Communication between physicians and patients has a great influence on patient adherence, patient satisfaction and the success of treatment. In this context, patient centered care and emotional support have a high positive impact; however, it is unclear how physicians can be motivated to communicate with patients in an appreciative and empathetic way. The implementation of such behavior requires a multitude of communicative skills. One of them is active listening, which is very important in two respects. On the one hand active listening provides the basis for several conversational contexts as a special communication technique and on the other hand active listening is presented in current textbooks in different ways: as an attitude or as a technique. In light of this, the question arises how active listening should be taught in order to be not only applicable in concrete conversations but also to lead to the highest possible level of patient satisfaction. The aim of this pilot study was to examine some variations in simulated doctor-patient conversations, which are the result of the different approaches to active listening. For this purpose three groups of first semester medical students were recruited, two of which were schooled in active listening in different ways (two groups of six students), i.e. attitude versus technique oriented. The third group (seven students) acted as the control group. In a pre-post design interviews with standardized simulation patients were conducted and subsequently evaluated. The analysis of these interviews was considered from the perspectives of participants and observers as well as the quantitative aspects. This study revealed some interesting tendencies despite its status as a pilot study: in general, the two interventional groups performed significantly better than the control group in which no relevant changes occurred. In a direct comparison, the group in which active listening was taught from an attitude approach achieved better results than the group in which the focus was on the technical aspects of active listening. In the group with active listening schooled as an attitude, the response to the feelings of the standardized simulation patients was significantly better from the perspectives of both participants and observers.
Objective Student evaluation of a communication‐education programme that combined patient consultation videos with peer‐ or expert‐based feedback. Methods A self‐perception questionnaire was given to undergraduate dental students who had undertaken a curricular communication training and feedback programme, in which each participant was videoed three times during a patient interview or consultation, subsequently receiving either peer (PG) or expert feedback (EG). The questionnaire used feedback programme content to evaluate student perspectives, ascertaining whether the students experienced a gain in knowledge and professional conversational skills, whether videos or feedback helped them improve more and general questions about the structure and content of the curriculum. Differences between feedback groups were analysed (Mann‐Whitney U test). Results 45 participants (peer group: n = 23, expert group: n = 22) took part in the study. The peer group experienced watching their video (38%) and receiving feedback (33%) as their major beneficial aspect to improve communication skills (watching fellow student´s video: 17%, providing feedback: 12%). The expert group experienced the major effect in receiving expert feedback (73%, video watching: 27%). The students said that communication skills should be a core competency in dental education learning outcomes (PG: 4.48 ± 0.67, EG: 4.41 ± 0.67; P > 0.05) and that communication curricula should include video‐based feedback (PG: 3.91 ± 0.73, EG: 4.00 ± 0.93; P > 0.05). Conclusion Watching videos and both receiving and providing peer group feedback were experienced as helpful in improving students’ communication skills. These findings suggest that a longitudinal communication curriculum, which includes both video‐based peer feedback and correlated self‐reflection, is a promising learning approach for dental education.
Shared decision making (SDM) has been investigated in numerous research projects. In 2001 the German Ministry of Health initiated a research program on patients as partners in medical decision making ("Der Patient als Partner im medizinischen Entscheidungsprozess"). In this context a large number of studies has been conducted on SDM. In this review the concept of SDM and the use of this term in scientific publications of German study groups is explored. A systematic literature review generated 147 publications on SDM by German researchers, which had been published between 2000 and 2009. The majority of publications identified in this study refer to clinical studies on patients with chronic diseases. Content analysis of the retrieved publications indicates that SDM as a term is used heterogeneously. There is only little research on the theoretical foundations and ethical implications of SDM. In addition to existent Anglo-Saxon definitions of SDM, new concepts of SDM such as involvement of relatives in the process of decision making were identified as part of this review of the German literature. There is only a limited number of empirical studies with a consistent approach towards a definition of SDM and the respective measurements. Against this background, the "SDM questionnaire", which had been developed as part of the German Ministry of Health's research programme, is an important contribution with respect to operationalising SDM and testing possible effects of SDM in clinical practice.
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