Abstract
Objective:To analyze communication skills of pediatric postgraduate residents in clinical encounter by using video recordings.Methods:This qualitative exploratory research was conducted through video recording at The Children’s Hospital Lahore, Pakistan. Residents who had attended the mandatory communication skills workshop offered by CPSP were included. The video recording of clinical encounter was done by a trained audiovisual person while the resident was interacting with the patient in the clinical encounter. Data was analyzed by thematic analysis.Results:Initially on open coding 36 codes emerged and then through axial and selective coding these were condensed to 17 subthemes. Out of these four main themes emerged: (1) Courteous and polite attitude, (2) Marginal nonverbal communication skills, (3) Power game/Ignoring child participation and (4) Patient as medical object/Instrumental behaviour. All residents treated the patient as a medical object to reach a right diagnosis and ignored them as a human being. There was dominant role of doctors and marginal nonverbal communication skills were displayed by the residents in the form of lack of social touch, and appropriate eye contact due to documenting notes. A brief non-medical interaction for rapport building at the beginning of interaction was missing and there was lack of child involvement.Conclusion:Paediatric postgraduate residents were polite while communicating with parents and child but lacking in good nonverbal communication skills. Communication pattern in our study was mostly one-way showing doctor’s instrumental behaviour and ignoring the child participation.
Highlights
A caring relationship is established by professional conversation between patient and treating doctor
Purposive sampling was done with inclusion of 12 postgraduate residents (PGR) of both sexes working in the Institute of Child Health (ICH) who had attended the mandatory communication skills workshop offered by CPSP and are in last year of training
PGR looking toward the mother and asked: “What is your child’s name?” Mother: looked toward the doctor and answered “Ayesha” PGR Looked toward the mother for short duration and while writing the name of the child again asked while
Summary
A caring relationship is established by professional conversation between patient and treating doctor. Physician and patient communication is an important component of patient care. Treating physician mostly focus on the technical and biomedical aspect of the case and they generally ignore patients’ own feelings and values. It is noticed that doctors’ clinical practice reflects their moral responsibility to improve patients’ health, while the human and personal dimensions of patients’ suffering are overlooked.[1] Medical care is based on interpersonal interactions including emotional and related phenomenon like nonverbal behaviour.[2] The critical factors predicting the quality of care and patient safety are physician
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