Doctors Using Patient Feedback to Establish Professional Learning Goals: Results from a Communication Skill Development Program

Doctors Using Patient Feedback to Establish Professional Learning Goals: Results from a Communication Skill Development Program

L. Baker (Auckland University of Technology, New Zealand), M. J. Greco (Auckland University of Technology, New Zealand) and A. Narayanan (Auckland University of Technology, New Zealand)
DOI: 10.4018/978-1-60566-266-4.ch022
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Abstract

There is growing interest in the way that communication between doctors and patients affects important aspects of patient care and health outcomes. However, there is not much research on quantifying the effect of specific training programmes in communication skills for doctors. The aim of this chapter is to describe a research project that addresses this issue by first asking patients to provide feedback to doctors on their interpersonal skills. A set of training objectives is then discussed with individual doctors based on patient feedback. A training programme is subsequently undertaken by doctors, who are re-assessed by patients to determine the effectiveness of the feedback and training. The results indicate significant improvement on re-measurement. The chapter discusses the reasons for this improvement and the implications for providing personalised interpersonal skills training programs that target those skills that have been specifically identified by patients.
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Background

Training modules in communication and interpersonal skill building are now prevalent in medical education programmes. Such modules typically involve senior colleagues observing student doctor interaction with standard patients and providing feedback to help student doctors improve their interviewing techniques (e.g. Roth et al, 2002). Performance-based training can also be used involving evaluation of clinical performance.

Patient feedback (outcomes-based research using patient questionnaires) has received little attention as a potentially effective educational tool in the training of medical practitioners. Research shows that discussing one's results of patient feedback with a more experienced colleague has a significantly positive impact on future performance (Cope et al, 1986; Blurton and Mazzaferri, 1985; Greco et al, 2001). Whilst there is some evidence that the use of patient feedback can stimulate change for doctors-in-training, there is little evidence that the same can be said of fully qualified and practising doctors as opposed to doctors going through medical education (Greco et al, 1998).

With regard to outcomes-based research, a number of tools have been developed to measure patient experience of interaction with doctors. For instance, Trumble et al (2006) used 10 questions modelled on the ‘Art of Medicine Survey’ (Webster, 1989):

  • How well did the doctor listen to your concerns and questions?

  • How respectful was the doctor?

  • How well did the doctor understand your problem?

  • How accepting was the doctor of you and your problem?

  • How well did the doctor explain to you what he or she was doing?

  • How well did the doctor use words that are easy to understand?

  • How well did the doctor cover what you expected of them?

  • Did the doctor spend enough time with you?

  • How much confidence do you have in the doctor's ability?

  • Overall, how satisfied are you with the service you received from your doctor?

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