Enduring impact of communication skills training: results of a 12-month follow-up

Abstract

The efficacy of a communication skills training programme was shown through a randomised trial. Oncologists (N ¼ 160) from 34 cancer centres were allocated to written feedback plus course; course alone; written feedback alone or control. Each clinician had 6 -10 interviews with patients videotaped at baseline and 3 months postintervention. Analysis of videotapes revealed improvements in the communication skills of clinicians randomised to training (n ¼ 80) compared with others (n ¼ 80). A 12-month follow-up assessment is reported here. Robust Poisson conditional analyses of counts of changes in communication behaviours revealed no demonstrable attrition in those who had shown improvement previously, including fewer leading questions, appropriate use of focused and open-ended questions and responses to patient cues. Additional skills, not apparent at 3 months, were now evident; the estimated effect sizes corresponded to 81% fewer interruptions (P ¼ 0.001) and increased summarising of information to 38% (P ¼ 0.038). However, expressions of empathy (54%, P ¼ 0.001) declined. The overall results show that 12 -15 months postintervention, clinicians had integrated key communication skills into clinical practice and were applying others. This is the first RCT to show an enduring effect of communication skills training with transfer into the clinic.

A Qualitative Study of Oncologists' Approaches to End-of-Life Care

“…If physicians who use a process-oriented approach to communication are found to have decreased burnout and increased job satisfaction and retention, a communication intervention targeting physicians early in their careers may be beneficial. 24,25 It is possible that providing communication training to physicians early in training (e.g., oncology fellows) may not only improve patient care, but also may improve job satisfaction and job retention among oncology junior faculty.…”

Enhancing Pediatric Mental Health Care: Algorithms for Primary Care

“…Considerable evidence suggests that medical generalists can readily learn and retain these techniques. [12][13][14] Note that the use of multiple, brief visits (in contrast with the 45-to 60-minute visits common in mental health specialty practice) will often be necessary to address a child's mental health concerns in a busy primary care practice. Experienced primary care clinicians can readily acquire skills in bringing a visit to an efficient close and increasing the likelihood that youth and families will continue in care.…”

Physician-patient communication among Southern European cancer physicians: The influence of psychosocial orientation and burnout

“…Several programs have been developed with the aims of training doctors in interviewing techniques, in providing patients with the opportunity to express feelings and emotions, in eliciting patients' concerns and problems, and in assessing possible symptoms of psychosocial distress (Back et al, 2003;Baile et al, 1999;Fallowfield et al, 1998Fallowfield et al, , 2003Maguire et al, 1996;Parle et al, 1997;Razavi et al, 2000Razavi et al, , 2003. It is widely acknowledged that learning communication skills and applying them in routine clinical practice with cancer patients requires a significant shift from a traditional biomedical paternalistic perspective to a more patient-centered biopsychosocial approach.…”