of communication and negotiation, influenced how they engaged with women during decision-making. While unfamiliar with the five Choosing Wisely questions, almost all participants considered them potentially useful, but for other clinicians. Strategies to actively involve women in decision-making about antiemetics were inconsistently used. The five Choosing Wisely questions may provide a useful tool for clinicians, but further research is needed to better understand women's perspectives and clinician-related barriers to shared decision-making.
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Affiliation(s)
| | - Alison M Hutchinson
- School of Nursing and Midwifery, Deakin University, Burwood, Victoria, Australia.,Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Burwood, Victoria, Australia.,Monash Health, Clayton, Victoria, Australia
| | - Bernice Redley
- School of Nursing and Midwifery, Deakin University, Burwood, Victoria, Australia.,Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Burwood, Victoria, Australia.,Monash Health, Clayton, Victoria, Australia
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Clinician Perspectives of Communication with Aboriginal and Torres Strait Islanders Managing Pain: Needs and Preferences. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031572. [PMID: 35162593 PMCID: PMC8835490 DOI: 10.3390/ijerph19031572] [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: 12/07/2021] [Revised: 01/25/2022] [Accepted: 01/26/2022] [Indexed: 12/03/2022]
Abstract
Poor communication is an important factor contributing to health disparity. This study sought to investigate clinicians’ perspectives about communicating with Aboriginal and Torres Strait Islander patients with pain. This multi-site and mixed-methods study involved clinicians from three pain management services in Queensland, Australia. Clinicians completed a survey and participated in focus groups. Clinicians rated the importance of communication training, their knowledge, ability, and confidence in communicating with Aboriginal and Torres Strait Islander patients using a 5-point Likert scale. Rating scores were combined into low (scores 1–2); moderate (score 3) and high (scores 4–5). Informed by an interpretive description methodology, thematic analysis of focus group data was used to identify the communication needs and training preferences of clinicians. Overall (N = 64), 88% of clinicians rated the importance of communication training when supporting Aboriginal and Torres Strait Islander patients as “high”. In contrast, far fewer clinicians rated as “high” their knowledge (28%), ability (25%) and confidence (28%) in effectively communicating with Aboriginal and Torres Strait Islander patients. Thematic analysis identified three areas of need: knowledge of Aboriginal and Torres Strait Islander cultures, health beliefs, and understanding cross-cultural cues. Communication skills can be learned and training, in the form of a tailored intervention to support quality engagement with Aboriginal and Torres Strait Islander patients, should combine cultural and communication aspects with biomedical knowledge.
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Rouleau G, Gagnon MP, Côté J, Richard L, Chicoine G, Pelletier J. Virtual patient simulation to improve nurses' relational skills in a continuing education context: a convergent mixed methods study. BMC Nurs 2022; 21:1. [PMID: 34983509 PMCID: PMC8725454 DOI: 10.1186/s12912-021-00740-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 10/17/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Effective provider-patient communication is crucial to the delivery of high-quality care. Communication roadblock such as righting reflex is widely observed among providers and can lead to relational disengagement. In previous work, nurses felt ill-equipped to communicate effectively with HIV-positive patients to support medication adherence. Providing nurses with continuing education opportunities to improve their relational skills is a major target for optimizing the quality of care. Virtual patient simulation is one promising strategy that needs to be evaluated among graduate nurses. This study aimed to assess the acceptability of a virtual patient simulation to improve nurses' relational skills in a continuing education context. METHODS We conducted a convergent mixed methods study by combining a quantitative pre-experimental, one-group post-test design and a qualitative exploratory study. We used convenience and snowball sampling approaches to select registered nurses (n = 49) working in Quebec, Canada. Participants completed an online sociodemographic questionnaire, consulted the automated virtual patient simulation (informed by motivational interviewing), and filled out an online post-test survey. Descriptive statistics (mean, SD, median, interquartile range) were used to present quantitative findings. From the 27 participants who completed the simulation and post-test survey, five participated in a focus group to explore their learning experience. The discussion transcript was subjected to thematic analysis. At the final stage of the study, we used a comparison strategy for the purpose of integrating the quantitative and qualitative results. RESULTS Nurses perceived the simulation to be highly acceptable. They rated the global system quality and the technology acceptance with high scores. They reported having enjoyed the simulation and recommended other providers use it. Four qualitative themes were identified: motivations to engage in the simulation-based research; learning in a realistic, immersive, and non-judgmental environment; perceived utility of the simulation; and perceived difficulty in engaging in the simulation-based research. CONCLUSIONS The simulation contributed to knowledge and skills development on motivational interviewing and enhanced nurses' self-confidence in applying relational skills. Simulation holds the potential to change practice, as nurses become more self-reflective and aware of the impact of their relational skills on patient care. TRIAL REGISTRATION ISRCTN18243005 , retrospectively registered on July 3 2020.
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Affiliation(s)
- Geneviève Rouleau
- Faculty of Nursing, Université Laval, Pavillon Ferdinand-Vandry, 1050 De la Médecine Ave., Québec City, QC, G1V 0A6, Canada.
- Research Chair in Innovative Nursing Practices, 850 St-Denis St., Tour S, Montréal, QC, H2X0A9, Canada.
| | - Marie-Pierre Gagnon
- Faculty of Nursing, Université Laval, Pavillon Ferdinand-Vandry, 1050 De la Médecine Ave., Québec City, QC, G1V 0A6, Canada
- Vitam Research Center in Sustainable Health, Université Laval, 2525 De la Canardière Rd., Québec City, QC, G1J 0A4, Canada
- Population Health and Optimal Health Practices Axis, CHU de Québec-Université Laval Research Centre, 1050 Sainte-Foy Rd., Québec City, QC, G1S 4L8, Canada
| | - José Côté
- Research Chair in Innovative Nursing Practices, 850 St-Denis St., Tour S, Montréal, QC, H2X0A9, Canada
- Faculty of Nursing, Université de Montréal, 2375 Côte Ste-Catherine Rd., Pavillon Marguerite d'Youville, Montréal, QC, H3T 1A8, Canada
- Centre de recherche du Centre hospitalier de l'Université de Montréal, 850 St-Denis St, Tour S, Montréal, QC, H2X0A9, Canada
| | - Lauralie Richard
- Faculty of Nursing, Université de Montréal, 2375 Côte Ste-Catherine Rd., Pavillon Marguerite d'Youville, Montréal, QC, H3T 1A8, Canada
- Department of General Practice and Rural Health, Dunedin School of Medicine, University of Otago, 55 Hanover Street, Dunedin, 9016, New Zealand
| | - Gabrielle Chicoine
- Research Chair in Innovative Nursing Practices, 850 St-Denis St., Tour S, Montréal, QC, H2X0A9, Canada
- Centre de recherche du Centre hospitalier de l'Université de Montréal, 850 St-Denis St, Tour S, Montréal, QC, H2X0A9, Canada
| | - Jérôme Pelletier
- Faculty of Nursing, Université Laval, Pavillon Ferdinand-Vandry, 1050 De la Médecine Ave., Québec City, QC, G1V 0A6, Canada
- Université du Québec à Rimouski, 300 Allée des Ursulines, Rimouski, QC, G5L 3A1, Canada
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Knight A, Palermo C, Reedy G, Whelan K. Communication skills in dietetic practice: a scoping review protocol. JBI Evid Synth 2021; 19:3363-3371. [PMID: 34149024 DOI: 10.11124/jbies-20-00559] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE This scoping review aims to examine and map the evidence regarding communication skills in dietetic practice and the education strategies used to develop them. Specifically, the review will address usage in practice, perceptions, and experiences, as well as the teaching and assessment of communication skills in student dietitians and dietitians. INTRODUCTION Communication skills are a key element of practice for dietitians. Dietetic practice is evolving, and there is a need to explore the breadth of literature on communication skills for contemporary practice and how these skills are taught. INCLUSION CRITERIA This scoping review will consider empirical research on dietitians' or nutritionists' communication skills. This will include skills used in dietitian-patient communication, in communication interactions in different employment contexts, and diverse forms of communication (verbal, written, technological). We will consider the views of student dietitians, dietitians, and patients, as well as evidence regarding how communication skills are taught and assessed in dietetics. Sources may include experimental, quasi-experimental, observational, and qualitative studies. METHODS The following electronic databases will be searched: MEDLINE, Embase, CINAHL, ERIC, and PsycINFO. There will be no date limits. Reference lists of eligible studies will be back-searched. Google Scholar will be used for forward citation tracking. Conference proceedings from the previous five years will be searched for eight conferences of the professional associations of dietetics and health care education. ProQuest Dissertations and Theses, and WorldCat Dissertations and Theses will be searched for unpublished literature. The findings will be summarized in tabular format and a narrative synthesis.
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Affiliation(s)
- Annemarie Knight
- Department of Nutritional Sciences, King's College London, London, UK
| | - Claire Palermo
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, VIC, Australia
| | - Gabriel Reedy
- Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Kevin Whelan
- Department of Nutritional Sciences, King's College London, London, UK
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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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Koopman WJ, LaDonna KA, Anne Kinsella E, Venance SL, Watling CJ. Getting airtime: Exploring how patients shape the stories they tell health practitioners. MEDICAL EDUCATION 2021; 55:1142-1151. [PMID: 33979015 DOI: 10.1111/medu.14561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 05/04/2021] [Accepted: 05/06/2021] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Effective communication during health encounters is known to decrease patient complaints, increase patient adherence and optimise health outcomes. While the aim of patient-centred care is to find common ground, health practitioners tend to drive the encounter, often interrupting patients within the first minute of the clinical conversation. Optimal care for people with chronic illnesses requires individuals to interact with health practitioners regarding their health concerns, but given these constraints, we know little about how patients strategise conversations with their care providers. This understanding may further our efforts to educate health practitioners and trainees to learn and practice patient-centred care. METHODS A constructivist grounded theory approach with iterative data collection and analysis was used to explore the processes patients use to present and shape their stories for interactions with health practitioners. Twenty-one patients (n = 16 female; 5 male) representing a variety of chronic illnesses participated in semi-structured interviews. Using the constant comparative method of analysis, salient themes were ascertained. RESULTS Patients engage in extensive strategic preparations for productive health encounters. From the data, we identified four related elements comprising patients' process of planning, preparing, and strategising for health encounters: deciding to go, organising to get airtime, rehearsing a game plan, and anticipating external forces. By focusing on the extensive preparatory work patients engage in, our study expands the dimensions of how we understand illness-related work. Assembling personal health information, gathering disease information and achieving equanimity represent the dimensions of this 'health interaction work'. CONCLUSION The work patients engage in for health encounters is noteworthy yet often invisible. And work that is unseen may also be undervalued. Acknowledging, illuminating and valuing patients' preparatory work for health encounters add to how we understand patient-centred care, and this offers new targets for us to effectively teach and deliver it.
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Affiliation(s)
- Wilma J Koopman
- Health and Rehabilitation Sciences, Western University, London, ON, Canada
- London Health Sciences Centre, London, ON, Canada
| | - Kori A LaDonna
- Department of Innovation in Medical Education, University of Ottawa, Ottawa, ON, Canada
- Department of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Elizabeth Anne Kinsella
- Health and Rehabilitation Sciences, Western University, London, ON, Canada
- Centre for Education Research & Innovation, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Faculty of Medicine and Health Sciences, Institute of Health Sciences Education, McGill University, Montreal, QC, Canada
| | - Shannon L Venance
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Christopher J Watling
- Centre for Education Research & Innovation, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
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Thompson T, Grove L, Brown J, Buchan J, Kerry AL, Burge S. COGConnect: A new visual resource for teaching and learning effective consulting. PATIENT EDUCATION AND COUNSELING 2021; 104:2126-2132. [PMID: 33422369 DOI: 10.1016/j.pec.2020.12.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 11/22/2020] [Accepted: 12/16/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Consultation skills are essential to clinical practice and, when effective, can facilitate diagnoses and improve patient satisfaction. Various models exist to facilitate consultation teaching. These can be prescriptive, a challenge to apply in clinical settings and are often designed for primary care. In redesigning our entire curriculum, we sought to create a new visual, digital, resource for consultation teaching, aligned with statements from the UK Council for Clinical Communication (UKCCC), and suitable for the evolving expectations of patients, clinicians and the UK NHS, in 21st century medicine. METHODS We conducted a literature review encompassing teaching methods, NHS Priorities, patients' priorities, lifestyle interventions and practitioner resilience. COGConnect was designed iteratively through consultation with a graphic designer, health psychologists, a range of clinicians, and a consultation expert, and has evolved through extensive use in our new "effective consulting" course in primary and secondary care. RESULTS COGConnect is deliberately visual, iterative, bi-directional and multi-phasic. The central image of COGConnect is two persons in connection; the floating cogs suggesting an encounter of different agents who must adapt their cog-connection in terms of speed, direction and dimension. Around this image we place five core values. The consultation phases are represented by ten colourful cogs, with important additions including 'formulating', 'activating' and 'integrating'. CONCLUSION COGConnect builds on the strengths of existing frameworks and provides a strong visual resource suitable for digital learning. It offers greater emphasis on explicit clinical reasoning, activation of patient self-care and learning from the interaction. Having become the de facto resource for consultation skills training across primary and secondary care in our institution, the next phase is to develop the COGConnect.info website and a programme of formal evaluation.
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Affiliation(s)
- Trevor Thompson
- Centre for Academic Primary Care, School of Population Health Sciences, University of Bristol, Bristol, BS8 2PS, UK.
| | - Lizzie Grove
- Centre for Academic Primary Care, School of Population Health Sciences, University of Bristol, Bristol, BS8 2PS, UK
| | - Juliet Brown
- Centre for Academic Primary Care, School of Population Health Sciences, University of Bristol, Bristol, BS8 2PS, UK
| | - Jess Buchan
- Centre for Academic Primary Care, School of Population Health Sciences, University of Bristol, Bristol, BS8 2PS, UK
| | - Anthony L Kerry
- Department of Respiratory Medicine, Western Hospital NHS Foundation Trust, Swindon, SN3 6BB, UK
| | - Sarah Burge
- Bristol Medical School, University of Bristol, 69 St Michael's Hill, Bristol, BS2 8DZ, UK
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Fisher R, Parmar J, Duggleby W, Tian PGJ, Janzen W, Anderson S, Brémault-Phillips S. Health-care Workforce Training to Effectively Support Family Caregivers of Seniors in Care. Can Geriatr J 2020; 23:160-171. [PMID: 32494332 PMCID: PMC7259919 DOI: 10.5770/cgj.23.384] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Introduction Family caregivers (FCGs) play an integral, yet often invisible, role in the Canadian health-care system. As the population ages, their presence will become even more essential as they help balance demands on the system and enable community-dwelling seniors to remain so for as long as possible. To preserve their own well-being and capacity to provide ongoing care, FCGs require support to the meet the challenges of their daily caregiving responsibilities. Supporting FCGs results in better care provision to community-dwelling seniors receiving health-care services, as well as enhancing the quality of life for FCGs. Although FCGs rely upon health-care professionals (HCPs) to provide them with support and services, there is a paucity of research pertaining to the type of health workforce training (HWFT) that HCPs should receive to address FCG needs. Programs that train HCPs to engage with, empower, and support FCGs are required. Objective To describe and discuss key findings of a caregiver symposium focused on determining components of HWFT that might better enable HCPs to support FCGs. Methods A one-day symposium was held on February 22, 2018 in Edmonton, Alberta, to gather the perspectives of FCGs, HCPs, and stakeholders. Attendees participated in a series of working groups to discuss barriers, facilitators, and recommendations related to HWFT. Proceedings and working group discussions were transcribed, and a qualitative thematic analysis was conducted to identify key themes. Results Participants identified the following topic areas as being essential to training HCPs in the provision of support for FCGs: understanding the FCG role, communicating with FCGs, partnering with FCGs, fostering FCG resilience, navigating healthcare systems and accessing resources, and enhancing the culture and context of care. Conclusions FCGs require more support than is currently being provided by HCPs. Training programs need to specifically address topics identified by participants. These findings will be used to develop HWFT for HCPs.
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Affiliation(s)
- Rachel Fisher
- Department of Occupational Therapy, University of Alberta, Edmonton, AB, Canada
| | - Jasneet Parmar
- Department of Family Medicine, University of Alberta, Edmonton, AB, Canada.,Covenant Health-Network of Excellence in Seniors' Health and Wellness, Grey Nuns Community Hospital, Edmonton, AB, Canada
| | - Wendy Duggleby
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | | | - Wonita Janzen
- Faculty of Humanities and Social Sciences, Athabasca University, Athabasca, AB, Canada
| | - Sharon Anderson
- Covenant Health-Network of Excellence in Seniors' Health and Wellness, Grey Nuns Community Hospital, Edmonton, AB, Canada
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Björklund K, Silén C. Occupational therapy and physiotherapy students' communicative and collaborative learning in an interprofessional virtual setting. Scand J Occup Ther 2020; 28:264-273. [PMID: 32412813 DOI: 10.1080/11038128.2020.1761448] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Interprofessional learning activities can contribute to preparing students to function in health care teams. Although the importance of communication is acknowledged, there is still a lack of understanding about how students learn to communicate interprofessionally. AIM To explore occupational therapist and physiotherapist students learning of skills in interprofessional communication by studying the students' communication while working together with a virtual patient. MATERIAL AND METHODS The students carried out a virtual patient encounter in pairs of two, using one computer per student, sitting side by side. The students' actions and conversations were recorded as video films, the oral communication was transcribed and analysed using qualitative content analysis. RESULTS The students created a social learning environment by posing questions, acknowledging each other and clarifying their professional perspective using familiar professional concepts. Comparing their professional views, students related their peers' statements to their own. Departing from their own profession and using the created open environment, the students' communication led to an interprofessional meaning-making process, with students aiming to understand each other. CONCLUSIONS AND SIGNIFICANCE A reciprocal learning situation was created when students worked together in a virtual setting. Communicating and making shared decisions about a patient can facilitate learning how to communicate interprofessionally and improve students' understanding of their own profession.
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Affiliation(s)
- Karin Björklund
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden
| | - Charlotte Silén
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
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Visker JD, Welker K, Rhodes D, Forsyth E, Melvin P, Cox C. Effect of a rapid e-learning module and brief interprofessional simulation event on medical and nursing student collaborative attitudes and behaviors. Int J Nurs Educ Scholarsh 2020; 17:/j/ijnes.ahead-of-print/ijnes-2019-0122/ijnes-2019-0122.xml. [PMID: 32374283 DOI: 10.1515/ijnes-2019-0122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 04/13/2020] [Indexed: 11/15/2022]
Abstract
Objectives Undergraduate nursing and first-year medical students participated in a brief, scenario-based, interprofessional event. The experimental group only was provided an innovative, rapid e-learning instructional module focused on interprofessional roles/responsibilities and communication prior to the event. Methods Pre-post attitudes toward physician-nurse collaboration were surveyed, and collaborative behaviors were observed during the event. Results For the experimental group, a statistically significant (p<0.05) attitude improvement was found between pre-post e-learning module scores as well as pre-e-learning module and post-simulation event scores. For the control group, a statistically significant (p=0.001) attitude improvement was found between pre-post simulation event scores. No statistically significant differences in team collaborative behaviors were observed between experimental and control. Conclusions The combination of module and simulation event was not a more effective option than the event alone. As both interventions present unique challenges in regards to technology and facility requirements, having multiple effective intervention options will be of benefit to educational institutions.
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Affiliation(s)
| | | | - Darson Rhodes
- SUNY Brockport School of Health and Human Performance, Brockport, NY, USA
| | - Emily Forsyth
- Minnesota State University Mankato, Mankato, MN, USA
| | | | - Carol Cox
- Truman State University, HES, 2123 Pershing Building - HES, 100 E Normal St, Truman State University, Kirksville, MO, USA
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19
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Gottesman M. Communication Considerations for Physician Assistants. PHYSICIAN ASSISTANT CLINICS 2020. [DOI: 10.1016/j.cpha.2019.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Jager M, de Zeeuw J, Tullius J, Papa R, Giammarchi C, Whittal A, de Winter AF. Patient Perspectives to Inform a Health Literacy Educational Program: A Systematic Review and Thematic Synthesis of Qualitative Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E4300. [PMID: 31694299 PMCID: PMC6862529 DOI: 10.3390/ijerph16214300] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 10/28/2019] [Accepted: 10/29/2019] [Indexed: 01/22/2023]
Abstract
Patient-centred care is tailored to the needs of patients and is necessary for better health outcomes, especially for individuals with limited health literacy (LHL). However, its implementation remains challenging. The key to effectively address patient-centred care is to include perspectives of patients with LHL within the curricula of (future) healthcare providers (HCP). This systematic review aimed to explore and synthesize evidence on the needs, experiences and preferences of patients with LHL and to inform an existing educational framework. We searched three databases: PsychInfo, Medline and Cinahl, and extracted 798 articles. One-hundred and three articles met the inclusion criteria. After data extraction and thematic synthesis, key themes were identified. Patients with LHL and chronic diseases encounter multiple problems in the care process, which are often related to a lack of person-centeredness. Patient perspectives were categorized into four key themes: (1) Support system; (2) Patient self-management; (3) Capacities of HCPs; (4) Barriers in healthcare systems. "Cultural sensitivity" and "eHealth" were identified as recurring themes. A set of learning outcomes for (future) HCPs was developed based on our findings. The perspectives of patients with LHL provided valuable input for a comprehensive and person-centred educational framework that can enhance the relevance and quality of education for (future) HCPs, and contribute to better person-centred care for patients with LHL.
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Affiliation(s)
- Margot Jager
- Department of Health Sciences, University Medical Center Groningen and University of Groningen, 9700 AD Groningen, The Netherlands; (J.T.); (A.F.d.W.)
| | - Janine de Zeeuw
- Department of Health Sciences, University Medical Center Groningen and University of Groningen, 9700 AD Groningen, The Netherlands; (J.T.); (A.F.d.W.)
- Department of Medical Sciences, Educational Institute, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands
| | - Janne Tullius
- Department of Health Sciences, University Medical Center Groningen and University of Groningen, 9700 AD Groningen, The Netherlands; (J.T.); (A.F.d.W.)
| | - Roberta Papa
- Regional Health Agency Marche Region, 60125 Ancona, Italy; (R.P.); (C.G.)
- IRCCS INRCA, 60124 Ancona, Italy
| | - Cinzia Giammarchi
- Regional Health Agency Marche Region, 60125 Ancona, Italy; (R.P.); (C.G.)
- IRCCS INRCA, 60124 Ancona, Italy
| | - Amanda Whittal
- Department of Psychology & Methods, Jacobs University, 28759 Bremen, Germany;
| | - Andrea F. de Winter
- Department of Health Sciences, University Medical Center Groningen and University of Groningen, 9700 AD Groningen, The Netherlands; (J.T.); (A.F.d.W.)
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21
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Kaper MS, Winter AFD, Bevilacqua R, Giammarchi C, McCusker A, Sixsmith J, Koot JAR, Reijneveld SA. Positive Outcomes of a Comprehensive Health Literacy Communication Training for Health Professionals in Three European Countries: A Multi-centre Pre-post Intervention Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16203923. [PMID: 31619010 PMCID: PMC6843857 DOI: 10.3390/ijerph16203923] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 10/10/2019] [Accepted: 10/11/2019] [Indexed: 11/16/2022]
Abstract
Many professionals have limited knowledge of how to address health literacy; they need a wider range of health literacy competencies to enhance empowerment and person-centred prevention. We evaluated whether: (1) a comprehensive health literacy training increased self-rated competencies of health professionals to address health literacy related problems and support the development of people's autonomy and self-management abilities after training and 6-12 weeks later, (2) professionals were satisfied with the training, (3) outcomes differed for the three participating European countries. Health professionals (N = 106) participated in a multicentre pre-post intervention study in Italy, the Netherlands and Northern Ireland. The 8-hour training-intervention involved health literacy knowledge, the practice of comprehensible communication skills, shared decision-making, and enhancing self-management. Self-rated health literacy competencies and training satisfaction were assessed at baseline, immediately after training and 6-12 weeks later, and analysed by multi-level analysis. Professionals' self-rated health literacy competencies significantly improved following training in all three countries; this increase persisted at 6-12 weeks follow-up. The strongest increase regarded professional's skills to enhance shared-decision making and enabling self-management after training and follow-up respectively. Professionals perceived the training as relevant for practice. Competency increases seemed to be consistent across countries. In three countries, professionals' self-rated health literacy competencies increased following this comprehensive training. These promising findings should be confirmed in a further full effect study. Implementation of this training in European education and health care may improve person-centred communication by professionals and might help to tackle health literacy related problems and to strengthen people's abilities in achieving better health outcomes.
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Affiliation(s)
- Marise S Kaper
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, 9700 RB Groningen, The Netherlands.
| | - Andrea F de Winter
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, 9700 RB Groningen, The Netherlands
| | - Roberta Bevilacqua
- IRCCS INRCA (the National Institute of Health and Science on Aging), 60124 Ancona, Italy
| | - Cinzia Giammarchi
- IRCCS INRCA (the National Institute of Health and Science on Aging), 60124 Ancona, Italy
- The Regional Agency for Health (ARS of the Marche region), 60125 Ancona, Italy
| | | | - Jane Sixsmith
- Health Promotion Research Centre, National University of Ireland Galway, Galway H91 TK33, Ireland
| | - Jaap A R Koot
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, 9700 RB Groningen, The Netherlands
| | - Sijmen A Reijneveld
- University of Groningen, University Medical Center Groningen, Department of Health Sciences, 9700 RB Groningen, The Netherlands
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Lo WL, Hsieh MC. Teaching communication skills: Using Gagne's model as an illustration. Tzu Chi Med J 2019; 32:19-25. [PMID: 32110515 PMCID: PMC7015010 DOI: 10.4103/tcmj.tcmj_59_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 05/14/2019] [Accepted: 05/29/2019] [Indexed: 11/05/2022] Open
Abstract
Communication skills is an essential competence for physicians. Good communication skills correlate with higher patient satisfaction and overall patient outcome. Therefore, such training should start as early as in the undergraduate curriculum with experiential methods and more advanced skills to be integrated at different levels. Design of the training program should prepare for the transfer of communication skills into the clinical setting. Supervision from clinician educators could enhance the transfer of communication skills. Faculty development programs could help clinician educators to develop teaching skills needed in teaching communication. Continuous feedback from teachers and reflective practice of the learners are essential for effective learning of communication skills. The design of the teaching should be based on theory such as adult learning theory or experiential learning. Gagne's model provides a template for the systemic design of instructional events, and this article will illustrate an example of teaching communication skills based on the model.
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Affiliation(s)
- Wen-Lin Lo
- Department of Internal Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.,Department of Medical Education, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Ming-Chen Hsieh
- Department of Internal Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.,Department of Medical Education, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan
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Wattanapisit A, Petchuay P, Wattanapisit S, Tuangratananon T. Developing a training programme in physical activity counselling for undergraduate medical curricula: a nationwide Delphi study. BMJ Open 2019; 9:e030425. [PMID: 31481372 PMCID: PMC6731937 DOI: 10.1136/bmjopen-2019-030425] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVES To identify the essential content and approaches for developing a training programme in physical activity (PA) counselling for undergraduate medical curricula. DESIGN A three-round Delphi survey was conducted to investigate four key topics: (1) contents of PA counselling in medical education; (2) teaching and learning methods; (3) medical school collaboration and (4) educational policy implementation. Round 1 collected opinions from the participants. Round 2 focused on scoring the opinions. Round 3 summarised the expert opinions. A mean score of 4 or above identified as an important item. SETTING All 23 medical schools in Thailand. PARTICIPANTS Academic staff who were experts or in charge of medical schools in the fields of PA, health promotion or medical education. RESULTS A total of 20 representatives from 18 of the 23 Thai medical schools participated in the study (for a response rate of 78.2%). The top three most important indicators of knowledge were (1) the definition and types of PA (4.75±0.55), (2) the FITT principle (frequency, intensity, time and type) (4.75±0.55) and (3) the benefits of PA (4.65±0.67). The most important component of the training involved general communication skills (4.55±0.60). An extracurricular module (4.05±0.76) was preferable to an intracurricular module (3.95±0.94). Collaborations with medical education centres and teaching hospitals (4.45±0.78) and supporting policies to increase medical students' PA (4.40±0.73) were considered to be important. CONCLUSION Knowledge and counselling skills are important for PA counselling. Building collaborations between medical education and health institutions, as well as implementing effective educational policies, are key approaches to the integration of PA counselling into medical education. Future research should focus on investigating the effects of training in PA counselling on the learning outcomes of medical students and the clinical outcomes of patients.
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Affiliation(s)
- Apichai Wattanapisit
- Department of Clinical Medicine, Walailak University School of Medicine, Thasala, Nakhon Si Thammarat, Thailand
- Family Medicine Clinic, Walailak University Hospital, Thasala, Nakhon Si Thammarat, Thailand
| | - Prachyapan Petchuay
- Department of Clinical Medicine, Walailak University School of Medicine, Thasala, Nakhon Si Thammarat, Thailand
| | | | - Titiporn Tuangratananon
- International Health Policy Program, Thailand, Ministry of Public Health, Muang, Nonthaburi, Thailand
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Feinberg I, Ogrodnick MM, Hendrick RC, Bates K, Johnson K, Wang B. Perception Versus Reality: The Use of Teach Back by Medical Residents. Health Lit Res Pract 2019; 3:e117-e126. [PMID: 31294313 PMCID: PMC6610032 DOI: 10.3928/24748307-20190501-01] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 11/30/2018] [Indexed: 01/05/2023] Open
Abstract
Background: Health care providers (HCPs) may ask patients if they understand their diagnosis or instructions during clinic visits; patients often simply say yes. However, many patients leave with little idea of their medication and discharge instructions. Teach Back (TB) is a patient-centered health-literate technique that allows HCPs to confirm patient understanding during clinic visits. Objective: The purpose of this pilot study was to determine a relationship between perception and actual use of TB by medical residents in primary care outpatient clinics (providers, N = 16; clinic visits, N = 80) and, if the observed rate of TB was discordant with perception, did a TB skills training intervention have any impact on use of TB (clinic visit, N = 78). We were also interested in language used during TB and if use of TB was related to patient demographics or health literacy level. Methods: Medical residents' perception was measured using the “Always Use Teach-Back Confidence and Conviction Scale” (N = 16). Clinic visits were audiotaped and scored for use of TB (pre-intervention, N = 80; post-intervention, N =78). The intervention was a 1-hour TB skills training course. Content analysis was performed to understand the use of TB language. Key Results: Despite the high level of confidence/conviction about TB (r[16] = .669, p <. 05) TB was only used twice out of 80 visits during pre-intervention clinic visits. During post-intervention, use of TB increased to 41 times by 10 residents (c2[1, N = 16] = 6.533, p <. 05). TB language after the intervention was more collaborative; there was a relationship between gender and use of TB. Conclusion: Results from our pilot study identified three important observations that may be critical to improving health-literate physician communication: residents believe they are using TB in the clinic for many patients; use of TB was discordantly low at 2.5%; and a single 1-hour skills training intervention dramatically increased TB use to 53%. Residents used patient-centered TB language after the training intervention. [HLRP: Health Literacy Research and Practice. 2019;3(2):e117–e126.] Plain Language Summary: Medical residents believe they are using Teach Back to confirm patient understanding in the clinic 60% of the time when they actually used Teach Back only 2.5% of the time. After an educational intervention, they used Teach Back 53% of the time; Teach-Back language was collaborative and patient-centered, and all but two patients confirmed their medication and discharge plan.
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Affiliation(s)
- Iris Feinberg
- Address correspondence to Iris Feinberg, PhD, Adult Literacy Research Center, Georgia State University, One Park Place, Suite 519, Atlanta, GA 30303;
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Muddle L, O'Malley CJ, Stupans I. Learning and teaching of patient-centred communication skills in allied healthcare manual therapy students: A systematic review. INT J OSTEOPATH MED 2019. [DOI: 10.1016/j.ijosm.2019.04.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Marshall S, Kiegaldie D. Opening Editorial: Conversations in health care education. MEDEDPUBLISH 2019; 8:71. [PMID: 38089261 PMCID: PMC10712593 DOI: 10.15694/mep.2019.000071.1] [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: 03/06/2024] Open
Abstract
This article was migrated. The article was marked as recommended. Clinical education happens predominantly via conversations. Conversations between the educator and learner, among learners, between those giving and receiving health care and even among educators striving to improve in their teaching. Sometimes these conversations may be difficult, with troublesome feedback and hard lessons to learn, sometimes they are unstructured and messy. Almost always, more dialogue is needed. This theme coincides with the 8 th International Clinical Skills Conference in Prato, Italy. The conference has a history of starting conversations among researchers, educators and clinicians and the theme for the conference coincides with the theme for this issue. This pairing of a conference with a post publication peer review journal has not to our knowledge been previously attempted. This format gives a unique opportunity to provide a deeper learning from the peer review process. High-quality submissions will be published on the site and presented at the conference. Readers and conference attendees alike will be able to comment on the papers presented. In this way, discussions in person, online and via the traditional publishing route can be brought together to improve the publishing and research process. Indeed, the theme of 'conversations' could not be more apt than in these 'metaconversations' about educational research. We believe that the conversations within the walls and courtyard of the Palazzo Vaj that have influenced so many educational researchers in the past will have a chance to reach a wider audience than just the conference attendees. Some of the types of conversations in clinical skills we will discuss have great importance in the future of clinical education and for developing health professionals with the skills needed for person-centre care. We especially wish to promote articles that highlight work undertaken in Low-Middle Income Countries (LMICs) as these align with the values of the charity that underpins the conference, the International Clinical Skills Foundation (Inc.).
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Denniston C, Molloy EK, Ting CY, Lin QF, Rees CE. Healthcare professionals' perceptions of learning communication in the healthcare workplace: an Australian interview study. BMJ Open 2019; 9:e025445. [PMID: 30782935 PMCID: PMC6377557 DOI: 10.1136/bmjopen-2018-025445] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 10/19/2018] [Accepted: 12/12/2018] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES The literature focuses on teaching communication skills in the 'classroom', with less focus on how such skills are informally learnt in the healthcare workplace. We grouped healthcare work based on the cure:care continuum to explore communication approaches based on work activities. This study asks: 1) How do healthcare professionals believe they learn communication in the workplace? 2) What are the differences (if any) across the 'type of work' as represented by the cure:care continuum? DESIGN This qualitative study used semi-structured individual interviews. SETTING Community care and acute hospitals in Australia (Victoria and New South Wales). PARTICIPANTS Twenty qualified healthcare professionals (medicine n=4, nursing n=3, allied health n=13) from various clinical specialties (eg, acute, rehabilitation, surgery, palliative care) participated. METHODS Data were analysed using framework analysis, which involved the development of a thematic coding framework. Findings were mapped to participants' descriptions of work using the cure:care continuum. RESULTS Three themes were identified that varied across the cure:care continuum: professional discourse-tying communication approaches to work activities; personal identities-the influence of personal identities on healthcare communication and role modelling-the influence of others in the socially bound context of healthcare work. CONCLUSIONS This study highlights the influence of professional, personal and social factors on the learning of healthcare communication in the workplace. Our study illuminates differences in communication practice related to work activities, as conceptualised by the cure:care continuum. The results call for further examination of the 'nature' of work activities and the concomitant influence on developing healthcare communication.
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Affiliation(s)
- Charlotte Denniston
- Monash Centre for Scholarship in Health Education (MCSHE), Monash University, Clayton, Victoria, Australia
- Department of Medical Education, The University of Melbourne, Melbourne, Victoria, Australia
| | - Elizabeth K Molloy
- Department of Medical Education, The University of Melbourne, Melbourne, Victoria, Australia
| | - Chee Yan Ting
- Department of Physiotherapy, Monash University, Clayton, Victoria, Australia
| | - Qi Fei Lin
- Department of Physiotherapy, Monash University, Clayton, Victoria, Australia
| | - Charlotte E Rees
- Monash Centre for Scholarship in Health Education (MCSHE), Monash University, Clayton, Victoria, Australia
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Aires MJ, Gagnayre R, Gross O, Khau CA, Haghighi S, Mercier A, Ruelle Y, Marchand C. The Patient Teacher in General Practice Training: Perspectives of Residents. J Patient Exp 2018; 6:287-295. [PMID: 31853484 PMCID: PMC6908989 DOI: 10.1177/2374373518803630] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: Patient teachers were involved in training general practice residents (GPRs) to strengthen the patient-centered approach. They teach a course on health democracy by themselves and teach in tandem with a physician teacher during reflective practice-based classes (named GEPRIs). We present the GPRs’ representations of patient teacher characteristics and capacities and their perception of how useful patient teachers are to their professional development. Methods: We administered a questionnaire based on a preliminary qualitative study to 124 GPRs. It explored (a) changes in the GPRs’ representations about patient teacher characteristics and capacities with regard to teaching over the first year of the experiment; (b) GPRs’ perception of patient teacher utility to their training and their contribution to developing patient perspective–related competencies. Results: The response rate was 89.5% (111/124). The majority of GPRs agreed with 17 (before) and 21 (after) of the 23 patient teacher characteristics and with 17 (before) and 19 (after) of the 20 capacities. The agreement rate increased, overall, after patient teacher participation. The GPRs found patient teacher useful to their training in 9 of 11 topics (agreement rate 65%-92%). They felt they had developed the 14 patient knowledge–related competencies (agreement rate 62%-93%), and 52% to 75% of the GPRs rated the patient teachers’ contribution to those competencies “high or very high,” depending on the competency. Conclusion: This study demonstrates the specific contribution of patient teachers to university-level medical training in France. The GPRs recognized that patient teachers helped them develop competencies by providing patient-specific content.
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Affiliation(s)
- Marie José Aires
- Health Education and Practices Laboratory (LEPS EA3412), University Paris 13, Sorbonne Paris Cité, Bobigny, France
| | - Rémi Gagnayre
- Health Education and Practices Laboratory (LEPS EA3412), University Paris 13, Sorbonne Paris Cité, Bobigny, France
| | - Olivia Gross
- Health Education and Practices Laboratory (LEPS EA3412), University Paris 13, Sorbonne Paris Cité, Bobigny, France
| | - Cam-Anh Khau
- Department of General Practice, University Paris 13, Sorbonne Paris Cité, Bobigny, France
| | - Sophie Haghighi
- Department of General Practice, University Paris 13, Sorbonne Paris Cité, Bobigny, France
| | - Alain Mercier
- Department of General Practice, University Paris 13, Sorbonne Paris Cité, Bobigny, France
| | - Yannick Ruelle
- Department of General Practice, University Paris 13, Sorbonne Paris Cité, Bobigny, France
| | - Claire Marchand
- Health Education and Practices Laboratory (LEPS EA3412), University Paris 13, Sorbonne Paris Cité, Bobigny, France
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Denniston C, Molloy E, Rees CE. 'I will never ever go back': patients' written narratives of health care communication. MEDICAL EDUCATION 2018; 52:757-771. [PMID: 29879300 DOI: 10.1111/medu.13612] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 02/08/2018] [Accepted: 03/26/2018] [Indexed: 06/08/2023]
Abstract
CONTEXT Although communication with patients is essential to health care, education designed to develop patient-centred communication often ignores patients' voices. Patient stories may offer a means to explore patient experiences to inform patient-centred communication skills education design. OBJECTIVES Our research questions were: (i) What are the features of patients' health care communication narratives? (ii) What differences exist between patient narratives evaluated as positive and those evaluated as negative? (iii) How do patients narrate emotion in their narratives? METHODS This interpretivist research was underpinned by social constructionism. We employed a narrative approach to design an online questionnaire that was advertised to patients in the community. Analysis of the stories that were generated involved analysis of what was written (i.e. framework analysis) and of how it was written (i.e. attending to linguistic features). RESULTS Participants shared 180 written narratives about previous health care professional (HCP) communication interactions. Narratives commonly included those of female patients seeking help for musculoskeletal or psychological concerns, which most frequently had occurred within the previous 6 months with male general practitioners in community settings. Framework analysis revealed four key themes: (i) patient actions during consultations; (ii) patient actions afterwards; (iii) lasting legacy, and (iv) interpersonal factors. Patients in narratives evaluated as positive actively engaged during and after interactions, had ongoing positive relationships with HCPs and felt valued in these relationships. Patients in narratives evaluated as negative were either passive or active during the interaction, but mostly failed to return to the HCP and felt devalued in their interaction. Further analysis of the linguistic features of select narratives revealed rich constructions of positive and negative emotions emphasising the lasting legacies of these interactions. CONCLUSIONS Analysis of patient narratives provides a detailed way of exploring patients' experiences, emotions and behaviours during and after consultations. Educational implications include emphasising the importance of valuing the patient, and of seeking and acting on patient feedback to calibrate HCPs' patient-centred communication practices.
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Affiliation(s)
- Charlotte Denniston
- Monash Centre for Scholarship in Health Education (MCSHE), Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
- Department of Medical Education, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Elizabeth Molloy
- Department of Medical Education, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Charlotte E Rees
- Monash Centre for Scholarship in Health Education (MCSHE), Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
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Bogetz AL. How Residents Learn From Patient Feedback: A Multi-Institutional Qualitative Study of Pediatrics Residents' Perspectives. J Grad Med Educ 2018; 10:176-184. [PMID: 29686757 PMCID: PMC5901797 DOI: 10.4300/jgme-d-17-00447.1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 10/16/2017] [Accepted: 12/13/2017] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Residents may view feedback from patients and their families with greater skepticism than feedback from supervisors and peers. While discussing patient and family feedback with faculty may improve residents' acceptance of feedback and learning, specific strategies have not been identified. OBJECTIVE We explored pediatrics residents' perspectives of patient feedback and identified strategies that promote residents' reflection on and learning from feedback. METHODS In this multi-institutional, qualitative study conducted in June and July 2016, we conducted focus groups with a purposive sample of pediatrics residents after their participation in a randomized controlled trial in which they received written patient feedback and either discussed it with faculty or reviewed it independently. Focus group transcripts were audiorecorded, transcribed, and analyzed for themes using the constant comparative approach associated with grounded theory. RESULTS Thirty-six of 92 (39%) residents participated in 7 focus groups. Four themes emerged: (1) residents valued patient feedback but felt it may lack the specificity they desire; (2) discussing feedback with a trusted faculty member was helpful for self-reflection; (3) residents identified 5 strategies faculty used to facilitate their openness to and acceptance of patient feedback (eg, help resident overcome emotional responses to feedback and situate feedback in the context of lifelong learning); and (4) residents' perceptions of feedback credibility improved when faculty observed patient encounters and solicited feedback on the resident's behalf prior to discussions. CONCLUSIONS Discussing patient feedback with faculty provided important scaffolding to enhance residents' openness to and reflection on patient feedback.
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de Bere SR, Baines R. Developing measures for assessment of patient-centred communication: a case of the tail wagging the dog? MEDICAL EDUCATION 2017; 51:1092-1094. [PMID: 29024153 DOI: 10.1111/medu.13458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Tai S, Barr C, Woodward-Kron R. Competing agendas and other tensions in developing patient-centred communication in audiology education: a qualitative study of educator perspectives. Int J Audiol 2017; 57:274-282. [DOI: 10.1080/14992027.2017.1385863] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Samantha Tai
- The HEARing Cooperative Research Centre, Carlton, Victoria, Australia,
- Department of Audiology and Speech Pathology, The University of Melbourne, Melbourne, Victoria, Australia, and
| | - Caitlin Barr
- The HEARing Cooperative Research Centre, Carlton, Victoria, Australia,
- Department of Audiology and Speech Pathology, The University of Melbourne, Melbourne, Victoria, Australia, and
| | - Robyn Woodward-Kron
- Department of Medical Education, The University of Melbourne, Melbourne, Victoria, Australia
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