Physician and patient communication training in primary care: Effects on participation and satisfaction.

Abstract

Objective: To assess the effects of a communication skills training program for physicians and patients. Design: A randomized experiment to improve physician communication skills was assessed 1 and 6 months after a training intervention; patient training to be active participants was assessed after 1 month. Across three primary medical care settings, 156 physicians treating 2,196 patients were randomly assigned to control group or one of three conditions (physician, patient, or both trained). Main Outcome Measures: Patient satisfaction and perceptions of choice, decision-making, information, and lifestyle counseling; physicians' satisfaction and stress; and global ratings of the communication process. Results:The following significant ( p Ͻ .05) effects emerged: physician training improved patients' satisfaction with information and overall care; increased willingness to recommend the physician; increased physicians' counseling (as reported by patients) about weight loss, exercise, and quitting smoking and alcohol; increased physician satisfaction with physical exam detail; increased independent ratings of physicians' sensitive, connected communication with their patients, and decreased physician satisfaction with interpersonal aspects of professional life. Patient training improved physicians' satisfaction with data collection; if only physician or patient was trained, physician stress increased and physician satisfaction decreased. Conclusion: Implications for improving physician-patient relationship outcomes through communication skills training are discussed.

Patient perspectives regarding communication about prognosis and end-of-life issues: How can it be optimised?

“…Many of the doctor and patient skills and relationship elements identified by participants in this study have been previously described and incorporated into systematic training programs [30] and best practice guidelines [31], though few interventions have addressed systematic communication skills training of patients [32]. Patient proactivity, here identified as assertiveness and persistence in raising challenging or complex issues and communicating needs, has been highlighted as important in promoting better control of pain and symptoms and general care [33] and more effective and efficient information seeking and patient controlled communication [34].…”

The relationship between physician humility, physician–patient communication, and patient health

“…Effective physician-patient communication, in turn, is associated with improved patient outcomes, including greater adherence to treatment regimens [10] and better subjective (i.e., patient-reports of overall health) and objective (e.g., physical signs) health [15,16]. An experimental study found that physician communication training increased patients' satisfaction with their physicians and promoted discussions of health-promoting behaviors [17]; this improvement in physician communication may in turn promote better patient health outcomes.…”

“…The data included in this study were collected from 1996 to 1998 as part of a larger study on physician and patient communication training (for more information, see [17]). Although the larger study included experimental training conditions for both physicians and patients, this study only examined baseline data collected before participants received training.…”

Communication between health professionals and patients: review of studies using the RIAS (Roter Interaction Analysis System) method

“…• The perception of respect by the participants in the consultations; 8,13 • The changes of the communication characteristics over time (longitudinal studies); 14,15 • The impact of training actions on patients and physicians; 9,11,22,23,28,33 • The reaction of simulated patients; 3,27,[29][30][31] • Burnout, 16,17 overwork, 18 tiredness 24 or clinical malpractice; 10 • The identification of conflicts 12,36 • The primary results (e.g satisfaction and the intention to adhere to treatment by the patient), secondary results (e.g changes in the way the patient approaches their health problems) 26 and treatment decisions; 32,35 • The use of technical terms 7 and informed consent (in clinical trials); 25,34,44 • The approach to matters of a psychosocial nature; 19,45 • Intercultural differences. 20 The involvement of various countries and continents 2,20,15,38 in the studies selected confirm the relevance of this methodology, but potential generalization of the conclusions is limited, given the differences in professional practice and context, from the training of the professionals up to the sociocultural characteristics of the populations.…”

“…8,9 To fully interpret these last categories of RIAS codes it is also important to evaluate the nonverbal components, such as intonation, words and type of voice used by speakers. 10,41 The literature describes various mathematical relationships between different RIAS coding units, using formulas that result in composite variables or even constructs that describe linguistic and behavioral structures of the communication, such as patient-centeredness.…”