Abstract
BackgroundPatient-centred communication and empathy are key enablers for patient-centred care. However, several studies suggest a downward trend regarding the empathic communication skills of physicians during medical residency. It is known that communication training can have a positive effect on patient-centred communication, empathy and relational skills. Training residents in patient-centred communication and empathy can be an opportunity to improve the patient-centred care. To evaluate the training a tri-focal perspective will be used.MethodsA 3-day training was developed to improve residents’ patient-centred communication and empathy skills at an academic medical health centre, in the Netherlands. The training included: (1) the basics of patient-centred communication and empathy (through presentations, scientific literature), (2) practicing with actors, and (3) reflecting on residents’ video recorded consultations (by themselves and communication experts). A pilot study with a pre-post design was conducted to evaluate the training from patient and observer perspectives. Semi-structured interviews were used to get insight into residents’ perspective. Nine residents from different specialities followed the training and enrolled in the pilot study. During two random days consultations between residents and patients were video recorded. Patients were asked to fill in two questionnaires, indicating their perspective on residents’ empathy and communication skills before as well as after the consultation. All video recorded consultations were coded to rate residents’ communication skills, empathy, computer use and agenda-setting. Statistical analysis were performed using multilevel analysis.ResultsA total of 137 eligible patients took part in the pilot study. Trained residents showed significant improvement in patient-rated empathy scores. According to observers, residents’ computer use improved significantly after the training. The communication skills of trained residents did not improve significantly. Agenda setting by residents showed a downward trend. Almost all residents were satisfied with the training, especially with the video-feedback.ConclusionsA brief training significantly increased residents’ empathy scores according to patients and significantly decreased residents’ computer use according to observers. These findings indicate that the quality of patient-centred care can be improved by integrating patient-centred communication into residency programs, at an academic medical health centre. The ultimate goal is to structurally embed the training in residents’ education program.
Highlights
Follow-up consultation 2.42 Request for helpPhysical examination Diagnosis 0.02* Management
Many different definitions of the concept of patient-centred care have been proposed, but all include the key enablers of patient-centred communication, as well as empathy of the physician as an essential characteristic [1, 2, 4,5,6]
Participants Of 14 initially interested residents, 10 (71%) agreed to participate. Due to ending her proceedings in the academic medical health centre, one resident did not participate in the training program
Summary
Training residents in patient-centred communication and empathy can be an opportunity to improve the patient-centred care. Many different definitions of the concept of patient-centred care have been proposed, but all include the key enablers of patient-centred communication, as well as empathy of the physician as an essential characteristic [1, 2, 4,5,6]. A randomized controlled trial studied the effect of physician-patient interaction on the duration of common cold. They concluded that positive patient perception of practitioner’s empathy is significantly correlated to the duration and severity of commoncold-symptoms [11]. Another study found that the empathic capacity of doctors (rated by the doctors themselves) showed a positive correlation between doctors’ empathy scores and glycated hemoglobin control of diabetes patients [9]
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