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

King, Ann; Hoppe, Ruth B.

doi:10.4300/jgme-d-13-00072.1

Cited by 437 publications

(337 citation statements)

References 87 publications

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“…Interaction and communication between patient and doctor in clinical encounters are integral to how health services work (King & Hoppe, 2013). Strong and collaborative doctor-patient partnerships can mitigate the challenges brought by the lack of clarity, and thereby reduce detrimental effects of medical uncertainty (Kornelsen et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

“It´s incredible how much I´ve had to fight.” Negotiating medical uncertainty in clinical encounters

Lian

Robson

2017

International Journal of Qualitative Studies on Health and Well

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Purpose: Clinical encounters related to medically unexplained physical symptoms (MUPS) are associated with high levels of conflict between patients and doctors. Collaborative difficulties are fused by the medical uncertainty that dominates these consultations. The main aim of this study is to explore the interactional dynamics of clinical encounters riddled by medical uncertainty, as experienced by people living with long-term medically unexplained fatigue in Norway. Method: A qualitative thematic analysis of written texts from 256 study participants. Results: We found that patients experience being met with disbelief, inappropriate psychological explanations, marginalisation of experiences, disrespectful treatment, lack of physical examination and damaging health advice. The main source of their discontent is not the lack of biomedical knowledge, but doctors who fail to communicate acknowledgement of patients’ experiences, knowledge and autonomy. War metaphors are emblematic of how participants describe their medical encounters. The overarching storyline depicts experiences of being caught in a power struggle with doctors and health systems, fused by a lack of common conceptual ground. Conclusion: When physical symptoms cannot be detected, explained and managed by biomedical knowledge and technology, good doctor-patient partnerships are crucial. Without clearly acknowledging patients’ perspectives and capabilities in clinical practice, such partnerships cannot be achieved.

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Section: Introductionmentioning

confidence: 99%

“It´s incredible how much I´ve had to fight.” Negotiating medical uncertainty in clinical encounters

Lian

Robson

2017

International Journal of Qualitative Studies on Health and Well

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“…Another way to improve physician-patient communication is to enhance the teaching of communication skills during undergraduate medical education [2]. This is particularly important, as studies have shown that students become more cynical and less empathetic during medical school [23].…”

Section: Making a Change: Methods To Improve Communication With Patientsmentioning

confidence: 99%

“…Although communication is recognized as an important physician competency, physicians are not well trained to communicate effectively [2]. Additionally, physicians' position of authority in the physician-patient relationship may intimidate some patients, rendering them overly deferential or susceptible to undue influence in health care decision making.…”

Section: Introductionmentioning

confidence: 99%

Strategies for Acing the Fundamentals and Mitigating Legal and Ethical Consequences of Poor Physician-Patient Communication

Brueck¹,

Salib

2017

AMA Journal of Ethics

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This article explores how the absence of effective verbal and nonverbal communication in the physician-patient encounter can lead to poor outcomes for patients and physicians alike. The article discusses legal and ethical topics physicians should consider during a medical encounter and provides educational and practical suggestions for improving effective communication between physicians and their patients. IntroductionConsider the hypothetical case of a young university student, Patient Johnson, who enters the doctor's office experiencing frequent headaches and anxiety. After checking in and waiting in the main office, Johnson is greeted by a nurse and taken back to an exam room, where she anxiously sits and waits for 20 minutes for the physician to arrive. Dr. Smith enters the room, quickly glances at the chart, remains standing, and begins asking a series of general questions using a slew of medical terminology-particularly psychological and neurological vocabulary-when responding to Johnson's concerns about headaches. While Dr. Smith does not appear concerned, the use of unfamiliar terms leaves Johnson uneasy and unclear about her current health status.

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“…Nearly half of all adults in the United States over 50 have significant hearing loss 8,9 that can lead to problems understanding spoken discourse even under quiet listening conditions. 9 Like closed captioning on television, speech-to-text devices can be used to improve comprehension of everyday conversations by the hearing impaired.…”

Section: Introductionmentioning

confidence: 99%

Real-Time Captioning for Improving Informed Consent

Spehar

Tye‐Murray

Myerson

et al. 2016

Regional Anesthesia and Pain Medicine

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Better methods are needed to improve physicians’ skill in communicating information and to enhance patients’ ability to recall that information. We evaluated a real-time speech-to-text captioning system to aid hearing-impaired patients that simultaneously provided a speech-to-text record for both patient and anesthesiologist. The goals of the study were to assess patient’s recall of an informed consent discussion about regional anesthesia using real-time captioning and to determine whether the physicians found the system useful for monitoring their own performance. Methods We recorded two simulated informed consent encounters with hearing-impaired older adults in which physicians provided descriptions of regional anesthetic procedures. The conversations were conducted with and without real-time captioning. Afterwards, the patient-participants, who wore their hearing aids throughout, were tested on the material presented and video recordings of the encounters were analyzed to determine how effectively physicians communicated with and without the captioning system. Results The anesthesiology residents provided similar information to the patient-participants regardless of whether the real-time captioning system was used. Although the patients retained relatively few details regardless of the informed consent discussio, they could recall significantly more of the key points when provided with real time captioning. Conclusions Real-time speech-to-text captioning improved recall in hearing-impaired patients and proved useful for determining the information provided during an informed consent encounter. Real-time speech-to-text captioning could provide a method for assessing physicians’ communication that could be used both for self-assessment and as an evaluative approach to training communication skills in practice settings.

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

Cited by 437 publications

References 87 publications

“It´s incredible how much I´ve had to fight.” Negotiating medical uncertainty in clinical encounters

“It´s incredible how much I´ve had to fight.” Negotiating medical uncertainty in clinical encounters

Strategies for Acing the Fundamentals and Mitigating Legal and Ethical Consequences of Poor Physician-Patient Communication

Real-Time Captioning for Improving Informed Consent

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