Abstract
To explore experiences with and views of general practitioners (GPs) on a physician communication training method in primary care and its applicability and implementation in daily practice, we performed a semi-structured qualitative study of GPs’ experience of training in and implementing a communication skills training program for managing lower respiratory tract infection (LRTI) which included a seminar, simulated patient consultation together with providing and receiving feedback on ones own transcript, and a seminar in a structured approach to the LRTI consultation. Seventeen out of 20 eligible GPs who had participated in the IMPAC3T trial and were allocated to receiving enhanced physician communication training for managing lower respiratory tract infection participated. GPs’ experiences with the physician communication training method and its specific components were positive. The method gave GPs additional tools for managing LRTI consultations and increased their sense of providing evidence-based management. During the study, GPs reported using almost all communication items covered in the training, but some GPs stated that the communication skills diluted over time, and that they continued to use a selected set of the skills. The general communication items were most regularly used. Implementation of the method in daily practice helped GPs to prescribe fewer antibiotics in LRTI with the only perceived disadvantage being time-pressure. This study suggests that GPs felt positive about the physician communication training method for enhanced management of LRTI in primary care. GPs continued to use some of the communication items, of which general communication items were the most common. Furthermore, GPs believed that implementation of the communication skills in daily practice helped them to prescribe fewer antibiotics. The context-rich communication method could have wider application in common conditions in primary care.
Highlights
The quality of doctor-patient communication is crucial in general medical practice
Largely practice-based and context-rich communication skills method for general practitioners (GPs), for the exemplar condition of lower respiratory tract infection (LRTI) [5]
We previously demonstrated a significant increase of evidence in competence in selected core communication skills for managing LRTI in primary care [5]
Summary
The quality of doctor-patient communication is crucial in general medical practice. Models in patient-doctor communication set out to make the implicit in patient care explicit. While models help to clarify the basics in communication, they never completely capture what happens in reality. Implementation and assessment of acquired communication skills is challenging. Competence assessments measure what doctors can do in controlled representations of professional practice; performance assessments measure what doctors do in actual professional practice. Only competence is measured as these assessments are generally easier administered through exams or structured observations. The perspectives of patients and society demand that doctors should meet the assessment standards in their working conditions in any given situation. It has been suggested that the emphasis in assessing communication skills should lie on the assessment of performance [2]
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