A physician communication coaching program: Developing a supportive culture of feedback to sustain and reinvigorate faculty physicians.

Abstract

Physician-patient communication involves complex skills that affect quality, outcome, and satisfaction for patients, families, and health care teams. Yet, institutional, regulatory, and scientific demands compete for physicians' attention. A framework is needed to support physicians continued development of communication skills: Coaching is 1 such evidence-based practice, and we assessed the feasibility of implementing such a program. Method: Participants were 12 physicians, representing high and low scorers on the Hospital Consumer Assessment of Health Care Providers and Systems (HCAHPS) survey. We added items to capture empathy and family experience to the CalgaryϪCambridge Observation Guide for the Medical Interview. Coaches observed communication associated with patient satisfaction and quality measures: introductions (I), asking about concerns (C), and check for understanding (U), or ICU. Participants received a report describing their communication behaviors, emphasizing strengths, and identifying areas for improvement. Results: Scores on the ICU significantly discriminated between low and high HCAHPS scorers, physicians from surgical and cognitive specialties, men and women. We collected anonymous feedback regarding the value of this training; participants recommended expanding the program. Discussion: Based on physician endorsement, experienced coaches are expanding the coaching program to physicians throughout our institution. Public Significance StatementThe patient-physician relationship depends on a foundation of effective communication skills by physicians. One-to-one coaching helps physicians recognize patterns in their communication style that can be enhanced to promote improved

Trauma‐informed primary care for medical residents

“…Lastly, the curriculum provided an opportunity for live observation and individualised feedback regarding patient interactions. Though most trainees declined observation and feedback, perhaps due to a concern about the evaluative nature of the observation, the use of direct observation can be a powerful tool in improving patient‐centred care, improving physician communication, strengthening biopsychosocial approaches to care, and reducing burnout, all of which are highly relevant in a trauma‐informed care domain.…”

Physician Communication Coaching: How Psychologists can Elevate Skills and Support Resident Education, Professionalism, and Well-being

“…A pilot study focused on three skills associated with patient satisfaction and quality measures: Introduce yourself; elicit patient/family Concerns; and check for patient/family Understanding (or “ICU”). Results revealed differences in how high and low Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHP) scorers communicated with their patients on “ICU” behaviors (McDaniel et al, 2020 ). The program grew rapidly.…”

Coaching patients to be active, informed partners in their health.

“…An alternative paradigm is the philosophy of health coaching. While McDaniel et al (2020) describe coaching physicians, the new paradigm involves coaching patients. Health coaching can be summed up in the adage: "Give a man a fish and you feed him for a day.…”

“…In this issue, the article “A Physician Communication Coaching Program,” by McDaniel and colleagues (McDaniel, DeCaporale-Ryan, & Fogarty, 2020), addresses this untenable situation through the coaching of physicians as part of continuing medical education. The coaching program hopes to explode the traditional paradigm of physician–patient interaction.…”

“…Health coaching as taught at my medical school, University of California, San Francisco (UCSF), includes at least six modules: (a) ask-tell-ask rather than tell-tell-tell, (b) agenda setting, (c) teachback, (d) “knowing your numbers” (i.e., what is your A1c number, what is your A1c goal, how do you get from your number to your goal), (e) medication adherence counseling, and (f) behavior change action plans (Center for Excellence in Primary Care, 2015). These modules overlap with the three communication behaviors that are the subject of the article by McDaniel et al (2020)—introduce yourself, elicit patient concerns, and check for patient understanding (teachback). Let us focus on teachback, the behavior least adopted by physician participants in McDaniel et al’s pilot study—only 23%.…”