Improving Clinician Competency in Communication About Schizophrenia: a Pilot Educational Program for Psychiatry Trainees

Loughland, Carmel; Kelly, Brian; Ditton-Phare, Philippa; Sandhu, Harsimrat; Vamos, Marina; Outram, Sue; Levin, Tomer T.

doi:10.1007/s40596-014-0195-7

Cited by 25 publications

(25 citation statements)

References 17 publications

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“…Gaining insight into the perceptions and experiences of people with schizophrenia about the way a schizophrenia diagnosis is communicated is a key outcome of this research, highlighting the need for a patient-centred approach. The results of this research aim to inform the development of training programmes for mental health practitioners (see Loughland et al, 2014), and improve the clinical practices of healthcare professionals caring for patients with schizophrenia.…”

Section: Resultsmentioning

confidence: 99%

Communication of a schizophrenia diagnosis: A qualitative study of patients’ perspectives

Loughland

Cheng

Harris

et al. 2015

Int J Soc Psychiatry

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Section: Resultsmentioning

confidence: 99%

Communication of a schizophrenia diagnosis: A qualitative study of patients’ perspectives

Loughland

Cheng

Harris

et al. 2015

Int J Soc Psychiatry

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“…Actors rotated around the groups. Each trainee undertook at least two scenarios with feedback from facilitators, peers and actors using Pendleton's rules Increase in communication skills and ability to deal with difficult situations (self-rated) High level of satisfaction with training Themes from qualitative analysis included scenarios, feedback, small groups, self-awareness, educational impact, exams and benefits of simulation Loughland et al (2015) Training in agenda setting, questioning, checking, information organisation and empathy. Two modules, approximately 3 hours each in length.…”

Section: Resultsmentioning

confidence: 99%

“…The current authors (Loughland et al, 2015) conducted a self-report one-group pretest/posttest study. Thirty-eight participants attended the CST; however, the evaluations reported consisted of only 32 participants.…”

Section: Risk Of Bias Within Studiesmentioning

confidence: 99%

Communication skills in the training of psychiatrists: A systematic review of current approaches

Ditton-Phare

Loughland

Duvivier

et al. 2017

Aust N Z J Psychiatry

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Objectives: A range of communication skills training programmes have been developed targeting trainees in various medical specialties, predominantly in oncology but to a lesser extent in psychiatry. Effective communication is fundamental to the assessment and treatment of psychiatric conditions, but there has been less attention to this in clinical practice for psychiatrists in training. This review examines the outcomes of communication skills training interventions in psychiatric specialty training. Methods:The published English-language literature was examined using multiple online databases, grey literature and hand searches. The review was conducted and reported using Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Studies examining the efficacy of communication skills training were included. Randomised controlled trials, pseudo-randomised studies and quasi-experimental studies, as well as observational analytical studies and qualitative studies that met criteria, were selected and critically appraised. No limits were applied for date of publication up until 16 July 2016. Results:Total search results yielded 2574 records. Of these, 12 studies were identified and reviewed. Two were randomised controlled trials and the remaining 10 were one-group pretest/posttest designs or posttest-only designs, including self-report evaluations of communication skills training and objective evaluations of trainee skills. There were no studies with outcomes related to behaviour change or patient outcomes. Two randomised controlled trials reported an improvement in clinician empathy and psychotherapeutic interviewing skills due to specific training protocols focused on those areas. Non-randomised studies showed varying levels of skills gains and self-reported trainee satisfaction ratings with programmes, with the intervention being some form of communication skills training. Conclusion:The heterogeneity of communication skills training is a barrier to evaluating the efficacy of different communication skills training programmes. Further validation studies examining specific models and frameworks would support a stronger evidence base for communication skills training in psychiatry. It remains a challenge to develop research to investigate behaviour change over time in clinical practice or to measure patient outcomes due to the effects of communication skills training.

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“…Authors' reply: We thank Dr Tully for his thoughtful comments on the DEPSCREEN-INFO randomised controlled trial. 1 We share his conclusion about the need to better align mental health services with cardiac patient needs, [2][3][4] and we appreciate the studies he cited in his letter. However, these studies did not specifically investigate the efficacy of patient-targeted feedback after depression screening using a randomised controlled study design.…”

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confidence: 90%

Authors' reply

Löwe¹,

Gierk

Kohlmann

2017

Br J Psychiatry

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Depression is associated with poorer coronary heart disease (CHD) outcomes; however, routine screening for depression is controversial and difficult to implement in clinical practice, and randomised clinical trial (RCT) evidence is scarce. 1 The DEPSCREEN-INFO parallel group efficacy RCT reported by Löwe et al 2 randomised participants to written patient-targeted feedback versus no written patient feedback after depression screening. The sample comprised in-patients and outpatients with CHD, but also those with arterial hypertension. Löwe et al argued that the role of the patient within the depression screening process had not yet been studied. Previously, we reported two examples of depression screening involving patient, general practitioner and cardiologist feedback in heart failure 3 and cardiac surgery populations. 4 Our findings, and those of others, 5,6 diverge from Löwe et al's in terms of mental health service use. Lowe et al showed that 13% of participants contacted a psychotherapist, which might reflect generous health insurance benefits in Germany, including up to 2 years of psychotherapy. By comparison, in England an RCT for depression and CHD or diabetes by Coventry et al 5 revealed that 33% of individuals randomised to collaborative care did not attend any depression treatment session. Coventry et al 5 used the Improving Access to Psychological Therapy (IAPT) services in the English National Health Service (NHS). Other depression screening studies in CHD indicate that uptake of mental health services is 52% in the USA 6 and Australia, 4 with the latter study providing a rebate for mental health services similar to IAPT. Mounting evidence indicates incongruity between international efforts to improve depression care and the uptake of mental health services by the CHD patients we are targeting with depression screening. Integration of mental health services within cardiology and primary care services may be warranted. Clearly, more concerted efforts are required internationally to improve existing mental health services by adopting innovative methods such as 'blended' collaborative care, computerised cognitive-behavioural therapy (CBT) and telehealth. It remains crucial to better align mental health services with CHD patient needs in order to better engage CHD patients.

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Improving Clinician Competency in Communication About Schizophrenia: a Pilot Educational Program for Psychiatry Trainees

Cited by 25 publications

References 17 publications

Communication of a schizophrenia diagnosis: A qualitative study of patients’ perspectives

Communication of a schizophrenia diagnosis: A qualitative study of patients’ perspectives

Communication skills in the training of psychiatrists: A systematic review of current approaches

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