Need For Communication Skills Training Research Articles

Pharmacists' communication skills with deaf and hard of hearing patients: A needs assessment.

Assess the Saudi pharmacists' perceptions of their responsibilities toward deaf and hard-of-hearing (DHH) patients, their current practices, and their need for communication skills training. A prospective cross-sectional study. Pharmacist and deaf communication questionnaire (PDCQ), a newly structured, validated, pilot-tested, and self-administered online questionnaire, was used to collect data. A total of 303 pharmacists working in the Saudi community and outpatient pharmacies participated in the study. Data were analyzed using SPSS and descriptive statistics were used to describe the study findings. These included Mean ± standard deviation (SD), frequency, and Chi-square tests. Most pharmacists perceived that DHH patients had difficulty correctly understanding their medication instructions. Writing was the most common method used for communication, whereas the unavailability of interpreters and the low reading levels of these patients were the highest barriers to communication. Moreover, most pharmacists believed that they should be skilled at communicating with DHH patients. However, many pharmacists felt that they are not well prepared to communicate with these patients. This research highlights the poor skills, low confidence and low knowledge Saudi pharmacists have about their legal obligations towards DHH patients. In addition, there is paucity of sufficient resources to help pharmacists improve their communication with such patients.

General and Unique Communication Skills Challenges for Advanced Practice Providers: A Mixed-Methods Study.

Aims:Advanced practice providers are a rapidly growing sector of the health-care field. Despite their relatively new place in the medical establishment, these providers are held to high standards of education, practice, and communication skills. However, the communication needs of these practitioners are somewhat different than those of nurses or physicians. These skills are even more necessary in specialized fields where providers frequently are involved in discussions of prognosis, goals of care, and end of life.Design:This was a mixed-methods study.Methods:We completed a needs assessment of communication skills for advanced practice providers at a large cancer center in the northeastern United States from June to July 2017.Results:Participants were confident in their skills across several areas of communication, but also endorsed the need for communication skills training, particularly for challenging interactions with patients and families. Advanced practice providers described many challenges similar to those descried by other health-care providers, including general communication skills problems, navigating team dynamics, and goals-of-care planning. However, participants also endorsed communication skills needs specific to their field, including certain patient-centered challenges, perceived/real limitations of their role, serving as the “middleman,” and understanding the advanced practice provider's role.Conclusion:Given the general and unique communication challenges advanced practice providers in oncology face, we conclude with recommendations for further institutional and educational changes to better address these needs.

Patient autonomy in dentistry: demonstrating the role for shared decision making

BackgroundEvidence-based practice, decision aids, patient preferences and autonomy preferences (AP) play an important role in making decisions with the patient. They are crucial in the process of a shared decision making (SDM) and can be incorporated into quality criteria for patient involvement in health care. However, there are few studies on SDM and AP in the field of dentistry. This study explored patients’ autonomy preferences in dentistry in comparison to other medical domains, comparing them with patient preferences in two other cohorts of patients with different conditions and in different health care settings.MethodsA sample of 100 dental patients attending 16 dentists was consecutively recruited in a university-based prosthodontic clinic. Patients’ and dentists’ preferences regarding their roles in dental decision making for commonly performed diagnostic and treatment decisions were compared using the Control Preference Scale (CPS). This was followed by cross sectional surveys to study autonomy preferences in three additional cohorts recruited from general practices (n = 100), a multiple sclerosis clinic (n = 109), and a university-based prosthodontic clinic (n = 100). A questionnaire with combined items from the Autonomy Preference Index (API) to assess general and the CPS to assess specific preferences was used in the additional cohorts.ResultsDentists were less willing to give patients control than patients were willing to enact autonomy. However, decisions about management of tooth loss were considered relevant for a shared decision making by both parties. When comparing cohorts from different samples, the highest AP was expressed by people with multiple sclerosis and the lowest by patients in dentistry (means: dentistry 2.5, multiple sclerosis 2.1, general practice 2.4, p = .035). There were considerable intra-individual differences in autonomy preferences referring to different decision types (p < .001). In general, more autonomy was desired for treatment decisions in comparison to diagnostic decisions, for trivial compared to severe conditions, and for dental care compared to general practice (all: p < .001).ConclusionThere is an important role of patient participation in decision making in dentistry. Furthermore, PA should be considered with respect to specific medical decisions instead of assessing autonomy preferences in general implying a need for communication skills training of health care professionals.

Peri-Operative Communication with Patients who have Mental Health Illness or Autism: The Need for Communication Skills Training for Anaesthetists

Compared with other specialties, the anaesthetist has a variable relationship with the patient peri-operatively. This can be divided into three phases, firstly the pre-operative assessment, secondly the peri-procedural period, and finally the post-operative period.

Perceived Communication Skills Among Tertiary Care Physicians.

Self-perception in clinical skills, including communication skills (CS), has been found to provide insights on strengths, weaknesses, and opportunities for skill improvement. The present study is aimed at exploring perceived CS among physicians working at a tertiary healthcare level. Physicians working at a tertiary hospital based in Saudi Arabia were invited to complete a modified self-questionnaire that assesses CS. Descriptive and association studies were performed. Psychometric properties of the questionnaire were determined. Out of the 101 participating physicians, 57.2% rated their CS in the range of very good and excellent, but only 30.7% rated themselves as overall excellent. The question item with the highest mean score (score range, 1 to 5) was related to encouraging patients to ask questions (4.2 ± 0.9), while the lowest was for the item that assessed information disclosure (3.8 ± 0.8). Males rated themselves higher than females in the item related to explaining things to patients (p < 0.05), whereas physicians with non-surgical specialties rated themselves better than those with surgical specialties in the item related to expressing interest in patients (p < 0.05). Based on physicians' self-rated assessment, less than the third of tertiary care physicians considered themselves as maintaining an excellent level of CS. Future studies are encouraged to examine CS through a multisystem assessment and promote the need for CS training for physicians working at a tertiary care level.

P065: Emergency department staff perceived need and preferred methods for communication skills training

Introduction: Burnout includes emotional exhaustion (EE), depersonalization (DP) and personal accomplishment (PA). Emergency Department (ED) staff have high levels of burnout that may be responsive to communication skills training. We surveyed ED staff perception of need and efficacy before and after an intervention using an established conflict resolution methodology. Methods: ED physicians, nurses and support staff were surveyed at two regional hospitals using the Maslach Burnout Inventory (MBI) and a communications questionnaire to establish the perceived need for communication skill training. Participants from one center were provided with a communications intervention (Crucial Conversations®, VitalSmarts®), and a refresher course 6-15 months later. The survey was then repeated at both sites and course participant feedback was elicited. Results: MBI results were high (mean EE = 25.25 (high &amp;gt; 25), 95% CI = 22.5-28; DP = 11.6 (high &amp;gt; 8), 95% CI = 10.1-13.2; PA = 35.85 (low &amp;lt;34), 95% CI = 34.3-37.4). Initially 82% of intervention and 77% of control site participants responded that “attending an educational session about ways to communicate better would help the participants at work”. Post intervention group responses to “The program will be helpful to me in communicating more effectively in my work environment” were: 75% “strongly agree” and 25% “agree”. No rating below “agree” was assigned by any of the participants. Participants preferred facilitated small group simulations and advocated for earlier career implementation. Conclusion: There was a perceived need for and impact from communication skills training for ED staff with high measured burnout. Training may be best implemented in small group simulated encounters and in health professional education curriculum or as part of work orientation.

How do Swiss medical schools prepare their students to become good communicators in their future professional careers: a questionnaire and interview study involving medical graduates, teachers and curriculum coordinators

BackgroundSince 2011, the Swiss Catalogue of Learning Objectives (SCLO) has provided the framework for assessing communication skills in the Swiss Medical Federal Licensing Examination (FLE). This study evaluates how far the communication curricula of five Swiss medical schools match the SCLO and international recommendations. It also explores their strengths, weaknesses, opportunities and threats (SWOT).MethodsA mixed method approach was used. In a first step, curriculum coordinators/key communication skills teachers and medical graduates were asked to fill out a questionnaire based on communication related objectives from the SCLO and a review of European consensus statements on communication training. Second, information was collected from all Swiss medical schools to identify which communication skills were taught in which formats and at what time points within the 6-year curricula. Finally, 3–4 curriculum coordinators/key communication skills teachers from each medical school were interviewed about their communication curriculum, using SWOT analysis.ResultsSixteen teachers/coordinators (response rate 100%) and 389 medical graduates (response rate 43%) filled out the questionnaire. Both the teachers/coordinators and the graduates considered that two thirds of the communication items listed in the questionnaire were covered in their curricula. Between sixty and two hundred structured hours were dedicated to communication, predominantly in small group and experiential formats. Assessment relied on both MCQs and OSCEs. Most of the training occurred during the first three years of medical school. Teachers felt that the need for communication skills training was now well-recognized by their institution and was taught with appropriate teaching methods. However, recruitment and training of teachers, continuity of communication skills training during clinical years, and the adoption of a common frame of reference among the five medical schools, remained a challenge.ConclusionAlthough the Swiss medical schools all offered a partly longitudinal communication skills training, with appropriate teaching methods, this study indicates that the communication skills actually taught do not fully match the SCLO or international recommendations. There was less training for complex communication skills training during the clinical years, and ensuring quality and coherence in the teaching remained a challenge.

Our Wish for End of Life Care- A collaborative approach to Improving End of Life Care

Background: Beaumont Hospital has a high level of activity surrounding end-of-life care. The hospital has introduced many initiatives to implement the Quality Standards for End of Life Care in Acute Hospitals. As part of a review, the End of Life Care Committee decided to engage with staff to determine what supports them to deliver good quality end of life care (EoLC), and to identify any additional initiatives required to support staff in this work. Aims & Objectives: To celebrate good practices and improvements in EOLC to date. To share the experience of bereaved relatives with staff members. To understand what supports staff to deliver compassionate person centred end of life care and what are the factors that act as barriers. To inform the EoLC Committee work plan. Methodology: A workshop event was determined to be the most appropriate mechanism to achieve the goals outlined and a number of communication approaches were taken to ensure staff from as many different departments and disciplines as possible attended. A total of 52 staff attended the event representing 11 different occupational groups. The event was designed to facilitate participants to connect with compassion and feeling. It began by showing ‘A Wish’ a short animated video about the End of Life care in Acute hospitals. This was followed by actors presenting dramatised accounts of the real EoLC experiences of six bereaved families. These stories demonstrated the positive impact of the quality improvement initiatives already in place, and highlighted the negative impact of some poor practices. The participants were invited to reflect on their reaction to the material by writing one word on an A4 page. Three questions were posed to the participants. 1).What supports you to deliver compassionate EolC? 2).What factors prevent this from happening? 3). What else could support the delivery of compassionate EoLC? The conversation at each table was facilitated by experienced facilitators. Each group recorded their answers on flip chart paper and the groups were invited to feedback the conversation at their table to the main group. Analysis of the words, flip chart pages and facilitator notes revealed the themes outlined below. Results & Discussion: The Physical Environment: limited availability of single rooms for patients and private spaces impacts on EoLC. The cost of car parking is a problem for families. Resources such as the End of Life Symbol, canvas property bags and resource folders are valued by staff. The Work Environment: Strong role models and appropriate staffing combined with good team work involving all staff grades is essential for good EoLC. Staff Supports: Personal experience and access to specialist knowledge, e.g. Palliative Care, Chaplaincy, Mortuary staff, Social Work and the Bereavement Service supports good EoLC. Education & Training: Staff are empowered by education and training. There is a need for in-depth education on EoLC issues, in addition to the programmes already available. Communication within teams and between staff and patients and their families is essential. There is a need for communication skills training. Patient/ Family Engagement: We need to engage with patients and families about end of life care and seek feedback in a structured way. Conclusions:The event raised awareness of the EoLC programme and provided a rich source of information for the EoLC Committee. The findings endorsed the Hospitals approach to improving the quality of EoLC while also highlighting areas requiring further work. Implications: The information gained, together with the Quality Standards for End of Life Care have informed EoLC Committee work plans.

Nurses' communication with patients who are mechanically ventilated in intensive care: the Botswana experience.

Communication is an integral part of nursing practice not just only for therapeutic reasons but also for sharing information. Nurses working in intensive care experience challenges when communicating with patients who are mechanically ventilated due to lack of knowledge and skill. These challenges infringe on the patients' rights to receive information and as such they may impact negatively on the patients' outcomes. This study determined the existing knowledge and skills of intensive care nurses working with mechanically ventilated patients in Botswana. A retrospective descriptive and explorative research design with a quantitative approach was used to audit patients' records. This was augmented by further interviewing nurses for their knowledge and skills when communicating with ventilated patients within the two intensive care units in Botswana. The American Association of Critical Nurses Synergy Model was used to guide the study. One hundred and fifty-nine (159) patients' files were audited and 50 nurses chosen by purposive sampling completed a self-administered 42-item questionnaire. Statistical Package for Social Sciences version 10 and Microsoft Excel were used to analyse the data. Assessment of patients' ability to communicate was recorded in more than 90% of files audited. Four per cent (4%) of the respondents only communicated essential information and no other strategies or devices were used to aid communication. Communication with ventilated patients can be quite challenging to nurses working in the intensive care unit. There is a need for communication skills training to ensure that all nurses working with mechanically ventilated patients are properly trained, equipped and capable of communicating effectively with the patient. A greater understanding of communication dynamics with the intensive care unit with patients who are mechanically ventilated is crucial to enable nurses to improve their care and improve patients' comfort. Incorporating communication in the nursing standards would ensure that patients are treated with dignity which would help improve patient outcomes.

Facilitators and Barriers to Discussing HIV Prevention With Adolescents: Perspectives of HIV-Infected Parents

We examined HIV-infected parents' conversations about HIV prevention with their uninfected children, including what facilitated or hindered communication. Parents with HIV/AIDS (n = 90) who had children aged 10 to 18 years were recruited for a mixed method study from 2009 to 2010. Interviews assessed facilitators and barriers to discussing HIV prevention. A questionnaire identified the frequency and content of conversations, parental confidence level, and perceived importance of discussing preventive topics. Eighty-one percent of parents reported "sometimes" or "often" communicating about HIV prevention. A subset of parents found these conversations difficult; 44% indicated their desire for support. Facilitators to communication included utilizing support, focusing on the benefits of talking, and having a previous relationship with one's child. Barriers to discussions included fear of negative consequences, living in denial, and lacking a parental role model who discussed safer sex. Parents varied as to how they believed their HIV status affected communication. Those who did not disclose their HIV status to their children reported less frequent communication; self-efficacy partially mediated this relationship. Findings highlighted the need for communication skills training that support HIV-infected parents in their efforts to discuss HIV-related information with adolescents.

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.

Patient compliance with telephone triage recommendations: A meta-analytic review

ObjectiveTo systematically investigate the extent to which patients comply with triage advice from telenurses and to identify factors that potentially influence compliance. MethodsFindings from 13 studies identified through interdisciplinary research databases (1990–2010) were meta-analyzed. Separate pooled analyses compared patients’ compliance rates for emergency services and office care (13 outcomes), emergency services and self care (13 outcomes), and self care and office care (12 outcomes). ResultsOverall patient compliance was 62%, but varied by intensity of care recommended with low compliance rates for advice to see a general practitioner. Reasons for noncompliance include patients reporting to have heard a different disposition, patients’ intentions and health beliefs. ConclusionPatient compliance to triage recommendations was influenced by the interactive role of patient perceptions and the quality of provider communication, both of which were mediated by access to health services. Further research is needed to clarify whether noncompliance is attributable to poor communication by the nurse or patient misinterpretation. Practice implicationsWe highlight the need for communication-skills training in a telephone-consultation context that is patient centered, and specifically addresses building active listening and active advising skills and advantages to structuring the call.

Promoting knowledge and understanding in society

PurposeThe ability to communicate with society is one of the key skills by which our students can help enhance knowledge and understanding of different subjects within the general population. Unfortunately, up until recently few subject areas have provided tailored training for their students in the art of communicating with different audiences, especially a non‐specialist one. This review paper aims to discuss the rationale for incorporating defined communication skills training (CST) into higher education courses, focusing on medicine, other healthcare professions and science. In addition the review aims to identify example methodologies used for the training and assessment of communication skills.Design/methodology/approachThe approach taken for this review has been to: identify and review national, subject specific and individual drivers for why higher education should be including CST in their courses and programmes; evaluate some of the published approaches and innovations used to introduce CST into higher education courses; and finally, assess the factors that curriculum designers should consider when incorporating CST into their programmes or modules.FindingsThe review shows that there are a number of important drivers for including CST in higher education curricula, especially training which is directed to communicating with non‐specialist audiences. The paper identifies a number of varied approaches for integrating training into existing and emerging HE courses and modules, aimed at developing both oral and written communication skills.Originality/valueThe paper demonstrates the need for CST in undergraduate courses and acts as a challenge to others to devise strategies to ensure their students are ready and able to communicate with society in the twenty‐first century.

Understanding and defining roles in the pharmacist–patient relationship

Along with increased consumerism in healthcare, pharmacists (RPhs) are quickly advancing as key medical advisers to patients; however, minimal research focuses on this particular relationship between health professional and patient. A recent study of RPhs and patients explored: (1) current views of RPh–patient communication related to traditional medication therapy, as well as increased use of herbal therapies; (2) the perceptions and expectations inherent in the RPh's role as a healthcare professional. Results identified three significant roles for modern RPhs, key responsibilities associated with each role, and an inherent need for communication skills training for RPhs and patients to maximise this relationship and realise positive health outcomes.

Understanding and defining roles in the pharmacist–patient relationship

Along with increased consumerism in healthcare, pharmacists (RPhs) are quickly advancing as key medical advisers to patients; however, minimal research focuses on this particular relationship between health professional and patient. A recent study of RPhs and patients explored: (1) current views of RPh–patient communication related to traditional medication therapy, as well as increased use of herbal therapies; (2) the perceptions and expectations inherent in the RPh's role as a healthcare professional. Results identified three significant roles for modern RPhs, key responsibilities associated with each role, and an inherent need for communication skills training for RPhs and patients to maximise this relationship and realise positive health outcomes.

Seeking informed consent to cancer clinical trials:: describing current practice

Clinical trials have come to be regarded as the gold standard for treatment evaluation. However, many doctors and their patients experience difficulties when discussing trials, leading to poor accrual to trials and questionable quality of informed consent. We have previously developed a typology for ethical communication about Phase II and III clinical trials within four domains: (a) shared decision making, (b) sequencing information, (c) type and clarity of information, and (d) disclosure/coercion. The aim of this study was to compare current clinical practice when seeking informed consent with this typology. Fifty-nine consultations in which 10 participating oncologists sought informed consent were audiotaped. Verbatim transcripts were analysed using a coding system to (a) identify the presence or absence of aspects of the four domains and (b) rate the quality of aspects of two domains: (i) shared decision-making and (ii) type and clarity of information. Oncologists rarely addressed aspects of shared decision-making, other than offering to delay a treatment decision (78%). Moreover, many of these discussions scored poorly with respect to ideal content. The oncologists were rarely consistent with the sequence of information provision. A general rationale for randomising was only described in 46% of consultations. In almost one third of the consultations (28.8%) doctors made implicit statements favouring one option over another, either standard or clinical trial treatment. Doctors complied with some but not other aspects of a standard procedure for discussing clinical trials. This reflects the difficulty inherent in seeking ethical informed consent and the need for communication skills training for oncologists.

The Effects of Communication Motives, Interaction Involvement, and Loneliness on Satisfaction

A small group model was tested that traced the path by which communication motives influenced interaction involvement and loneliness and the ways that these factors, in turn, influenced group satisfaction. Results indicated that pleasure was a reason for communicating responsively, whereas escape, control, and inclusion were not reasons. Escape was not a motive reported by those who were lonely. With regard to group satisfaction, it was found that loneliness was a mediatingfactor in that members who interacted responsively were not lonely, and those who were not lonely reported satisfaction with the group. Finally, there was a direct link between the need for affection and satisfaction. Implications of the model's findings support the need for communication skills training and understanding members' motives for interacting in ongoing task groups.

Evaluating a workshop designed to help medical students improve their skills in communicating about cancer: methodological considerations--and worries.

Increasingly, communication skills training is being introduced into medical schools. Evaluations of post-training assessments document its success and add momentum to this movement. In addition, evaluations of student feedback shape course content and teaching methods. Two types of self-selection might bias evaluations and hence, lead to erroneous decisions: (1) students who attend a course may differ from nonattenders; and (2) students who give feedback may differ from those who do not. These two types of bias were examined in the context of a workshop designed to help medical students talk to patients about cancer. Overall, the need for communication skills training was endorsed. However, sex and experiential differences between attenders and non-attenders were identified and if replicated, could confound post-training evaluations. Similarly, differences between students who were more and less willing to provide feedback suggested that decisions based on student evaluations might systematically shape courses to the needs of unrepresentative student groups. Furthermore, qualitative data suggested that students who are least likely to give feedback, are those most likely to have critical or negative comments. Such a bias could mislead evaluators to underestimate the need for change. Rather than cancel each other out, biases associated with attendance and motivation to provide feedback combined. This is serious, because in practice, evaluators are likely to receive data only from those who both attend a given course and provide feedback. The danger is that evaluators may base decisions on information from a doubly self-selected minority of students.