Doctor-patient Communication Skills Research Articles

Application of the combination of CBL teaching method and SEGUE framework to improve the doctor-patient communication skills of resident physicians in otolaryngology department

BackgroundTo explore the feasibility and effectiveness of applying CBL teaching method and SEGUE Framework in the doctor-patient communication skills of resident physicians in the department of otolaryngology.MethodsThis is an observational study to compare the score changes in doctor-patient communication skills of 120 resident physicians, before and after using CBL combined SEGUE Framework teaching method. The effects of gender, age, grade, educational background and marital status on SEGUE score were analyzed.ResultsThrough the combined application of CBL teaching method and SEGUE Framework, the SEGUE score of 120 resident physicians was significantly improved. There was no significant difference in SEGUE score among different sex and marital status of resident physicians. SEGUE score is positively correlated with age; Different grades and educational backgrounds have significant effects on SEGUE score.ConclusionThe combination of CBL teaching method and SEGUE Framework is feasible and effective in the education program of doctor-patient communication skills for resident physicians in the department of otolaryngology, and worthy of popularization and application in other medical specialties.

Evaluating clinical communication skills of medical students, assistants, and professors

BackgroundThe skill of communicating with the patient is one of the basic clinical skills and part of the necessary competencies for medical doctors. The present study aimed to evaluate the knowledge, attitude, and performance (KAP) of medical students, assistants, and professors of Shahrekord University of Medical Sciences regarding clinical communication skills with patients.MethodThis cross-sectional study was conducted at the hospitals of Shahrekord University of Medical Sciences in Iran. The study included a total of 289 participants, consisting of 51 professors, 72 assistants, 90 external staff, and 76 interns who work at these hospitals. The participants were selected through a convenience sampling method. The data-gathering tools used included a questionnaire to collect demographic characteristics, a researcher-made questionnaire to assess knowledge, a communication skills attitude questionnaire, and a communication skills survey questionnaire. The data were analyzed using descriptive statistics such as mean, standard deviation, and frequency, as well as statistical tests that included one-way ANOVA and Pearson’s correlation test. The significance level for the study was considered to be 0.05.ResultsThe mean scores of knowledge of professors were higher compared to other groups (P = 0.002). All participating groups had a positive attitude toward learning communication skills. There were statistically significant differences between the mean scores of the communication performance of the study groups (P < 0.001). There was a positive relationship between positive attitude and communication performance, and a significant negative relationship was observed between negative attitude and communication performance.ConclusionThe results indicate the relatively favorable attitude and performance of the groups and their low knowledge. It is suggested that the doctor-patient communication skills courses be included as one of the necessary courses in the medical education curriculum.

A Randomized Controlled Study of Improving Patient Satisfaction With Community Health Services Through Health Promotion Interventions in Xian, China

Introduction: This study examines the effectiveness of health promotion in improving patient satisfaction with community health services. Methods: We conducted a single-blind randomized controlled trial on the patients from the Community Health Service Centres of Xi’an, China, from June to August 2022. The participants were randomly assigned to either an intervention group or a placebo group. Both groups received 3-week WeChat education, with the intervention group receiving online intervention education including 9 items, such as about community health service, the rights and welfare of patients, the basic workflow of staff, routine medical examination items for patients, common medical knowledge, nutrition during COVID-19 pandemic, doctor-patient communication skill and medical advice and discussion, while the placebo group received related information about health care and health. Data were collected before and after the intervention, and the results were measured using a social demographic questionnaire and the Patient Satisfaction Questionnaire (PSQ-18), which were analysed using SPSS 23.0 version. Results: In the study, 312 patients were enrolled, with 156 assigned to the intervention group and 156 assigned to the placebo group. The Patient Satisfaction Questionnaire (PSQ-18) revealed that the general satisfaction domain showed the most improvement, increasing from Mean (SD)=3.474 (0.060) to Mean (SD)=3.994 (0.045) before the intervention. Results from the two-way repeated measures ANOVA show that time has a significant effect on patient satisfaction particularly the general satisfaction, technical quality, communication, financial aspect, and time spent. Conclusions: The intervention significantly improved patient satisfaction in the intervention group compared to the placebo group, particularly in the areas of general satisfaction, technical quality, communication, and time spent (test within subjects). Statistically significant differences were observed in mean values before and after the intervention.

Effective communication with patients during COVID-19 pandemic

Introduction. The COVID-19 pandemic caused that many outpatient clinics implement telemedical consultations. It requires from the physician special skills when providing information during a phone call. Even though there is no possibility of physical examination on such occasions, we need to obtain as much information as possible from the patient or his family members and provide them with instructions that can be understood and applied in practice. Aim. The aim of the article is to review available publications about doctor-patient communication. Materials and methods. The Pubmed database was searched with use of the phrases: ’doctor-patient communication skills” and “storytelling; doctor-patient communication’ in November 2022. Results. Despite obstacles in providing good healthcare for patients during the COVID-19 pandemic, there are effective methods of obtaining a lot of information from the patient and provide him with easy-to-understand messages to take home. Storytelling is one of the methods of visualizing the disease and sometimes may improve patient’s mood. Conclusions. Telemedical consultations can be helpful if we spend enough time talking to the patient and provide him with information in an understandable format. Keywords: communication, COVID-19 pandemic, doctor-patient communication skills.

Stakes of Assessments in Residency: Influence on Previous and Current Self-Regulated Learning and Co-Regulated Learning in Early Career Specialists.

Assessments drive learning but the influence of the stakes of the assessments on self-regulated (SRL) during and after residency are unknown. As early career specialists (ECS) must continue learning independently, the answer to this is important as it may inform future assessments with the potential to promote life-long learning after graduation. We utilized constructivist grounded theory to explore the perspectives of eighteen ECS on the influence of stakes of assessments within residency on their SRL during training and in current practice. We conducted semi-structured interviews. We initially set out to examine the influence of the stakes of assessments on SRL during residency and after graduation. However, it was apparent that learners increasingly engaged with others in co-regulated learning (CRL) as the perceived stakes of the assessments increased. The individual learner's SRL was embedded in CRL in preparation for the various assessments in residency. For low-stakes assessments, the learner engaged in less CRL, taking less cues from others. As stakes increased, the learner engaged in more CRL with peers with similar intellectual level and supervisors to prepare for these assessments. SRL and CRL influenced by assessments in residency had a knock-on effect in clinical practice as ECS in: 1) developing clinical reasoning, 2) improving doctor-patient communication and negotiation skills, and 3) self-reflections and seeking feedback to deal with expectations of self or others. Our study supported that the stakes of assessments within residency reinforced SRL and CRL during residency with a continued effect on learning as ECS.

Application Analysis of Virtual Simulation Experiment Combined with Picture Archiving and Communication System in the Practical Teaching of Medical Imaging

Objective: To explore the application effect of virtual simulation experiment combined with picture archiving and communication system (PACS) in medical imaging practical teaching. Methods: 97 students from the medical imaging class of 2022 were divided into two groups; the control group (n = 48) was taught by the traditional teaching method, whereas the research group was taught by virtual simulation experiment combined with PACS (n = 49). The teaching achievements and teaching effects of the two groups were compared to define the advantages of the two teaching modes. Results: Initially, there were no significant differences in the basic theory, image analysis, report writing, and differential diagnosis scores between the two groups of students (P &gt; 0.05); however, after 16 weeks of teaching, the scores of the research group were better than those of the control group (P &lt; 0.05); the pass rate of students in the study group (93.88%) was higher than that in the control group (81.25%); the scores of students in the research group in terms of clinical inquiry skills, X-ray/computed tomography/magnetic resonance imaging (X-ray/CT/MRI) operation skills, and doctor-patient communication skills were significantly higher than those in the control group (P &lt; 0.05). Conclusion: In medical imaging practical teaching, the application of virtual simulation experiment combined with PACS can effectively address several problems in the traditional teaching mode, including the single teaching method, the single teaching content, and the lack of innovation, and, at the same time, improve students’ basic theoretical knowledge, X-ray/CT/MRI operation skills, consultation skills, and doctor-patient communication skills, thereby effectively improving the teaching quality and learning effect.

Student review of doctor-patient communication skills training in a South African undergraduate medical programme

Background. Barriers to the training of doctor-patient communication in the South African (SA) context have been well explored through qualitative research at several SA medical schools. However, this aspect of training has not been reviewed in a systematic way by a large number of students. A student review of doctor-patient communication skills training in the undergraduate medical programme of a medical school in SA was obtained to improve training and identify further research needs.Objective. To investigate doctor-patient communication skills training in the undergraduate programme of a medical school in SA to identify shortcomings and further research needs.Methods. A descriptive, cross-sectional design was used. Data were collected through an anonymous questionnaire based on Harden’s extended vision of the curriculum. Printed anonymous questionnaires, distributed to all the fourth- and fifth-year undergraduate medical students, were analysed quantitatively. Open-ended questions were analysed qualitatively using grounded theory.Results. The sample comprised 106/132 fifth-year students (response rate 80.3%) and 65/120 fourth-year students (response rate 54.2%). Frequent training in history-taking was reported by &gt;75% of students, while &gt;60% reported infrequent training in breaking bad news. More than 50% of participants indicated that senior doctors seldom or never modelled patient-centred communication in the clinical teaching milieu. Students preferred experiential learning to didactic methods.Conclusion. Medical students want to see patient-centred communication unequivocally modelled in the clinical setting. A greater emphasis on practical training in context-specific communication skills is required. Positive role-modelling is needed in the clinical environment.

The use of peer role-play in doctor-patient communication skills training for medical students: A systematic review

The quality of communication is directly related to patient satisfaction and can influence health outcomes. However, most doctors still have poor communication skills. A systematic literature search in PubMed, Cochrane, and Science Direct was conducted to retrieve studies reporting the use of peer role-play (PRP) for doctor-patient communication skills training in medical students. The quality of each study was assessed using the Joanna Briggs Institute (JBI) critical appraisal checklist. A total of 1,620 studies were obtained from electronic database search and screening of reference lists. After removing irrelevant studies and duplicates, one randomized control trial (RCT) and eight quasi-experimental studies were included in this systematic review. Peer role-play was perceived to be as useful as simulated patients (SP) training methods with comparable post-intervention objective structured clinical examination (OSCE) scores. Majority of students preferred PRP for learning communication skills over didactic lectures. The limitation of this review is the scarcity of eligible studies, high variability in the PRP programs across studies, and the lack of grey literature included. Peer role-play might be a cost-effective method to improve doctor-patient communication skills with comparable results (student’s perception and OSCE scores) with the expensive use of simulated patients. However, further study is needed to support this statement.

Research on Countermeasures of Occupational Health Protection for Rehabilitation Therapists under the COVID-19 Pandemic

In China, the level of occupational health protection of medical staff is relatively low, which is prone to occupational diseases and psychological problems. Focusing on the occupational health protection of rehabilitation therapists, the paper summarizes the current situation of six aspects included epidemic prevention control measures, therapy postures, therapy rooms’ environment, doctor-patient communication skills, mental health, and basic legal guarantee. Then give three aspects of countermeasures.

Discussion on the Necessity of Doctor-patient Communication Skills Training for Pharmaceutical Undergraduates under the New Doctor-patient Relationship

Discussion on the Necessity of Doctor-patient Communication Skills Training for Pharmaceutical Undergraduates under the New Doctor-patient Relationship

Practical approach to train and assess professional behaviour of medical students

The gradual decline of doctor-patient communication skills and professional attitudes and behaviour have steadily been observed in all countries across the globe. This deterioration has resulted in repeated and renewed demands to make medical schools more aligned to the necessity to train professional behaviours in undergraduate medical study. Medical educators have been criticised for not effectively training and rigorously assessing these skills. Training of behaviour has been abstracted in teaching of ethics and communication skills which in most of the cases is based on theoretical “preaching” lectures and use of book/guide and in some cases, training using supervised role-playing sessions at the best of options. Although good communication skills are essential for an optimal doctor-patient relationship and certainly contribute to improved health outcomes, still other aspects of behaviour are not covered. Furthermore, while the need for training on professional behaviour is specified as a requirement in the adopted graduate outcomes, formal training in these skills has been fragmentary and not clearly addressed in curriculum documents of the medical colleges in Iraq. A practical approach is here proposed to support medical colleges to bridge this gap. The methods of design, construction and use of standardised checklists for training medical students and assessing their acquisition of behavioural (affective) skills is described

Examining doctor-patient communication skills among senior medical students based on calgary cambridge observation guide.

Background: This study aimed to determine the level of communication skills in residents of Shahid Beheshti University of Medical Sciences in the final year of the main courses in accordance with the Calgary Cambridge Observation Guide for the purpose of improving their skills and improving the quality and correcting the existing problems. Methods: In this cross-sectional study, 190 residents of 14 majors were evaluated using a checklist of patient and physician communication skills based on the Calgary Cambridge Guide that has been localized in Persian language and culture using the cross-cultural adaptation standard in 6 stages. Content validity was verified by the primary author. The skills within the 71-item checklist were examined via a 3-point Likert-type rating scale, with scores ranging from 1 to 3 (good to poor) and the data were analyzed using the SPSS 16 software. Results: Of the190 residents, 161 were enrolled in the study. Of them 74 were internal and 87 surgical residents, and 89 were male and 72 were female. The mean score of the total communication skills in 14 major courses was 128.68±37.2264; it was 121.7±36.990 in the Department of Surgery, and 136.8±36.073 in the Department of Internal Medicine, with p=0.010, in female students 126.6 and in male student 130.3 with p=0.500. Conclusion: The score of 71 communication skills points in the list was prepared using the Likert scale option 3. In the overall skills, the weak score is 71 to 118.33, the average score is 118.34 to 165.66, and the good score is 165.67 to 213. Based on the findings of the study and examining the educational curriculum, it can be stated that unlike in psychiatry with an average score of 168.83, which is at a good level, the other fields are not well-developed and overall the communication skills in the residents, with a mean score of 128.68, are moderately poor and therefore further education and training is needed in these fields for resident students.

Utilizing a Learning Strategy Analysis to Determine a System’s Potential Impact on Student Learning: The Augmented-Reality Emotive Virtual Patient System Platform

A learning strategy analysis was performed on the Emotive Virtual Patient System, an augmented reality platform that teaches medical students doctor-patient communication skills. The Emotive Virtual Patient System is a complex mixed reality platform that includes both virtual and human peers/instructors who use natural language processing to provide feedback and dialog modeling as a means to improve patient communication learning outcomes. The learning strategy analysis (i.e., system learning strategy/component review, literature review, and heuristic evaluation of best practices) was conducted on the early system plans to determine its potential in supporting student learning and to provide shortand-long-term design considerations. The analysis identified three major categories for potential consideration: verbal interactions, user groups/system objective monitoring, and security. Specific recommendations were given for each of these areas, as supported by the literature.

How physicians respond to negative emotions in high-risk preoperative conversations

ObjectiveTo investigate physicians’ responses to negative emotions in high-risk preoperative conversations; and to explore the influencing factors of these responses. MethodsOne hundred and sixty-two audio recordings were coded using the Chinese Verona Coding Definition of Emotional Sequences (VR-CoDES). Big Five Personality Inventory Brief Version and Emotional Intelligence Scale were administered to explore the influencing factors of physicians’ responses. SPSS 24.0 and R 3.6.3 LME4 Package were used for data analysis. ResultsReduce Space (83%), referring to physicians’ responses reducing the opportunities of patients to disclose emotions, was physicians’ most frequent response to patients or families’ emotions. The main responses were Information-advice (ERIa) and Ignoring (NRIa). Younger age, female, Agreeableness and Openness were factors positively associated with Explicit Provide Space (EP); Neuroticism was negatively correlated with EP. Extroversion was negatively correlated with Explicit Reduce Space (ER); Conscientiousness was negatively correlated with both EP and ER responses. Emotional intelligence had no significant influence on physicians’ responses. ConclusionThe majority of physicians were inclined to reduce space by providing information advice or ignoring. Physicians’ responses were correlated with their gender, age and personality traits. Practice implicationsThe trainees’ gender, age and personality should be considered when conducting doctor-patient communication skills training.

Doctor-patient communication skills: a survey on knowledge and practice of Iranian family physicians

BackgroundCommunication skills are fundamental to successful medical practice and can greatly impact patient satisfaction, compliance and outcomes. This study evaluated knowledge and practice of doctor- patient communication among the urban family physicians based on main items of Calgary Cambridge Observation Guides.MethodThis cross-sectional study was conducted from July to September, 2019, in a 400 randomly selected sample of family physicians of Shiraz, Fars province. The data collection tool was a self-administered, second-part questionnaire developed by the researchers. Participants were asked about their age, gender, practice setting, and years of work experience and if they received any formal training in doctor- patient communication. Data were analyzed using SPSS (Version 16, SPSS Inc., Chicago, IL, USA). A p-value of less than 0.05 was considered statistically significant.ResultsThe study participants included 204 male and 196 female family physicians with a mean age of 46.7 ± 7.7 years. The mean communication skills knowledge score was 41.5 (SD: ± 2.8) indicating a high level of knowledge. The mean score for practices was 38.7 (SD: ± 3.4), implying a moderate level of practice. Based on Bloom’s scale, nearly 80% of family physicians had good knowledge about doctor-patient communication skills, however, 55% of participants reported moderate to poor level of practice in this regard. Results of multivariate regression analysis suggest that higher levels of related knowledge, having higher age or longer work experience, and working in the public sector can predict better practice scores (P < 0.005).ConclusionThere is a potential gap between knowledge and self-reported practices toward communication skills among a sample of Iranian family physicians. They have fundamental weakness in the most important evidence-based items of doctor- patient communication. Considering significant role of family physicians in prevention and control of non-communicable diseases (NCDs) as an emerging challenge of our country, the topic of communication skills should be inserted as a top educational priority of family physicians.

To play or pause: Video-based or conventional lectures in medical classrooms

Objectives: Medical knowledge has increased by leaps and bounds over the past century, but our teaching-learning methods remain archaic, lecturing being one of the oldest. This study was conducted to assess the change in knowledge following a conventional lecture and that following a video-based lecture using a medical television (TV) serial. Material and Methods: The students were divided into two groups based on their registration numbers. To one group, a video-based lecture using appropriate clips from a medical TV serial was administered while the other group was taught the same topic using conventional teaching-learning method of a lecture. A pre-test and a post-test were conducted and the change in the results compared. Results: The mean pre-test scores were higher in the successively senior batches of students as compared to the junior batches in both groups. The post-test scores were significantly higher in both the conventional lecture and the video group. Surprisingly, the mean post-test scores in the conventional lecture group were significantly higher than that of video-based lecture group. Students preferred the video-based lecture more than the conventional lecture. Conclusion: Both teaching learning methods have their own advantages. The conventional lecture uses an outcome-oriented session while the video-based sessions do not. The soft skills like breaking bad news, doctor patient communication skills etc which we never teach in conventional lectures can be learnt using these video-based sessions. Thus, we need a blended approach here as well, utilising the strengths of each of the teaching learning methods so that our students can achieve the laid down competencies.

Occupational burnout and job satisfaction among physicians in times of COVID-19 crisis: a convergent parallel mixed-method study

BackgroundHealthcare professionals including physicians were subjected to an increased workload during the COVID-19 crisis, leaving them exposed to significant physical and psychological distress. Therefore, our present study aimed to (i) assess the prevalence of burnout and levels of job satisfaction among physicians in Jordan, and (ii) explore physicians’ opinions, experiences, and perceptions during the pandemic crisis.MethodsThis was a mixed-method study that utilized a structured web-based questionnaire and semi-structured individual interviews. The 10-Item Burnout Measure-Short version (BMS), and the 5-Item Short Index of Job Satisfaction (SIJS) were adopted to assess occupational burnout and job satisfaction, respectively. Semi-structured interviews were conducted, based on a conceptual framework that was developed from Herzberg’s Two-Factor Theory of Motivation and Job Demands-Resources Model. Descriptive statistics and regression models, as well as inductive thematic analysis, were used to analyze quantitative and qualitative data, respectively.ResultsA total of 973 survey responses and 11 interviews were included in our analysis. The prevalence of burnout among physicians was (57.7%). Several significant factors were positively associated with burnout, including female gender, working at highly loaded hospitals, working for long hours, doing night shifts, lack of sufficient access to personal protective equipment, and being positively tested for SARS-CoV-2. Regarding job satisfaction, regression analysis revealed that age was positively associated with higher levels of job satisfaction. On contrary, being a general practitioner or specialist, working at highly loaded hospitals, low salaries, and suffering from burnout have predicted lower levels of job satisfaction.Besides, four themes have emerged from the thematic analysis: (i) Work-induced psychological distress during the pandemic, (ii) Decision-driven satisfactory and dissatisfactory experiences, (iii) Impact of the pandemic on doctor-patient communication and professional skills, and (iv) Economic impacts of the pandemic crisis and lockdown.ConclusionA significant physical and psychological burden was associated with the COVID-19 pandemic. Reliable efforts should be implemented aiming at protecting physicians’ physical and mental wellbeing, enhancing their working conditions, and raising awareness about burnout. Evidence-based decisions and proper utilization of financial and human resources at institutional and national levels are believed to be crucial for the sustainability of the health workforce, especially in crises.

Problems Existing in the Process of Clinical Medicine Undergraduate Practice and Coping Strategies

The effect of clinical practice directly affects the clinical ability and professional quality of graduates, lack of interest in practice, lack of doctor-patient communication skills and conflict with other clinical training doctors arecommon problems in current practice. This article through to the clinical medical undergraduate interns in practice there is lack of interest, in the process of doctor-patient communication skills and conflict with other clinical training for doctors and other issues were discussed, and through the reform of teaching methods, strengthen the teaching supervision and organize training of doctor-patient communication, in order to improve the clinical interns learning autonomy, strengthen the doctor-patient communication skills, to further improve the quality of medical personnel training to provide help.

Effectiveness of clinical scenario dramas to teach doctor-patient relationship and communication skills

BackgroundThe doctor-patient relationship in China has deteriorated in recent years, and poor doctor-patient communication is one of the main reasons. How to effectively carry out doctor-patient communication training originated from the West among Chinese medical students still to be studied. In the past decade, Peking Union Medical College has adopted clinical scenario drama to teach doctor-patient relationship and clinical communication skills. The aim of this study was to introduce clinical scenario dramas and evaluate its effectiveness in promoting doctor-patient relationships and clinical communication skills through students’ self-perceptions in Chinese medical students.MethodsThis study was a retrospective, self-controlled study and conducted from March 2009 to October 2018. Doctor-patient relationship and communication skills training were administered to all sixth-year medical students, which involved lectures and various clinical scenario dramas. The program totaled 24 h, of which each class session was 3 h, with 8 sessions in total. All students were requested to complete an anonymous 5 likert self-rating survey including self-confidence in using communication skills and self-perceived learning attitude and ability before and at the end of the course. In addition, they were requested to evaluate the curriculum after completion of the course.ResultsClinical scenario dramas helped students improve their self-confidence in clinical communication skills except for psychosomatic history taking (p < 0.05). The interests for participation in clinical scenario dramas were higher compared to attending lectures (4.39 ± 0.610 Vs 4.07 ± 0.831, p<0.01). Study participants were highly satisfied in the course setting, teaching instructors and content (4.61 ± 0.546, 4.65 ± 0.535, 4.63 ± 0.534). The self-evaluation results demonstrated that clinical scenario dramas improved the learning ability of medical students (p < 0.05).ConclusionThe use of clinical scenario dramas was helpful in teaching doctor-patient communication skills.

Awareness of MBBS Students on Effects of Workplace Violence and Conflict Management in Hospital Scenario

According to World Health Organisation, healthcare workers are four times more prone to injuries due toworkplace violence compared to other professions. An ongoing study by the Indian Medical Associationinferred that about 75% of doctors have faced violence at work, where many of the cases were reported fromEmergency wards and Intensive Care Units and the patient’s relatives were the prime offenders. Poor doctorpatient communication and weak conflict resolution skills are some of the preventable reasons for violenceon doctors. A questionnaire-based study was conducted on MBBS students to assess the effects of violenceon doctors and their level of preparedness in dealing with violent situations. Majority of the students werenot taught precautionary measures or methods of managing conflicts and thus are not properly equipped intackling workplace violence. By improving their manner of conduct towards the patients in likely incidentsof violence and training them in managing conflicts, such acts shall be curbed effectively