Healthcare Communication Skills Research Articles

Teaching intercultural communication skills in healthcare to improve care for culturally and linguistically diverse patients

ObjectiveTo provide recommendations for adequately training healthcare providers in intercultural communication skills. DiscussionWe discuss three main recommendations concerning intercultural communication skills training. First, we give an overview of the fundamental skills in which healthcare providers should receive training, such as self-awareness and adaptability. Second, we briefly discuss how such training should be delivered, and focus on different language support methods, including those that work with different types of interpreters and digital tools. Third, we discuss how within-group differences can be taken into account to prevent stereotyping. To illustrate these recommendations, we provide certain examples of existing good practices and interventions. ConclusionIn today’s superdiverse societies, delivering culturally and linguistically sensitive healthcare tailored to the needs, values, and preferences of individual patients is a prerequisite for good quality healthcare communication. To achieve this goal, there is a need for clearer recommendations for affirmative action, guidelines, policy, and support for the topic of diversity sensitivity in healthcare, such as evidence-based interventions, than is currently the case. That is, structural changes on a system level are urgently needed to support healthcare providers to implement diversity sensitivity in their daily clinical work.

Using Simulation to Teach Learners in Health Care Behavioral Skills Related to Diversity, Equity, and Inclusion: A Scoping Review.

Bias is commonplace in the health care environment and can negatively impact patients and their health outcomes. Simulation has long been shown to be an effective teaching tool for communication skills in health care, but it has rarely been used to deliver concrete behavioral skills that address issues of diversity, equity, and inclusion (DEI). This scoping review examines 23 published articles surrounding the use of simulation in health care education to impart behavioral skills that reduce bias and promote DEI. Included articles described various behavioral skills including communication, history-taking, and system/community-level advocacy. The most commonly used simulation modality to teach these skills included the use of simulated participants (16 articles, 70%). The main DEI topics addressed in the trainings included sexual orientation/gender identity, language, and culture/ethnicity. Based on findings from this review, the authors suggest recommendations for educators who are considering teaching DEI-related skills through simulation.

From chaos to creativity: Designing collaborative communication training for the delivery of bad news

BackgroundBefore the COVID-19 pandemic, teaching communication skills in health care focused primarily on developing skills during face-to-face conversation. Even experienced clinicians were unprepared for the transition in communication modalities necessitated due to physical distancing requirements and visitation restrictions during the COVID-19 pandemic. We aimed to develop and pilot a comprehensive video-mediated communication training program and test its feasibility in multiple institutional settings and medical disciplines. MethodsThe education team, consisting of clinician-educators in general surgery and emergency medicine (EM) and faculty specialists in simulation and coaching, created the intervention. Surgery and EM interns in addition to senior medical students applying in these specialties were recruited to participate. Three 90-minute sessions were offered focusing on 3 communication topics that became increasingly complex and challenging: breaking bad news, goals of care discussions, and disclosure of medical error. This was a mixed-methods study using survey and narrative analysis of open comment fields. ResultsLearner recruitment varied by institution but was successful, and most (75%) learners found the experience to be valuable. All of the participants reported feeling able to lead difficult discussions, either independently or with minimal assistance. Only about half (52%) of the participants reported feeling confident to independently disclose medical error subsequent to the session. ConclusionWe found the program to be feasible based on acceptability, demand, the ability to implement, and practicality. Of the 3 communication topics studied, confidence with disclosure of medical error proved to be the most difficult. The optimal length and structure for these programs warrants further investigation.

Informing Simulation Design: A Qualitative Phenomenological Study of the Experiences of Bereaved Parents and Actors.

Simulations, which represent reality, are effective in pediatric healthcare communication skills education and training. Parents are increasingly engaged in simulation development, particularly for authentic character development, to help achieve greater psychological fidelity. For simulated encounters related to a child's end-of-life, involvement of bereaved parents would make sense. However, this is challenging because there is limited research to guide their inclusion and significant responsibility for any approach to be thoughtful and psychologically safe for participating parents. This study explores the impact and experiences of bereaved parents and actors who participated in simulation design. This qualitative phenomenological study involved five bereaved parents and two actors who participated in a full-day workshop to design and develop characters for use in a simulation. Individual semistructured interviews were conducted up to four weeks after the workshop. Data collected from these telephone interviews were analyzed using inductive content analysis. Bereaved parents found the workshop emotionally challenging but positive, worthwhile, and beneficial. Similarly, actors found the workshop helpful in character development and, although it was an intense experience for them, it validated the importance of their work. Key elements of our research findings could inform future such activities. Involving bereaved parents in simulation design can be psychologically safe and beneficial for both parents and actors. Ongoing involvement of bereaved parents may lead to higher-quality simulated experiences, allowing clinicians to practice skills to enhance care provided at a child's end-of-life.

Interpersonal Communication Skills in Healthcare: Literature Review On Doctors and Patients Communication

Interpersonal Communication Skills in Healthcare: Literature Review On Doctors and Patients Communication

Innovative Communication Learning: Combining TED Talks and Reflective Writing for Nursing Students.

As educational programs compete with online and open courseware, TED (Technology, Entertainment, and Design) Talks provide meaningful complementary content that can be easily integrated into curricula. Evaluate an innovative approach to the standard lecture by combining media mixture with reflective writing. Undergraduate nursing students were asked to view a TED Talk and write a brief narrative reflection as part of their preparation for a communication class. The video and reflective writing assignment were completed by 23/25 (92%) of students. Qualitative analysis of the reflective writing identified three primary themes: Communication as a Foundational Competency, Importance of Empathy, and Professional Role Development. This illustrative talk and narrative exercise provided an interactive learning experience for novice nurses that served as a compelling means to critically reflect on effective health-care communication skills, prior to entry into practice.

A study of the communication skills in health care and the role of demographic variables (a case study of the nurses at the Educational, Therapeutic and Research Center of Imam Reza Hospital, Kermanshah, Iran in 2018)

Nurses, as facilitators in hospitals, should be equipped with communication skills towards the realization of this goal. The present study aimed to investigate the status of communication skills in health care and the role of nurses’ demographic variables at the Educational, Therapeutic, and Research Center of Imam Reza Hospital, Kermanshah, Iran in 2018. In this descriptive–analytic study, the statistical population was 926 nurses working at the Educational, Therapeutic, and Research Center of Imam Reza Hospital affiliated to Kermanshah University of Medical Sciences, Kermanshah, Iran in 2018. Moreover, the random sampling was used as the sampling method. As for data collection, a two-part questionnaire, containing the demographic questions and the Queendom Communication Skills Test, was used. Furthermore, the independent t-test and one-way ANOVA using SPSS Statistical Software Version 22.0 were used for data analysis. The results of the present study demonstrated that the mean and standard deviation of the total score of communication skills measured 2.70 ± 0.43. The results also indicated that assertiveness and understanding verbal and nonverbal messages had the highest and lowest mean scores (3.20 ± 0.64 and 2.30 ± 0.58 respectively). Further, there was a significant relationship between the mean scores of communication skills and variables such as marital status, employment background, department, work shift, and type of employment (P < 0.05). The results of the present study revealed that nurses’ knowledge of communication skills was moderate. Therefore, it is recommended that courses on communication skills training be considered in their continuing education and on-the-job training, with the aim of improving the quality of nursing care.

Interprofessional communication in a socio-hierarchical culture: development of the TRI-O guide.

ObjectivesInterprofessional education (IPE) and collaborative practice are essential for patient safety. Effective teamwork starting with partnership-based communications should be introduced early in the educational process. Many societies in the world hold socio-hierarchical culture with a wide power distance, which makes collaboration among health professionals challenging. Since an appropriate communication framework for this context is not yet available, this study filled that gap by developing a guide for interprofessional communication, which is best suited to the socio-hierarchical and socio-cultural contexts.Materials and methodsThe draft of the guide was constructed based on previous studies of communication in health care in a socio-hierarchical context, referred to international IPE literature, and refined by focus group discussions among various health professionals. Nominal group technique, also comments from national and international experts of communication skills in health care, was used to validate the guide. A pilot study with a pre–posttest design was conducted with 53 first- and 107 fourth-year undergraduate medical, nursing, and health nutrition students.ResultsWe developed the “TRI-O” guide of interprofessional communication skills, emphasizing “open for collaboration, open for information, open for discussion”, and found that the application of the guide during training was feasible and positively influenced students’ perceptions.ConclusionThe findings suggest that the TRI-O guide is beneficial to help students initiate partnership-based communication and mutual collaboration among health professionals in the socio-hierarchical and socio-cultural context.

Implementing and tailoring a western-developed communication skills training program for graduate medical trainees in Qatar.

In 2009, the Accreditation Council for Graduate Medical Education launched an international branch (ACGME-I). In July 2012, Hamad Medical Corporation (HMC) in Qatar was the second international organization to receive institutional accreditation. The evolution of the ACGME into an international organization leads to the need to understand how to effectively build upon educational programs developed in western cultures while still being attentive to important cultural differences and local needs of international programs. Harden1 delineated three ways of approaching curriculum in international medical education: (1) local educators build a local curriculum; (2) a curriculum built in one country is exported to another; or (3) a transnational curriculum is developed with a strong international basis and attention to local students’ needs. All three approaches may be used by ACGME-I accredited institutions. Communication skills training (CST) programs are of particular interest since the key concept of communication crosses many of the competencies and milestones. Yet communication, perhaps more than other competencies, is subject to differences in interpretation and cultural norms.2 For example, a communication competency such as “Create and sustain a relationship that is therapeutic for patients and supportive of their families”3 may be applied differently in international graduate medical education programs where the role of the family in healthcare is central.2 Important cultural differences notwithstanding, we began this project believing that there were more cross-cultural similarities than differences in healthcare communication skills. Thus, rather than develop a new program, we chose to tailor and implement a western model of CSTin graduate medical education in Qatar.Much has been published internationally on CST for medical students, graduate medical trainees and practicing physicians.4-6 Best practices for teaching communication skills are well-established,7 focusing on facilitator-guided, experiential work.8,9 Research on these programs generally show positive evaluations of such interventions and demonstrate skills uptake as measured with Standardized Patients (SPs). However, most published work about CST has been from western countries. Implementing a CST program in Qatar was innovative as we introduced a western-based curriculum. This is significant as previous educators have questioned whether an experiential role play approach would work in non-western countries.10 The primary purpose of this paper is to report on our experience tailoring and implementing a western-developed CST program in Qatar. Components of training Setting HMC is Qatar’s not-for-profit public healthcare system, consisting of eight public hospitals and other healthcare services, with 19 residency training programs, 14 of which are ACGME-I accredited. Residents and fellows are mandated to complete the CST course during their training.

Satisfaction with a 2-day communication skills course culturally tailored for medical specialists in Qatar.

OBJECTIVE:Health-care communication skills training may be particularly needed in the Arabian Gulf countries because of the variety of cultures within the physician and patient populations. This study describes the implementation and results of a communication skills training program for physicians in Qatar that assessed previous training, and effect of previous training on participants' course evaluations.MATERIALS AND METHODS:We conducted a 2-day communication skills training course covering seven culturally adapted modules. Educational strategies included large and small group work with the standardized patient, demonstration videos, and lectures. At the end, participants completed a course evaluation survey. Data analysis performed with SPSS; frequencies and percentages were calculated, and Chi-square test applied to evaluate statistical significance.RESULTS:A total of 410 physicians in Qatar have participated in the course over a period of 2 years. Evaluation ratings of the course were high. Participants rated the module on Breaking Bad News as the most useful, and the small group role-play as the most helpful course component. One-third of participants had previously participated in experiential communication skills training. There was no association between previous experience and evaluation of the course.CONCLUSION:Physicians in Qatar positively evaluated a 2-day communication skills course, though the majority of participants did not have any previous exposure to experiential communication skills training.

Misbelieves about medical communication

Despite a growing body of evidence about the importance of good communication skills in healthcare, every day practice shows several common myths or false believes about it. In the opinion of the authors these misbelieves are often behind doctors' or students' negative attitudes, which hinder the quality improvement or shift towards patient-centered approach. The scope of this article is to present the most frequently heard misbelieves from our empirical experiences in line with the evidence derived from current research data.

Communication skills: a preventive factor in Burnout syndrome in health professionals

Health professionals are a group that suffers high levels of job stress and burnout. The aim of this study is to demonstrate empirically that the healthcare count on communication skills helps prevent Burnout Syndrome. An observational, analytical, cross-sectional study was proposed, involving a sample of 927 health professionals (197 doctors, 450 nurses and 280 auxiliary nurses). Participants completed questionnaires measuring communication skills in health care (EHC-PS) and the Maslach Burnout Inventory Human Services Survey (MBI-HSS). A negative and statistically significant correlation between the different dimensions of communication skills and emotional exhaustion and depersonalization dimensions of burnout was obtained. On the other hand, a positive and statistically significant correlation between the dimensions of communication skills and the personal accomplishment dimension of burnout was observed. It was shown that the communication skills of health professionals provide protection from and cushion Burnout Syndrome.

Las habilidades de comunicación como factor preventivo del síndrome de Burnout en los profesionales de la salud

Background. Health professionals are a group that suffers high levels of job stress and burnout. The aim of this study is to demonstrate empirically that the healthcare count on communication skills helps prevent Burnout Syndrome. Method. An observational, analytical, cross-sectional study was proposed, involving a sample of 927 health professionals (197 doctors, 450 nurses and 280 auxiliary nurses). Participants completed questionnaires measuring communication skills in health care (EHC-PS) and the Maslach Burnout Inventory Human Services Survey (MBI-HSS). Results. A negative and statistically significant correlation between the different dimensions of communication skills and emotional exhaustion and depersonalization dimensions of burnout was obtained. On the other hand, a positive and statistically significant correlation between the dimensions of communication skills and the personal accomplishment dimension of burnout was observed. Conclusions. It was shown that the communication skills of health professionals provide protection from and cushion Burnout Syndrome.

Development of communication skills in healthcare: Perspectives of new graduates of undergraduate nursing education

Background : Communication between healthcare providers and patients affects patient care and safety. Nurses develop communication skills at the undergraduate level, after graduation and throughout their practice. This study explored perspectives of new graduates on the development and implementation of communication skills within the first six months after graduation. Methods : Descriptive study using an electronic survey to three cohorts of recent graduates. Surveys were sent within six months after graduation. Results : A total of 700 surveys were sent to three cohorts of recent graduates with 206 surveys completed (response rates ranged from 26%-35%). Participants reported always feeling confident communicating with patients and families 27% of the time, and 23.5% of the time with interdisciplinary teams. Only 50.8% reported always feeling confident to provide safe care all of the time with 44.5% reported feeling always able to ask colleagues for help with challenging situations. Conclusions : Undergraduate nursing programs should incorporate more didactic communication skills training and simulation to prepare nursing students and increase their confidence to provide safe care and consult with colleagues for help. Communication skills training in practice settings after graduation to increase skill development and confidence during independent clinical practice.

Improving Communication Skills in Health Care

Hospital reimbursements are linked to patient satisfaction surveys, which are directly related to interpersonal communication between provider and patient. In today’s health care environment, interactions are challenged by diversity — Limited English proficient (LEP) patients, medical interpreters, International Medical Graduate (IMG) physicians, nurses, and support staff. Accent modification training for health care professionals can improve patient satisfaction and reduce adverse events. Surveys were conducted with medical interpreters and trainers of medical interpreting programs to determine the existence and support for communication skills training, particularly accent modification, for interpreters and non-native English speaking medical professionals. Results of preliminary surveys suggest the need for these comprehensive services. 60.8% believed a heavy accent, poor diction, or a different dialect contributed to medical errors or miscommunication by a moderate to significant degree. Communication programs should also include cultural competency training to optimize patient care outcomes. Examples of strategies for training are included.

Fostering the development of effective person-centered healthcare communication skills: An interprofessional shared learning model

To describe the implementation of an interprofessional shared learning model designed to promote the development of person-centered healthcare communication skills. Master of social work (MSW) and doctor of physical therapy (DPT) degree students. The model used evidence-based principles of effective healthcare communication and shared learning methods; it was aligned with student learning outcomes contained in MSW and DPT curricula. Students engaged in 3 learning sessions over 2 days. Sessions involved interactive reflective learning, simulated role-modeling with peer assessment, and context-specific practice of communication skills. The perspective of patients/clients was included in each learning activity. Activities were evaluated through narrative feedback. Students valued opportunities to learn directly from each other and from healthcare consumers. Important insights and directions for future interprofessional learning experiences were gleaned from model implementation. The interprofessional shared learning model shows promise as an effective method for developing person-centered communication skills.

Promoting and Measuring Family Caregiver Self-Efficacy in Caregiver-Physician Interactions

This article describes the development of a 5-item scale that assesses family caregivers' self-efficacy in communicating with physicians about ill family members (Perceived Efficacy in Caregiver-Physician Interactions–PECPI) in the context of an evaluation study of an online training in health care communication skills for caregivers. A national sample of 197 self-identified family caregivers participated in an online webinar and completed a brief evaluation instrument before and immediately after the training. Results indicated that the webinar was effective in increasing perceived self-efficacy and self-reported knowledge about and level of preparation for medical visits. Principal component analysis indicates that the PECPI is unidimensional with a Cronbach's alpha of .91.

Enhancing Health Care Communication Skills

The Communicating Effectively with Health Care Professionals (CE) workshop curriculum is designed for family caregivers to encourage caregiver empowerment, effective health care communication, and advocacy in medical care contexts with the goal of promoting positive health outcomes for care recipients. This mixed-method study employed a cross-sectional quantitative mail survey (N= 51) and semi-structured qualitative telephone interviews (N= 14) to examine the effectiveness of the curriculum in promoting self-reported changes in caregiver attitudes and communication behavior. Respondents reported increased as-sertiveness in medical encounters, feelings of empowerment, and preparation and organization of medical information for their care recipients as a result of workshop participation.

Effective communication in health care: exploring the skills of the teachers

Following the growing commitment to teach communication skills in health care, a project was designed to identify a group of Health Professionals with a responsibility for teaching communication skills in Health Care. This group would have their communication skills assessed, using positive feedback, and attend workshops to improve both their communication and teaching skills. Four key tutors were recruited to the study and were each asked to identify a further three tutors, in their own geographical area, to form a “cell”. This sample of 16 tutors remained constant throughout the study. Skills were monitored by the assessment of audio-taped interviews, one made prior to the first workshop and two others at agreed intervals. Written feedback was given on the first interview, plus the option of verbal feedback on a skills study day. Written feedback was given on subsequent interviews. Changes in skills were monitored and baseline skills compared to previous skills training. The results show, with two exceptions, that there appears to be a link between baseline skills and previous training in communication skills. For three “cells”, there are gains in overall scores from first to third interview, but for the fourth “cell”, which had high baseline scores, there was only minimal change. The work suggests, that for those who teach Communication in Health Care, training is a pre-requisite. Further work is required in this area.

From needs analysis to curriculum development: designing a course in health-care communication for immigrant students in the USA

During the academic year 1997–1998, a needs analysis was conducted on the Minneapolis campus of the College of St. Catherine, to determine why many of the ESL students enrolled in the Associate of Science (A.S.) degree nursing program were not succeeding academically. Several procedures, primarily interviews, observations, and questionnaires, were used to gather information about the objective needs of the students, all of whom are immigrants. The course Speaking and Listening in a Health-Care Setting was developed to respond to what was identified as students’ area of greatest difficulty: communicating with clients and colleagues in the clinical setting. The content of the course is divided into four units: assertiveness skills, therapeutic communication, information-gathering techniques, and the role of culture in health-care communication. A variety of methods and materials, drawn primarily from sources for developing health-care communication skills in native speakers, is used to actively engage students in the learning process, with particular emphasis on role plays. The course has been very successful in helping students learn how to communicate more effectively in clinical settings. By helping culturally and linguistically diverse students succeed in their programs, the course is also helping to bring much needed diversity to the health-care professions in the United States.