Behaviorally Defined Patient-Centered Communication—A Narrative Review of the Literature

Smith, Robert C.; Dwamena, Francesca C.; Grover, Madhusudan; Coffey, John; Frankel, Richard M.

doi:10.1007/s11606-010-1496-5

Cited by 62 publications

(38 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The field of physician-patient communication has come a long way since the pioneering work of Korsch et al, 33 Lipkin et al, 11 Stiles et al, 34 Kaplan et al, 54 Roter et al, 42 and 25 Epstein and Street, 31 McCormack et al, 61 and Smith et al 88 Francis et al 47 The scope of communication skills important for successful clinical encounters has been broadened and better defined. 103 It has been demonstrated that these behaviors can be taught, and strategies for both instruction and assessment are developing.…”

Section: Resultsmentioning

confidence: 99%

“…A focus on these discipline-specific needs for physician-patient communication is likely to emerge from the ACGME Milestone Project, currently being implemented in 7 specialties that entered the Next Accreditation System on July 1, 2013 (emergency medicine, internal medicine, neurological surgery, orthopedic surgery, pediatrics, diagnostic radiology, and urology). 101 A best practice approach allows us to move forward, while acknowledging-as have de Haes and Bensing 80 and Smith et al 88 -that the evidence base underlying the efficacy of patient-centered communication is underdeveloped. Issues, such as inadequate conceptual grounding, small sample sizes, varying definitions and assessment methods, and inconsistent results, have been noted by various investigators.…”

Section: Discussionmentioning

confidence: 99%

“…61,[81][82][83][84][85][86][87][88] Similar lists can be derived from consideration of instruments used to assess communication skills. 89 It is possible to create an amalgam of these skills, which can be considered as a best practice for communication in medical encounters (T A B L E 3).…”

Section: Patient Views Of Physician-patient Communicationmentioning

confidence: 99%

“…A true evidence base for communication will articulate ''the hypothesized relationship between specified communication functions and elements and concrete endpoints (including the assumed mechanism and pathways).'' 80(p293) Smith and colleagues 88 agree that better-described, behaviorally defined skills are a critical next step in advancing the field.…”

Section: Patient Views Of Physician-patient Communicationmentioning

confidence: 99%

See 3 more Smart Citations

“Best Practice” for Patient-Centered Communication: A Narrative Review

King¹,

Hoppe²

2013

Journal of Graduate Medical Education

437

310

View full text Add to dashboard Cite

Background Communicating with patients has long been identified as an important physician competency. More recently, there is a growing consensus regarding the components that define physician-patient communication. There continues to be emphasis on both the need to teach and to assess the communication skills of physicians. Objective This narrative review aims to summarize the work that has been conducted in physician-patient communication that supports the efficacy of good communications skills. This work may also help to define the physician-patient communication skills that need to be taught and assessed. Results A review of the literature shows it contains impressive evidence supporting positive associations between physician communication behaviors and positive patient outcomes, such as patient recall, patient understanding, and patient adherence to therapy. There is a consensus about what constitutes “best practice” for physician communication in medical encounters: (1) fostering the relationship, (2) gathering information, (3) providing information, (4) making decisions, (5) responding to emotions, and (6) enabling disease- and treatment-related behavior. Conclusions Evidence supports the importance of communication skills as a dimension of physician competence. Effort to enhance teaching of communication skills to medical trainees likely will require significant changes in instruction at undergraduate and graduate levels, as well as changes in assessing the developing communication skills of physicians. An added critical dimension is faculty understanding of the importance of communication skills, and their commitment to helping trainees develop those skills.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Patient Views Of Physician-patient Communicationmentioning

confidence: 99%

Section: Patient Views Of Physician-patient Communicationmentioning

confidence: 99%

See 2 more Smart Citations

“Best Practice” for Patient-Centered Communication: A Narrative Review

King¹,

Hoppe²

2013

Journal of Graduate Medical Education

437

310

View full text Add to dashboard Cite

show abstract

“…The lack of a correlation has been attributed to variability in how the concept is defined and measured. 3,4 Studies comparing various measures of PCC show poor correlations among them. Hence, although PCC is highly valued, there remains a gap between the anticipated and demonstrated benefit of PCC on health care quality.…”

Section: Introductionmentioning

confidence: 99%

Unannounced Standardized Patient Assessment of the Roter Interaction Analysis System: The Challenge of Measuring Patient-Centered Communication

et al. 2012

View full text Add to dashboard Cite

BACKGROUND: Despite wide-spread endorsement of patient-centered communication (PCC) in health care, there has been little evidence that it leads to positive change in health outcomes. The lack of correlation may be due either to an overestimation of the value of PCC or to a measurement problem. If PCC measures do not capture elements of the interaction that determine whether the resulting care plan is patient-centered, they will confound efforts to link PCC to outcomes. OBJECTIVE: To evaluate whether one widely used measure of PCC, the Roter Interaction Analysis System (RIAS), captures patient-centered care planning. DESIGN: RIAS was employed in the coding of unannounced standardized patient (USP) encounters that were scripted so that the failure to address patient contextual factors would result in an ineffective plan of care. The design enabled an assessment of whether RIAS can differentiate between communication behavior that does and does not result in a care plan that takes into account a patient's circumstances and needs. PARTICIPANTS: Eight actors role playing four scripted cases (one African American and one Caucasian for each case) in 399 visits to 111 internal medicine attending physicians. MAIN MEASURES: RIAS measures included composites for physician utterance types and (in separate models) two different previously applied RIAS patientcenteredness summary composites. The gold standard comparison measure was whether the physician's treatment plan, as abstracted from the visit note, successfully addressed the patient's problem. Mixed effects regression models were used to evaluate the relationship between RIAS measures and USP measured performance, controlling for a variety of design features. KEY RESULTS: None of the RIAS measures of PCC differentiated encounters in which care planning was patient-centered from care planning in which it was not. CONCLUSIONS: RIAS, which codes each utterance during a visit into mutually exclusive and exhaustive categories, does not differentiate between conversations leading to and not leading to care plans that accommodate patients' circumstances and needs.

show abstract

Patients as Observers and Reporters in Support of Systems and Patient Safety

Pichert

Hickson

2014

Pediatric and Congenital Cardiac Care

View full text Add to dashboard Cite

Behaviorally Defined Patient-Centered Communication—A Narrative Review of the Literature

Cited by 62 publications

References 39 publications

“Best Practice” for Patient-Centered Communication: A Narrative Review

“Best Practice” for Patient-Centered Communication: A Narrative Review

Unannounced Standardized Patient Assessment of the Roter Interaction Analysis System: The Challenge of Measuring Patient-Centered Communication

Patients as Observers and Reporters in Support of Systems and Patient Safety

Contact Info

Product

Resources

About