Teaching clinically experienced physicians communication skills. A review of evaluation studies

Abstract

Context Interest 1 in the teaching of communication skills in medical schools has increased since the early seventies but, despite this growing interest, relatively limited curricular time is spent on the teaching of communication skills. The limited attention to the teaching of these skills applies even more to the physicians' clinical years, when attention becomes highly focused on biomedical and technical competence. Continuing training after medical school is necessary to refresh knowledge and skills, to prohibit decline of performance and to establish further improvements.Objective This review provides an overview of evaluation studies of communication skills training programmes for clinically experienced physicians who have ®nished their undergraduate medical education. The review focuses on the training objectives, the applied educational methods, the evaluation methodology and instruments, and training results.Methods CD-ROM searches were performed on MedLine and Psychlit, with a focus on effect-studies dating from 1985.Results Fifteen papers on 14 evaluation studies were located. There appears to be some consistency in the aims and methods of the training programmes. Course effect measurements include physician self-ratings, independent behavioural observations and patient outcomes. Most of the studies used inadequate research designs. Overall, positive training effects on the physicians' communication behaviour are found on half or less of the observed behaviours. Studies with the most adequate 2 designs report the fewest positive training effects.Conclusion Several reasons are discussed to explain the limited ®ndings. Future research may bene®t from research methods which focus on factors that inhibit and facilitate the physicians' implementation of skills into actual behaviours in daily practice.

Tailoring communication in cancer genetic counseling through individual video-supported feedback: A controlled pretest–posttest design

“…Nevertheless, more effects may be detected with a longer term training [25]. Training usually first changes trainees' attitude and enough time is necessary to translate intention to performance, or more specifically, to acquire new skills that may be used in daily practice [10]. Moreover, we did not assess longer term effects of training.…”

“…Results suggest that patient-oriented agenda setting is a teachable and learnable skill [9]. More generally, training of physicians' communication skills can effectively alter their communication behaviors [10,11], especially where video-feedback of real doctor-patient encounters is provided [12], and can increase patients' participation during the visit [13]. These training interventions were performed in medical settings other than cancer genetic counseling.…”

Teaching communication and stress management skills to junior physicians dealing with cancer patients: a Belgian Interuniversity Curriculum

“…This need to devote more time for complex interviews should be recognized by institutions. Moreover, there is clear evidence that communication skills once learned are easily forgotten [23,24,56,[63][64][65]. The 40-h training of the BIC is probably necessary to ensure this transfer in the clinical practice.…”

“…During the last decades, research efforts have focused on training techniques to be used and communication skills to be taught [23]. The usefulness of learner-centered, skillsfocused, and practice-oriented communication skills training programs organized in small groups and lasting at least 20 h has been confirmed [2].…”

Is Balint training associated with the reduced burnout among primary health care doctors?

“…Although the advanced skills are required for the purpose of building trust with a patient, they do not have a prominent space in medical schools’ syllabi [3]. Communication skills training during the medical studies are insufficient; however, its level decreases even more significantly during the physicians’ residency programs in a particular medical discipline [4]. …”