Objective To determine the efficacy and effectiveness of training to improve primary care providers’ patient-centered communication skills and proficiency in discussing their patients’ health risks. Methods Twenty-eight primary care providers participated in a baseline simulated-patient interaction and were subsequently randomized into intervention and control groups. Intervention providers participated in training focused on patient-centered communication about behavioral risk factors. Immediate efficacy of training was evaluated by comparing the two groups. Over the next three years, all providers participated in two more sets of interactions with patients. Longer term effectiveness was assessed using the interaction data collected at 6 and 18 months post training. Results The intervention providers significantly improved in patient-centered communication and communication proficiencies immediately post-training and at both follow-up time points. Conclusions This study suggests that the brief training produced significant and large differences in the intervention group providers which persisted two years after the training. Practice Implications The results of this study suggest that primary care providers can be trained to achieve and maintain gains in patient-centered communication, communication skills and discussion of adverse childhood events as root causes of chronic disease.
Introduction: Mentors are in short supply at academic health centers (AHC). The effectiveness of training mentors (without preselection for their research skills) to support faculty mentees in scholarly activities at AHCs is not well known. Methods: The University of New Mexico Health Sciences Center has a two-component program to develop effective mentors for scholarship for faculty mentees. It has an online component supplemented by an optional face-to-face (F2F) component. Study outcomes included changes in self-reported knowledge scores for online users and Mentoring Competency Assessment (MCA) scores for F2F users. Results: 105 mentors, mostly women associate professors, used the online program. Online users demonstrated improvement in self-reported knowledge scores. 38 users additionally completed the F2F program-63% on a clinician-educator track and none with a National Institutes of Healthfunded K-award mentee. The self-reported MCA composite score rose from 4.3 ± 1.0 to 5.5 ± 0.8 (paired t=7.37, df=37, p<0.001) for the F2F participants, with similar improvement noted in the clinician-educator subgroup. Discussion: Users of the online and F2F components of the program improved their selfassessed knowledge and mentoring skill respectively, demonstrating the effectiveness of the program. Such programs may help AHCs enhance the scholarship and the diversity of their scientific and clinician-educator workforce.
This exercise has given the faculty a detailed view of baseline clinical and written documentation skills of our entering interns. Overall, the residents demonstrated at least minimal competency in history taking and communication skills, but not in performing the expected focused physical exam. Their written reports showed adequate documentation of historical items but not of pertinent physical findings. The interns did not consistently make a problem list, provide a differential diagnosis, or show clinical reasoning despite being instructed to do so. There was great variation in performances between interns. Analysis of the interns' evaluations of this exercise showed that they felt it covered appropriate material, and they felt sufficiently prepared. Several interns had never done an OSCE prior to this exam. Written comments were positive about getting structured feedback early in their training. This format has allowed the identification of specific deficiencies in clinical skills for each of our interns, and this information will be used to guide our clinic preceptors in their teaching and in future evaluations. It would be ideal to design a second OSCE based on cases specific to internal medicine for the third-year residents, and compare skills developed over time.
Purpose This study explored cancer survivors' experiences of participation in a wearable intervention and the dimensions that influenced intervention engagement and physical activity behaviour change. Methods Semi-structured interviews (n = 23) were conducted with intervention participants (mean age 65.8 (SD ± 7.1) and analysed using thematic analysis. Results Four main themes were identified; (i) Commitment, (ii) Accountability and monitoring, (iii) Routine (iv) Fitbit as health coach. Those that assigned a higher priority to PA were more likely to schedule PA and be successful in PA change. Those less successful presented more barriers to change and engaged in more incidental PA. The Fitbit acting as health coach was the active ingredient of the intervention. Conclusions Commitment evidenced through prioritising PA was the foundational dimension that influenced PA engagement. Interventions that foster commitment to PA through increasing the value and importance of PA would be worthwhile. Wearables holds great promise in PA promotion and harnessing the technique of discrepancy between behaviour and goals is likely a valuable behaviour change technique.
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