Communication Skills Training Course Research Articles

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.

The feasibility of implementing a communication skills training course in pediatric hematology/oncology fellowship

ABSTRACTCommunication skills are a competency highlighted by the Accreditation Council on Graduate Medical Education; yet, little is known about the frequency with which trainees receive formal training or what programs are willing to invest. We sought to answer this question and designed a program to address identified barriers. We surveyed pediatric fellowship program directors from all disciplines and, separately, pediatric hematology/oncology fellowship program directors to determine current use of formal communication skills training. At our institution, we piloted a standardized patient (SP)-based communication skills training program for pediatric hematology/oncology fellows. Twenty-seven pediatric hematology/oncology program directors and 44 pediatric program directors participated in the survey, of which 56% and 48%, respectively, reported having an established, formal communication skills training course. Multiple barriers to implementation of a communication skills course were identified, most notably time and cost. In the pilot program, 13 pediatric hematology/oncology fellows have participated, and 9 have completed all 3 years of training. Precourse assessment demonstrated fellows had limited comfort in various areas of communication. Following course completion, there was a significant increase in self-reported comfort and/or skill level in such areas of communication, including discussing a new diagnosis (p =.0004), telling a patient they are going to die (p =.005), discussing recurrent disease (p <.001), communicating a poor prognosis (p =.002), or responding to anger (p ≤.001). We have designed a concise communication skills training program, which addresses identified barriers and can feasibly be implemented in pediatric hematology/oncology fellowship.

Improving Communication in Adolescent Cancer Care: A Multiperspective Study.

Professionals treating adolescents with cancer must communicate well with them and their parents. Evidence suggests that the communication needs of this population are rarely met. Skills training can improve professional communication, but has been criticized for not being based on the experience of the participants in the clinical encounter. We took a multiperspective approach, drawing on perspectives of former adolescents with cancer, patients' parents, physicians, and nurses with the aim to provide suggestions for improvement in communication in adolescent cancer care. Adolescent cancer survivors (n = 16), parents (n = 8), pediatric oncologists (n = 12), and pediatric oncology nurses (n = 18) participated in 11 focus groups. They discussed their experiences communicating with each other. Transcripts were analyzed by thematic analysis. We identified themes within the following sections: (1) The framework in which professionals communicate with adolescents with cancer (regression in a time of detachment, adolescents' perception and knowledge of illness, cognitive versus legal maturity, "lost in transition" between pediatric and adult oncology); (2) communication difficulties between professionals and patients and parents (professionals and patients/parents identified the other party as the source of difficulties), and (3) effective professional communication (there was some overlap on how doctors and nurses should communicate, along with substantially different expectations for the two professions). The framework within which professionals communicate, the different perspectives on the factors that make communication difficult, and the different expectations regarding good communication by doctors and nurses should be considered when communication skills training courses are developed for professionals who work in adolescent oncology.

EM Talk: communication skills training for emergency medicine patients with serious illness

The emergency department visit for a patient with serious illness represents a sentinel event, signalling a change in the illness trajectory. By better understanding patient and family wishes, emergency physicians...

G275(P) Impact of a Communication Skills training course on performance in high stakes Membership Communication OSCE Station

AimsTo assess the impact of a non-commercial communication-skills training course for paediatric Membership on candidate performance in the MRCPCH clinical exam, specifically within the communication skills stations.MethodsA one-day communication skills...

FORWARD TO THE FUTURE: INTRODUCTION OF ADVANCE CARE PLANNING IN A TERTIARY CANCER CENTRE

BackgroundAdvance Care Planning is a process of discussion with individuals about their wishes and preferences regarding the type of care they would wish to receive or refuse in the future,...

Orthopaedic outpatients’ assessment of information, continuity and care: An intervention study

Introduction: Despite the increasing interest in patient-centered communication in health care, patient surveys continue to show that patients experience serious problems connected with poor communication. Research has provided evidence that health care professionals’ communication skills and patient-centredness can be enhanced through training. The aim of this study was to investigate whether a communication skills training course for health care professionals would improve the adult orthopaedic out-patient’s experience of quality of information, care and continuity. Methods: An intervention study assessing the effect of a communication skills training course for health care professi- onals on the orthopaedic outpatients’ evaluation of the quality of care. Data were collected using a computer touch screen questionnaire with 19 items rated on a four-point scale assessing patients’ evaluation of information, continuity and care. Patients were included consecutively in the study (non-equivalent groups). Results: A total of 11.631 patients answered the questionnaire; 8.315 before and 3.316 after the intervention. The proportion of patients giving top ratings after the course increased for 6 of 19 questions, of which three showed significant increases ( p 0.05). Discussion: The results were ambiguous as to the impact of the course on the outpatients’ assessment. Among the trends found, are a more positive impact on nurses’ communication as compared to doctors’ communication and a positive impact on patients’ assessment of care in general.

The need for communication skills training in oncology.

Communication between health-care professionals and their patients is an element that can make all the difference in how those patients navigate their cancer journey. In a 2011 issue of the Annals of Oncology, Barth and Lannen reported on their systematic review and meta-analysis of the efficacy of communication skills training courses in oncology. In this issue of JADPRO, two authors share their perspectives on the findings of Barth and Lannen and what advanced practitioners (APs) can learn from their research.

Long term follow-up on health care professionals’ self-efficacy after communication skills training

Introduction: Good communication is commonly recognised to be a precondition for optimal health care and treatment. Nevertheless, serious communication problems are still experienced by patients as well as by health care professionals and therefore an orthopaedic surgery department initiated a three-day communication skills training course for all staff members expecting an increase in patient-centeredness in communication and more respectful inter-collegial communi- cation. The aim of this study is to report the long term effect of communication skills training course on health care professionals’ self-efficacy in communication with patients and colleagues. Method: An intervention study assessing health care professionals’ self-efficacy before and eighteen months after having participated in the course using pre-course data as baseline for paired t -tests of means. Data were collected by means of questionnaires. Results: Responses to the 18-months post-course questionnaire were received from 121 participants (93%) showing sustained significant increases in self-efficacy across professions for all questions regarding communication with both patients and colleagues. Discussion: This long term assessment shows that communication skills training can produce significant and sustainable increases in the self-efficacy of health care professionals in communication with both patients and colleagues.

Communication skills training for healthcare professionals working with people who have cancer.

This is an updated version of a review that was originally published in the Cochrane Database of Systematic Reviews in 2004, Issue 2. People with cancer, their families and carers have a high prevalence of psychological stress which may be minimised by effective communication and support from their attending healthcare professionals (HCPs). Research suggests communication skills do not reliably improve with experience, therefore, considerable effort is dedicated to courses that may improve communication skills for HCPs involved in cancer care. A variety of communication skills training (CST) courses have been proposed and are in practice. We conducted this review to determine whether CST works and which types of CST, if any, are the most effective. To assess whether CST is effective in improving the communication skills of HCPs involved in cancer care, and in improving patient health status and satisfaction. We searched the following electronic databases: Cochrane Central Register of Controlled Trials (CENTRAL) Issue 2, 2012, MEDLINE, EMBASE, PsycInfo and CINAHL to February 2012. The original search was conducted in November 2001. In addition, we handsearched the reference lists of relevant articles and relevant conference proceedings for additional studies. The original review was a narrative review that included randomised controlled trials (RCTs) and controlled before-and-after studies. In this updated version, we limited our criteria to RCTs evaluating 'CST' compared with 'no CST' or other CST in HCPs working in cancer care. Primary outcomes were changes in HCP communication skills measured in interactions with real and/or simulated patients with cancer, using objective scales. We excluded studies whose focus was communication skills in encounters related to informed consent for research. Two review authors independently assessed trials and extracted data to a pre-designed data collection form. We pooled data using the random-effects model and, for continuous data, we used standardised mean differences (SMDs). We included 15 RCTs (42 records), conducted mainly in outpatient settings. Eleven studies compared CST with no CST intervention, three studies compared the effect of a follow-up CST intervention after initial CST training, and one study compared two types of CST. The types of CST courses evaluated in these trials were diverse. Study participants included oncologists (six studies), residents (one study) other doctors (one study), nurses (six studies) and a mixed team of HCPs (one study). Overall, 1147 HCPs participated (536 doctors, 522 nurses and 80 mixed HCPs).Ten studies contributed data to the meta-analyses. HCPs in the CST group were statistically significantly more likely to use open questions in the post-intervention interviews than the control group (five studies, 679 participant interviews; P = 0.04, I² = 65%) and more likely to show empathy towards patients (six studies, 727 participant interviews; P = 0.004, I² = 0%); we considered this evidence to be of moderate and high quality, respectively. Doctors and nurses did not perform statistically significantly differently for any HCP outcomes.There were no statistically significant differences in the other HCP communication skills except for the subgroup of participant interviews with simulated patients, where the intervention group was significantly less likely to present 'facts only' compared with the control group (four studies, 344 participant interviews; P = 0.01, I² = 70%).There were no significant differences between the groups with regard to outcomes assessing HCP 'burnout', patient satisfaction or patient perception of the HCPs communication skills. Patients in the control group experienced a greater reduction in mean anxiety scores in a meta-analyses of two studies (169 participant interviews; P = 0.02; I² = 8%); we considered this evidence to be of a very low quality. Various CST courses appear to be effective in improving some types of HCP communication skills related to information gathering and supportive skills. We were unable to determine whether the effects of CST are sustained over time, whether consolidation sessions are necessary, and which types of CST programs are most likely to work. We found no evidence to support a beneficial effect of CST on HCP 'burnout', patients' mental or physical health, and patient satisfaction.

Development and evaluation of a learner-centered training course on communication skills for baccalaureate nursing students

There is no standardized or formal communication skills training in the current nursing curriculum in Macao, China. To develop and evaluate a learner-centered communication skills training course. Both qualitative and quantitative designs were used in two separate stages. A randomized sample and a convenience sample were taken from students on a four-year bachelor's degree program at a public institute in Macao. Stage I consisted of developing a learner-centered communication skills training course using four focus groups (n=32). Stage II evaluated the training's efficacy by comparing communication skills, clinical interaction, interpersonal dysfunction, and social problem-solving abilities using a quasi-experimental longitudinal pre-post design among 62 nursing students. A course evaluation form was also used. Content analysis was used to evaluate the essential themes in order to develop the specific content and teaching strategies of the course. Paired t-tests and Wilcoxon signed-rank tests showed significant improvement in all post-training scores for communication ability, content of communication, and handling of communication barriers. According to the mean scores of the course evaluation form, students were generally very satisfied with the course: 6.11 to 6.74 on a scale of 1 to 7. This study showed that the course was effective in improving communication skills, especially in terms of the content and the handling of communication barriers. The course filled an important gap in the training needs of nursing students in Macao. The importance of these findings and their implications for nursing education are discussed.

Communication skills training for physicians performing work disability assessments increases knowledge and self-efficacy: results of a randomised controlled trial

Purpose: It was assessed whether a post-graduate communication skills training course would increase physicians’ competence and knowledge with regard to communication during work disability assessment interviews, and would change the determinants of their communication behaviour. Methods: A randomised controlled trial was performed. At baseline and at follow-up, 42 physicians completed questionnaires. The primary outcome measures were competence and knowledge about communication. The secondary outcome measures were 21 self-reported determinants of communication behaviour. One-way analyses of variance and covariance were performed. Results: There was no significant difference between the intervention and control groups in overall competence, but there was for the introduction phase (intervention: mean = 7.0, SD 2.7; control: mean = 4.8, SD 2.7; p = 0.014). Knowledge about communication was significantly higher (p = 0.001) in the intervention group (mean = 79.6, SD 9.2) than in the control group (mean = 70.9, SD 6.7), especially concerning the information-gathering phase of the interview (intervention: mean = 80.0, SD 10.2; control: mean = 69.4, SD 8.9; p = 0.001). The intervention group scored significantly better on 7 of the 21 self-reported determinants (secondary outcomes), including self-efficacy, intentions, skills and knowledge. Conclusions: The communication skills training course may improve some aspects of physician communication, but not all. Because physicians were unanimously positive about the course, further development is warranted.Implications for RehabilitationEven though optimal communication is essential in face-to-face assessment interviews for determining entitlement to work disability benefits, and there is a lot at stake for the claimants, this issue has scarcely been addressed in scientific research.A tailor-made two-day communication skills training course, based on scientific research, increases physicians’ knowledge about communication (both objectively measured and self-reported), their self-efficacy and their intention to pay explicit attention to their communication during assessment interviews.The participants evaluated the communication skills training course as very positive, which indicates a successful application of scientific research in practice.It is essential to offer physicians assessing entitlement to work disability benefits the opportunity to attend post-graduate communication skills training courses, which are tailored to their needs and are continuously evaluated and improved.

Impact of a communication skills training course for students of therapist training schools

Kanetaka K, Suzukamo Y, Kakui T, Michimata A, Izumi S. Impact of a communication skills training course for students of therapist training schools. Jpn J Compr Rehabil Sci 2013; 4:47-54. Purpose: Communication skills are necessary when students of therapist training schools undergo clinical practice. We verified the effects of introducing a course on communication skills training based on coaching theory. Methods: Second-year students of a vocational college participated in the study. Fourteen students in the occupational therapy department attended a course on communication skills training (CS group) and 21 students in the physiotherapy department did not attend the course (control group). The CS group received 6 classes on communication skills. Assessments by self and others (CS group only) on communication skills, anxiety assessment, and selfefficacy assessment were conducted before the course (T1), two months after T1 (T2), and 3 months after T1 before clinical practice (T3). In the CS group, course evaluation was also conducted at T2. Results: For course evaluation, all participants selected the top two grades on a five-grade scale for necessity, satisfaction, contents, interest and understanding. For communication skills selfassessment, the scores at T2 and T3 were higher than that at T1 in both groups. For communication skills assessment by others, the score at T3 was higher compared to those at T1 and T2. For anxiety assessment, state anxiety did not change in the CS group, but increased at T3 in the control group. Conclusion: The findings of this study indicate that the communication skills training course improves the communication skills of students and eases their state anxiety before clinical practice.

Does communication skills training make a difference to patients' experiences of consultations in oncology and palliative care services?

There is much evidence supporting the efficacy of communication skills training; however, very little of this evidence comes from patient feedback. The primary aim of this pilot study was to evaluate whether the advanced communications skills training improves patients' experience of consultations. Healthcare professionals working in oncology and palliative care services from the North East of England were invited to participate in this study. Interactions between healthcare professionals (n = 21) and patients (n = 1103) were evaluated using the Consultation and Relational Empathy (CARE) Measure, which is a brief questionnaire designed to assess the patients' perceptions of relational empathy in the consultation. Additional demographic variables, such as patient age, length of consultation, familiarity with healthcare professional and overall satisfaction with consultation, were also collected. Healthcare professionals were either part of the intervention group who attended a 3-day communication skills training course or part of the control group who were on the waiting list for training. No differences in the patients' ratings on the CARE measure were found between Time 1 (before training) and Time 2 (after training) for the intervention group. Possible explanations for the findings are explored and implications for communication skills training are discussed.

Training improves inter-collegial communication

Good intercollegial communication is a relatively unstudied topic, although it is important for both health professionals and patients, contributing to enhanced well-being, self-awareness and integrity for health professionals, and positively affecting patient outcome and satisfaction. To investigate whether a communication skills training course would improve intercollegial communication in an orthopaedic department. The study was designed as an intervention study investigating the effectiveness of an in-house training course, evaluated by means of questionnaires. A total of 177/181 (97.8%) participants answered the questionnaire before (T1), 165/169 (97.6%) immediately after (T2) and 150/153 (98%) 6 months after the course (T3). Of six questions about intraprofessional communication, one and two questions were evaluated significantly higher at T2 and T3, respectively. Of the six questions about interprofessional communication, the increase was statistically significant for four questions in T2 and for five questions in T3, respectively. A communication skills training course improved health care professionals' assessment of intercollegial communication, and this was more pronounced in interprofessional rather than in intraprofessional communication, and was more pronounced 6 months after the training course than immediately after the training course. Communication skills training for health care professionals is recommended, and should also include all health care professions that have patient contact.

Communication skills training for health care professionals improves the adult orthopaedic patient’s experience of quality of care

Despite the fact that communication has become a core topic in health care, patients still experience the information provided as insufficient or incorrect and a lack of involvement. To investigate whether adult orthopaedic patients' evaluation of the quality of care had improved after a communication skills training course for healthcare professionals. The study was designed as an intervention study offering professionals training in communicating with patients and colleagues. The outcome was measured by assessing patients' experience of quality of care. Data were collected by means of a questionnaire and analysed using a linear regression model. Approval was obtained from the Danish Data Protection Agency. A total of 3133 patients answered the questionnaire, 1279 before staff had attended courses and 1854 in the postcourse period, with response rates of 67.8 and 77.8%, respectively. After the course period, significant increases in responses indicating 'considerable' improvement were recorded for 15/19 questions, nonsignificant increases were registered for 3/19 questions and a statistically significant decrease for one question. This being an effectiveness study, it is deemed that the organizational changes taking place during the study period constitute no serious limitation. Response rates were comparable to those of other studies. Patients show increased satisfaction with the quality of health care after professionals have attended a communication skills training course, even when implemented in an entire department. We recommend that healthcare professionals are trained in patient-centred communication and that training is extended to the entire organization.

Communication Skills Training Increases Self-Efficacy of Health Care Professionals

Despite the knowledge of good communication as a precondition for optimal care and treatment in health care, serious communication problems are still experienced by patients as well as by health care professionals. An orthopedic surgery department initiated a 3-day communication skills training course for all staff members expecting an increase in patient-centeredness in communication and more respectful intercollegial communication. The aim of this study was to investigate the impact of this training course on participants' self-efficacy with a focus on communication with both colleagues and patients. The study was designed as an effectiveness study with the training course implemented in a real-world context. The staff members attended a 3-day training course in patient-centered communication and communication with colleagues. The effect of the training was evaluated by means of a questionnaire filled out before, immediately after, and 6 months after the course. Of the 181 participants, 177 answered the questionnaire before, 165 immediately after, and 150 six months after the course. The mean score for self-efficacy in communication with patients increased from 6.68 to 7.88 (p < .001) and in communication with colleagues from 6.85 to 7.84 (p < .001) immediately following the training course. The effect was still present 6 months after the course was completed. Although the study was conducted in a real-world setting with many competing demands, a communication course produced an increase in self-efficacy. This result was observed for doctors, nurses, nursing assistants, and medical secretaries.

Geritalk: Communication Skills Training for Geriatric and Palliative Medicine Fellows

Expert communication is essential to high-quality care for older patients with serious illness. Although the importance of communication skills is widely recognized, formal curricula for teaching communication skills to geriatric and palliative medicine fellows is often inadequate or unavailable. The current study drew upon the educational principles and format of an evidence-based, interactive teaching method to develop an intensive communication skills training course designed specifically to address the common communication challenges that geriatric and palliative medicine fellows face. The 2-day retreat, held away from the hospital environment, included large-group overview presentations, small-group communication skills practice, and development of future skills practice commitment. Faculty received in-depth training in small-group facilitation techniques before the course. Geriatric and palliative medicine fellows were recruited to participate in the course and 100% (n=18) enrolled. Overall satisfaction with the course was very high (mean 4.8 on a 5-point scale). After the course, fellows reported an increase in self-assessed preparedness for specific communication challenges (mean increase 1.4 on 5-point scale, P<.001). Two months after the course, fellows reported a high level of sustained skills practice (mean 4.3 on 5-point scale). In sum, the intensive communication skills program, customized for the specific needs of geriatric and palliative medicine fellows, improved fellows' self-assessed preparedness for challenging communication tasks and provided a model for ongoing deliberate practice of communication skills.

The views of patients and the general public about expensive anti-cancer drugs in the NHS: a questionnaire-based study

ObjectivesTo determine the views of patients and members of the public about who should pay for expensive new cancer drugs not recommended by the National Institute for Health and Clinical Excellence (NICE).DesignA study-specific questionnaire was used to elicit the views of patients and the general public between April and June 2010. It examined whether participants thought patients should be told about all possible cancer treatments, if the NHS should always fund non-NICE recommended drugs and attitudes towards self-funding/co-payments. The influence of sociodemographic factors on responses was also examined.SettingOncology clinics in Sussex and various locations including old persons' lunch clubs, parks, sports venues and support groups.ParticipantsTwo hundred and 10 patients with common solid tumours, and 416 members of the general publicMain outcome measuresFrequencies of responses to items regarding payments for expensive anti-cancer drugs stratified by sociodemographic factors and comparison of responses between patients and members of the public.ResultsMost respondents (70% [147/210] of patients and 64% [266/416] of the general public) had heard of NICE. Both groups believed that doctors should tell patients about all available cancer treatments even if the NHS cannot pay (94%, 196/208; 93%, 388/415). However, only 49% (101/207) of patients and 36% (146/409) of the public believed that the NHS should always fund all new cancer drugs that have failed health technology assessments. Strong predictors of willingness to purchase expensive new cancer drugs included younger age (<45 years), sex (female) and higher educational level.ConclusionThe general population appear realistic about the difficulties of providing funding for expensive new drugs. A communication skills training course has been developed to help clinicians with these difficult consultations.

Health care professionals’ experience of participating in a communication course in an orthopaedic department

Summary Aim To demonstrate how health care professionals experienced participating in a communication skills training course and to what extent they felt that the training had influenced their ability to communicate with patients and colleagues. Method After having attended a 3day communication skills training course focused on patient centeredness and communication with colleagues, health care professionals from an orthopedic department participated in focus group interviews. The analysis was undertaken by indexing the transcripts, focusing on what had made the greatest impression during training. The extracted data were entered into a matrix. Results Following the training, nurses, nursing assistants, medical secretaries and managers experienced more control over the patient interview, increased confidence in communication, better intercollegiate understanding and more focus on patient-oriented communication. The doctors had an overall negative experience of participating in the training, but still experienced positive changes in their communication. Conclusion An enriched and more confident communication with patients and colleagues was the most common experience, although this depended on the informants' professional background. Implications Interprofessional communication skills training courses for health care professionals are recommended. Specially designed training for doctors might be necessary, but would greatly diminish the advantages of mixed classes.