Skip to main content
Erschienen in: Journal of General Internal Medicine 7/2016

26.02.2016 | Original Research

Communication Skills Training for Physicians Improves Patient Satisfaction

verfasst von: Adrienne Boissy, MD, MA, Amy K. Windover, PhD, Dan Bokar, Matthew Karafa, PhD, Katie Neuendorf, MD, Richard M. Frankel, PhD, James Merlino, MD, Michael B. Rothberg, MD, MPH

Erschienen in: Journal of General Internal Medicine | Ausgabe 7/2016

Einloggen, um Zugang zu erhalten

ABSTRACT

BACKGROUND

Skilled physician communication is a key component of patient experience. Large-scale studies of exposure to communication skills training and its impact on patient satisfaction have not been conducted.

OBJECTIVE

We aimed to examine the impact of experiential relationship-centered physician communication skills training on patient satisfaction and physician experience.

DESIGN

This was an observational study.

SETTING

The study was conducted at a large, multispecialty academic medical center.

PARTICIPANTS

Participants included 1537 attending physicians who participated in, and 1951 physicians who did not participate in, communication skills training between 1 August 2013 and 30 April 2014.

INTERVENTION

An 8-h block of interactive didactics, live or video skill demonstrations, and small group and large group skills practice sessions using a relationship-centered model.

MAIN MEASURES

Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CGCAHPS), Jefferson Scale of Empathy (JSE), Maslach Burnout Inventory (MBI), self-efficacy, and post course satisfaction.

KEY RESULTS

Following the course, adjusted overall CGCAHPS scores for physician communication were higher for intervention physicians than for controls (92.09 vs. 91.09, p < 0.03). No significant interactions were noted between physician specialty or baseline CGCAHPS and improvement following the course. Significant improvement in the post-course HCAHPS Respect domain adjusted mean was seen in intervention versus control groups (91.08 vs. 88.79, p = 0.02) and smaller, non-statistically significant improvements were also seen for adjusted HCAHPS communication scores (83.95 vs. 82.73, p = 0.22). Physicians reported high course satisfaction and showed significant improvement in empathy (116.4 ± 12.7 vs. 124 ± 11.9, p < 0.001) and burnout, including all measures of emotional exhaustion, depersonalization, and personal accomplishment. Less depersonalization and greater personal accomplishment were sustained for at least 3 months.

CONCLUSIONS

System-wide relationship-centered communication skills training improved patient satisfaction scores, improved physician empathy, self-efficacy, and reduced physician burnout. Further research is necessary to examine longer-term sustainability of such interventions.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
5.
Zurück zum Zitat Marvel MK, Epstein RM, Flowers K, Beckman HB. Soliciting the patient’s agenda: have we improved? JAMA. 1999;281(3):283–7.CrossRefPubMed Marvel MK, Epstein RM, Flowers K, Beckman HB. Soliciting the patient’s agenda: have we improved? JAMA. 1999;281(3):283–7.CrossRefPubMed
6.
Zurück zum Zitat Brock DM, Mauksch LB, Witteborn S, Hummel J, Nagasawa P, Robins LS. Effectiveness of intensive physician training in upfront agenda setting. J Gen Intern Med. 2011;26(11):1317–23.CrossRefPubMedPubMedCentral Brock DM, Mauksch LB, Witteborn S, Hummel J, Nagasawa P, Robins LS. Effectiveness of intensive physician training in upfront agenda setting. J Gen Intern Med. 2011;26(11):1317–23.CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Mazor KM, Beard RL, Alexander GL, Arora NK, Firneno C, Gaglio B, et al. Patients’ and family members’ views on patient-centered communication during cancer care. Psycho-Oncology. 2013;22(11):2487–95. doi:10.1002/pon.3317.CrossRefPubMed Mazor KM, Beard RL, Alexander GL, Arora NK, Firneno C, Gaglio B, et al. Patients’ and family members’ views on patient-centered communication during cancer care. Psycho-Oncology. 2013;22(11):2487–95. doi:10.​1002/​pon.​3317.CrossRefPubMed
10.
Zurück zum Zitat Robinson JD, Hoover DR, Venetis MK, Kearney TJ, Street RL Jr. Consultations between patients with breast cancer and surgeons: a pathway from patient-centered communication to reduced hopelessness. J Clin Oncol: Off J Am Soc Clin Oncol. 2013;31(3):351–8. doi:10.1200/JCO.2012.44.2699.CrossRef Robinson JD, Hoover DR, Venetis MK, Kearney TJ, Street RL Jr. Consultations between patients with breast cancer and surgeons: a pathway from patient-centered communication to reduced hopelessness. J Clin Oncol: Off J Am Soc Clin Oncol. 2013;31(3):351–8. doi:10.​1200/​JCO.​2012.​44.​2699.CrossRef
11.
Zurück zum Zitat Stewart M, Brown JB, Donner A, McWhinney IR, Oates J, Weston WW, et al. The impact of patient-centered care on outcomes. J Fam Pract. 2000;49(9):796–804.PubMed Stewart M, Brown JB, Donner A, McWhinney IR, Oates J, Weston WW, et al. The impact of patient-centered care on outcomes. J Fam Pract. 2000;49(9):796–804.PubMed
12.
Zurück zum Zitat Stewart M, Brown JB, Hammerton J, Donner A, Gavin A, Holliday RL, et al. Improving communication between doctors and breast cancer patients. Ann Fam Med. 2007;5(5):387–94.CrossRefPubMedPubMedCentral Stewart M, Brown JB, Hammerton J, Donner A, Gavin A, Holliday RL, et al. Improving communication between doctors and breast cancer patients. Ann Fam Med. 2007;5(5):387–94.CrossRefPubMedPubMedCentral
13.
Zurück zum Zitat Roter DL, Hall JA, Kern DE, Barker LR, Cole KA, Roca RP. Improving physicians’ interviewing skills and reducing patients’ emotional distress. A randomized clinical trial. Arch Intern Med. 1995;155(17):1877–84.CrossRefPubMed Roter DL, Hall JA, Kern DE, Barker LR, Cole KA, Roca RP. Improving physicians’ interviewing skills and reducing patients’ emotional distress. A randomized clinical trial. Arch Intern Med. 1995;155(17):1877–84.CrossRefPubMed
15.
Zurück zum Zitat Stein T, Frankel RM, Krupat E. Enhancing clinician communication skills in a large healthcare organization: a longitudinal case study. Patient Educ Couns. 2005;58(1):4–12.CrossRefPubMed Stein T, Frankel RM, Krupat E. Enhancing clinician communication skills in a large healthcare organization: a longitudinal case study. Patient Educ Couns. 2005;58(1):4–12.CrossRefPubMed
16.
Zurück zum Zitat Windover A, Boissy A, Rice T, Gilligan T, Velez V, Merlino J. The REDE model of healthcare communication: Optimizing relationship as a therapeutic agent. J Patient Experience. 2014;1(1):8–13.CrossRef Windover A, Boissy A, Rice T, Gilligan T, Velez V, Merlino J. The REDE model of healthcare communication: Optimizing relationship as a therapeutic agent. J Patient Experience. 2014;1(1):8–13.CrossRef
17.
18.
Zurück zum Zitat Merckaert I, Libert Y, Razavi D. Communication skills training in cancer care: where are we and where are we going? Curr Opin Oncol. 2005;17(4):319–30.CrossRefPubMed Merckaert I, Libert Y, Razavi D. Communication skills training in cancer care: where are we and where are we going? Curr Opin Oncol. 2005;17(4):319–30.CrossRefPubMed
19.
Zurück zum Zitat Dwamena F H-RM, Gaulden CM, Jorgenson S, Sadigh G, Sikorskii A, Lewin S, Smith RC, Coffey J, Olomu A, Beasley M. Interventions for providers to promote a patient-centred approach in clinical consultations. Cochrane Database of Syst Rev. 2012(12). doi:10.1002/14651858.CD003267.pub2. Dwamena F H-RM, Gaulden CM, Jorgenson S, Sadigh G, Sikorskii A, Lewin S, Smith RC, Coffey J, Olomu A, Beasley M. Interventions for providers to promote a patient-centred approach in clinical consultations. Cochrane Database of Syst Rev. 2012(12). doi:10.​1002/​14651858.​CD003267.​pub2.
20.
Zurück zum Zitat Frostholm L, Fink P, Oernboel E, Christensen KS, Toft T, Olesen F, et al. The uncertain consultation and patient satisfaction: the impact of patients’ illness perceptions and a randomized controlled trial on the training of physicians’ communication skills. Psychosom Med. 2005;67(6):897–905. doi:10.1097/01.psy.0000188403.94327.5b.CrossRefPubMed Frostholm L, Fink P, Oernboel E, Christensen KS, Toft T, Olesen F, et al. The uncertain consultation and patient satisfaction: the impact of patients’ illness perceptions and a randomized controlled trial on the training of physicians’ communication skills. Psychosom Med. 2005;67(6):897–905. doi:10.​1097/​01.​psy.​0000188403.​94327.​5b.CrossRefPubMed
21.
Zurück zum Zitat O’Leary KJ, Darling TA, Rauworth J, Williams MV. Impact of hospitalist communication-skills training on patient-satisfaction scores. J Hosp Med: Off Publ Soc Hosp Med. 2013;8(6):315–20. doi:10.1002/jhm.2041.CrossRef O’Leary KJ, Darling TA, Rauworth J, Williams MV. Impact of hospitalist communication-skills training on patient-satisfaction scores. J Hosp Med: Off Publ Soc Hosp Med. 2013;8(6):315–20. doi:10.​1002/​jhm.​2041.CrossRef
22.
Zurück zum Zitat Brown JB, Boles M, Mullooly JP, Levinson W. Effect of clinician communication skills training on patient satisfaction. A randomized, controlled trial. Ann Intern Med. 1999;131(11):822–9.CrossRefPubMed Brown JB, Boles M, Mullooly JP, Levinson W. Effect of clinician communication skills training on patient satisfaction. A randomized, controlled trial. Ann Intern Med. 1999;131(11):822–9.CrossRefPubMed
23.
Zurück zum Zitat Fossli Jensen B, Gulbrandsen P, Dahl FA, Krupat E, Frankel RM, Finset A. Effectiveness of a short course in clinical communication skills for hospital doctors: results of a crossover randomized controlled trial (ISRCTN22153332). Patient Educ Couns. 2011;84(2):163–9. doi:10.1016/j.pec.2010.08.028.CrossRefPubMed Fossli Jensen B, Gulbrandsen P, Dahl FA, Krupat E, Frankel RM, Finset A. Effectiveness of a short course in clinical communication skills for hospital doctors: results of a crossover randomized controlled trial (ISRCTN22153332). Patient Educ Couns. 2011;84(2):163–9. doi:10.​1016/​j.​pec.​2010.​08.​028.CrossRefPubMed
24.
Zurück zum Zitat Fujimori M, Shirai Y, Asai M, Kubota K, Katsumata N, Uchitomi Y. Effect of communication skills training program for oncologists based on patient preferences for communication when receiving bad news: a randomized controlled trial. J Clin Oncol: Off J Am Soc Clin Oncol. 2014;32(20):2166–72. doi:10.1200/JCO.2013.51.2756.CrossRef Fujimori M, Shirai Y, Asai M, Kubota K, Katsumata N, Uchitomi Y. Effect of communication skills training program for oncologists based on patient preferences for communication when receiving bad news: a randomized controlled trial. J Clin Oncol: Off J Am Soc Clin Oncol. 2014;32(20):2166–72. doi:10.​1200/​JCO.​2013.​51.​2756.CrossRef
25.
27.
Zurück zum Zitat Fallowfield L, Lipkin M, Hall A. Teaching senior oncologists communication skills: results from phase I of a comprehensive longitudinal program in the United Kingdom. J Clin Oncol: Off J Am Soc Clin Oncol. 1998;16(5):1961–8. Fallowfield L, Lipkin M, Hall A. Teaching senior oncologists communication skills: results from phase I of a comprehensive longitudinal program in the United Kingdom. J Clin Oncol: Off J Am Soc Clin Oncol. 1998;16(5):1961–8.
28.
Zurück zum Zitat Schell JO, Green JA, Tulsky JA, Arnold RM. Communication skills training for dialysis decision-making and end-of-life care in nephrology. Clin J Am Soc Nephrol: CJASN. 2013;8(4):675–80. doi:10.2215/CJN.05220512.CrossRefPubMed Schell JO, Green JA, Tulsky JA, Arnold RM. Communication skills training for dialysis decision-making and end-of-life care in nephrology. Clin J Am Soc Nephrol: CJASN. 2013;8(4):675–80. doi:10.​2215/​CJN.​05220512.CrossRefPubMed
30.
Zurück zum Zitat Levinson W, Roter D. The effects of two continuing medical education programs on communication skills of practicing primary care physicians. J Gen Intern Med. 1993;8(6):318–24.CrossRefPubMed Levinson W, Roter D. The effects of two continuing medical education programs on communication skills of practicing primary care physicians. J Gen Intern Med. 1993;8(6):318–24.CrossRefPubMed
31.
Zurück zum Zitat Canivet D, Delvaux N, Gibon AS, Brancart C, Slachmuylder JL, Razavi D. Improving communication in cancer pain management nursing: a randomized controlled study assessing the efficacy of a communication skills training program. Support Care Cancer : Off J Multinat Assoc Support Care Cancer. 2014. doi:10.1007/s00520-014-2357-2 [doi] Canivet D, Delvaux N, Gibon AS, Brancart C, Slachmuylder JL, Razavi D. Improving communication in cancer pain management nursing: a randomized controlled study assessing the efficacy of a communication skills training program. Support Care Cancer : Off J Multinat Assoc Support Care Cancer. 2014. doi:10.​1007/​s00520-014-2357-2 [doi]
32.
Zurück zum Zitat Gibon AS, Merckaert I, Lienard A, Libert Y, Delvaux N, Marchal S, et al. Is it possible to improve radiotherapy team members’ communication skills? A randomized study assessing the efficacy of a 38-h communication skills training program. Radiother Oncol: J Eur Soc Ther Radiol Oncol. 2013;109(1):170–7. doi:10.1016/j.radonc.2013.08.019.CrossRef Gibon AS, Merckaert I, Lienard A, Libert Y, Delvaux N, Marchal S, et al. Is it possible to improve radiotherapy team members’ communication skills? A randomized study assessing the efficacy of a 38-h communication skills training program. Radiother Oncol: J Eur Soc Ther Radiol Oncol. 2013;109(1):170–7. doi:10.​1016/​j.​radonc.​2013.​08.​019.CrossRef
33.
Zurück zum Zitat Smith RC, Lyles JS, Mettler J, Stoffelmayr BE, Van Egeren LF, Marshall AA, et al. The effectiveness of intensive training for residents in interviewing. A randomized, controlled study. Ann Intern Med. 1998;128(2):118–26.CrossRefPubMed Smith RC, Lyles JS, Mettler J, Stoffelmayr BE, Van Egeren LF, Marshall AA, et al. The effectiveness of intensive training for residents in interviewing. A randomized, controlled study. Ann Intern Med. 1998;128(2):118–26.CrossRefPubMed
34.
Zurück zum Zitat Yedidia MJ, Gillespie CC, Kachur E, Schwartz MD, Ockene J, Chepaitis AE, et al. Effect of communications training on medical student performance. JAMA : J Am Med Assoc. 2003;290(9):1157–65. doi:10.1001/jama.290.9.1157.CrossRef Yedidia MJ, Gillespie CC, Kachur E, Schwartz MD, Ockene J, Chepaitis AE, et al. Effect of communications training on medical student performance. JAMA : J Am Med Assoc. 2003;290(9):1157–65. doi:10.​1001/​jama.​290.​9.​1157.CrossRef
35.
Zurück zum Zitat Deveugele M, Derese A, De Maesschalck S, Willems S, Van Driel M, De Maeseneer J. Teaching communication skills to medical students, a challenge in the curriculum? Patient Educ Couns. 2005;58(3):265–70. doi:S0738-3991(05)00171-0 [pii].CrossRefPubMed Deveugele M, Derese A, De Maesschalck S, Willems S, Van Driel M, De Maeseneer J. Teaching communication skills to medical students, a challenge in the curriculum? Patient Educ Couns. 2005;58(3):265–70. doi:S0738-3991(05)00171-0 [pii].CrossRefPubMed
36.
Zurück zum Zitat Bragard I, Etienne AM, Merckaert I, Libert Y, Razavi D. Efficacy of a communication and stress management training on medical residents’ self-efficacy, stress to communicate and burnout: a randomized controlled study. J Health Psychol. 2010;15(7):1075–81. doi:10.1177/1359105310361992.CrossRefPubMed Bragard I, Etienne AM, Merckaert I, Libert Y, Razavi D. Efficacy of a communication and stress management training on medical residents’ self-efficacy, stress to communicate and burnout: a randomized controlled study. J Health Psychol. 2010;15(7):1075–81. doi:10.​1177/​1359105310361992​.CrossRefPubMed
38.
Zurück zum Zitat Dyrbye LN, West CP, Satele D, Boone S, Tan L, Sloan J, et al. Burnout among U.S. medical students, residents, and early career physicians relative to the general U.S. population. Acad Med: J Assoc Am Med Coll. 2014;89(3):443–51. doi:10.1097/ACM.0000000000000134.CrossRef Dyrbye LN, West CP, Satele D, Boone S, Tan L, Sloan J, et al. Burnout among U.S. medical students, residents, and early career physicians relative to the general U.S. population. Acad Med: J Assoc Am Med Coll. 2014;89(3):443–51. doi:10.​1097/​ACM.​0000000000000134​.CrossRef
Metadaten
Titel
Communication Skills Training for Physicians Improves Patient Satisfaction
verfasst von
Adrienne Boissy, MD, MA
Amy K. Windover, PhD
Dan Bokar
Matthew Karafa, PhD
Katie Neuendorf, MD
Richard M. Frankel, PhD
James Merlino, MD
Michael B. Rothberg, MD, MPH
Publikationsdatum
26.02.2016
Verlag
Springer US
Erschienen in
Journal of General Internal Medicine / Ausgabe 7/2016
Print ISSN: 0884-8734
Elektronische ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-016-3597-2

Weitere Artikel der Ausgabe 7/2016

Journal of General Internal Medicine 7/2016 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

„Jeder Fall von plötzlichem Tod muss obduziert werden!“

17.05.2024 Plötzlicher Herztod Nachrichten

Ein signifikanter Anteil der Fälle von plötzlichem Herztod ist genetisch bedingt. Um ihre Verwandten vor diesem Schicksal zu bewahren, sollten jüngere Personen, die plötzlich unerwartet versterben, ausnahmslos einer Autopsie unterzogen werden.

Hirnblutung unter DOAK und VKA ähnlich bedrohlich

17.05.2024 Direkte orale Antikoagulanzien Nachrichten

Kommt es zu einer nichttraumatischen Hirnblutung, spielt es keine große Rolle, ob die Betroffenen zuvor direkt wirksame orale Antikoagulanzien oder Marcumar bekommen haben: Die Prognose ist ähnlich schlecht.

Schlechtere Vorhofflimmern-Prognose bei kleinem linken Ventrikel

17.05.2024 Vorhofflimmern Nachrichten

Nicht nur ein vergrößerter, sondern auch ein kleiner linker Ventrikel ist bei Vorhofflimmern mit einer erhöhten Komplikationsrate assoziiert. Der Zusammenhang besteht nach Daten aus China unabhängig von anderen Risikofaktoren.

Semaglutid bei Herzinsuffizienz: Wie erklärt sich die Wirksamkeit?

17.05.2024 Herzinsuffizienz Nachrichten

Bei adipösen Patienten mit Herzinsuffizienz des HFpEF-Phänotyps ist Semaglutid von symptomatischem Nutzen. Resultiert dieser Benefit allein aus der Gewichtsreduktion oder auch aus spezifischen Effekten auf die Herzinsuffizienz-Pathogenese? Eine neue Analyse gibt Aufschluss.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.