Post-graduate education for medical specialists focused on patients with medically unexplained physical symptoms; development of a communication skills training programme

Weiland, Anne; Blankenstein, Annette H.; Willems, Mariëtte H.A.; Saase, Jan L.C.M. van; Molen, Henk T. van der; Dulmen, Sandra van; Arends, Lidia R.

doi:10.1016/j.pec.2013.06.027

Cited by 17 publications

(17 citation statements)

References 30 publications

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“…The MUPS-focused communication skills training for medical specialists and residents consisted of four sessions with intervals of four to six weeks with a total duration of 14 hours; it has been described elsewhere[ 17 ]. The training program consisted of experiential learning, role-play and feedback as crucial elements for learning MUPS-specific communication skills.…”

Section: Methodsmentioning

confidence: 99%

“…Furthermore, the majority of MUPS research on communication interventions is aimed at primary and mental care. We therefore developed a postgraduate training program for non-psychiatric medical specialists focused on MUPS patients and assessed its effects on their communication skills in a randomized clinical trial[ 17 ]. The study question was: Does MUPS-focused communication training facilitate medical specialists to use effective communication in MUPS consultations more often compared to non-trained medical specialists?…”

Section: Introductionmentioning

confidence: 99%

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Training Medical Specialists to Communicate Better with Patients with Medically Unexplained Physical Symptoms (MUPS). A Randomized, Controlled Trial

et al. 2015

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BackgroundPatients with medically unexplained physical symptoms (MUPS) are prevalent 25–50% in general and specialist care. Medical specialists and residents often find patients without underlying pathology difficult to deal with, whereas patients sometimes don’t feel understood. We developed an evidence-based communication training, aimed to improve specialists’ interviewing, information-giving and planning skills in MUPS consultations, and tested its effectiveness.MethodsThe intervention group in this multi-center randomized controlled trial received a 14-hour training program to which experiential learning and feedback were essential. Using techniques from Cognitive Behavioral Therapy, they were stimulated to seek interrelating factors (symptoms, cognitions, emotions, behavior, and social environment) that reinforced a patient’s symptoms. They were taught to explain MUPS understandably, reassure patients effectively and avoid unnecessary diagnostic testing. Before and after the intervention training, specialists videotaped a total of six consultations with different MUPS patients. These were evaluated to assess doctors’ MUPS-focused communicating skills using an adapted version of the Four Habit Coding Scheme on five-point Likert scales. Participants evaluated the training by self-report on three-point Likert scales. Doctors in the control group received training after completion of the study.Results123 doctors (40% specialists, 60% residents) and 478 MUPS patients from 11 specialties were included; 98 doctors completed the study (80%) and 449 videotaped consultations were assessed. Trained doctors interviewed patients more effectively than untrained ones (p < 0.001), summarized information in a more patient-centered way (p = 0.001), and better explained MUPS and the role of perpetuating factors (p < 0.05). No effects on planning skills were found. On a 3-point scale the training was evaluated with 2.79.ConclusionMUPS-focused communication training increases the interviewing and information-giving skills of medical specialists. We recommend that the training is incorporated in postgraduate education for medical specialists and residents who frequently encounter patients with MUPS.Trial RegistrationDutch Trial Registration NTR2612

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Training Medical Specialists to Communicate Better with Patients with Medically Unexplained Physical Symptoms (MUPS). A Randomized, Controlled Trial

et al. 2015

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“…The MUPS-focused communication skills training for medical specialists and residents consisted of four sessions with a total duration of 14 h; it has been described extensively elsewhere [15]. To summarize: the training was organized in small groups (7 to 12 participants) and provided by two trainers experienced in postgraduate education and MUPS skills for medical specialists.…”

Section: Interventionmentioning

confidence: 99%

“…All the trainers were instructed (by AW and AHB) about the training model. Medical specialists were informed about the Dutch multidisciplinary guideline for MUPS and somatoform disorders and they practiced patient-centered communication [15].…”

Section: Interventionmentioning

confidence: 99%

“…As MUPS can be explained and interpreted in various, sometimes inconsistent ways, it is important for specialists' reply letters to contain valid information that supports GPs and patients in gaining trust, reassurance and effective follow-up care [14]. To improve reply letters regarding MUPS patients, we therefore developed postgraduate training for medical specialists that included communication at the interface between specialist care and primary care [15]. To determine whether this training improved specialists' communication to GPs we measured whether reply letters about referred MUPS patients of trained medical specialists contained more specific information than reply letters of untrained medical specialists.…”

Section: Introductionmentioning

confidence: 99%

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Training specialists to write appropriate reply letters to general practitioners about patients with medically unexplained physical symptoms; A cluster-randomized trial.

Weiland

Blankenstein

Willems

et al. 2015

Patient Education and Counseling

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The effect of a goal-setting strategy with integrated feedback on goal attainment in inflammatory arthritis patients: a mixed method study

Slingerland¹,

Jong²,

Dolhain³

et al. 2023

Rheumatol Int

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Patients with Inflammatory Arthritis (IA) often experience difficulties in daily life as a result of their disease. Unfortunately, outpatient consultations in daily practice tend to focus on medical topics, thereby ignoring the impact of the disease on patients’ daily lives. Patient-Reported Outcomes (PROs) can be used to understand this impact, but they are not enough for offering person-centered care. Because the patient’s true values and goals can only be ascertained during a proper conversation, which should include both medical as well as patient goals. Therefore, the aim of the study is to evaluate the effect of a goal management strategy with integrated feedback on goal attainment and Health-Related Quality of Life(HRQoL) in IA patients. IA patients with an active disease were given the opportunity to set and follow-up goals. In addition to goal setting, patients were asked to complete online questionnaires on various PROs, including HRQoL. Ninety-two IA patients participated in the study. The mean age was 51 years and most of them had rheumatoid arthritis. A total of 302 patient goals were set, of which 32% were achieved. In the entire population, HRQoL did not change over time, but patients who did not meet their goals tended to report a lower HRQoL. Incorporating a feedback mechanism in a goal-setting strategy has a positive effect on goal attainment. Yet no effect was seen on HRQoL, but this may due to the fact that general HRQoL measurement are not sensitive or specific enough to detect changes that are accompanied with goal setting and attainment.

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Post-graduate education for medical specialists focused on patients with medically unexplained physical symptoms; development of a communication skills training programme

Abstract: If the RCT demonstrates sufficient effectiveness and efficiency of the MUPS focused communication skills training programme for medical specialists the intervention could be embedded in post-graduate education of medical specialists and residents.

Cited by 17 publications

References 30 publications

Training Medical Specialists to Communicate Better with Patients with Medically Unexplained Physical Symptoms (MUPS). A Randomized, Controlled Trial

Training Medical Specialists to Communicate Better with Patients with Medically Unexplained Physical Symptoms (MUPS). A Randomized, Controlled Trial

Training specialists to write appropriate reply letters to general practitioners about patients with medically unexplained physical symptoms; A cluster-randomized trial.

The effect of a goal-setting strategy with integrated feedback on goal attainment in inflammatory arthritis patients: a mixed method study

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