gms | German Medical Science

Research in Medical Education – Chances and Challenges International Conference

20.05. - 22.05.2009, Heidelberg

Study design and first results of a randomized control trial to enhance the physician-patient relationship in inpatient care by communication training and supervision

Meeting Abstract

  • corresponding author presenting/speaker Nadja Ringel - University Hospital Heidelberg, Internal Medicine II, Department of Psychososmatic and General Clinical Medicine, Heidelberg, Germany
  • B. Buermann - University Hospital Heidelberg, Internal Medicine II, Department of Psychososmatic and General Clinical Medicine, Heidelberg, Germany
  • author Andreas Möltner - University Hospital Heidelberg, Center of Excellence for Assessment in Medicine/Baden-Württemberg, Heidelberg, Germany
  • U. Riemann - SLK Hospital Heillbronn, Internal Medicine I, Heilbronn, Germany
  • G. Schillinger - AOK Bundesverband
  • author Christoph Nikendei - University Hospital Heidelberg, Internal Medicine II, Department of Psychososmatic and General Clinical Medicine, Heidelberg, Germany
  • Wolfgang Langewitz - University Hospital Basel, Division Psychosomatic Medicine/Internal Medicine, Basel, Schweiz
  • author Jobst-Hendrik Schultz - University Hospital Heidelberg, Internal Medicine II, Department of Psychososmatic and General Clinical Medicine, Heidelberg, Germany
  • author Jana Jünger - University Hospital Heidelberg, Internal Medicine II, Department of Psychososmatic and General Clinical Medicine, Heidelberg, Germany

Research in Medical Education - Chances and Challenges 2009. Heidelberg, 20.-22.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. Doc09rmeJ4

doi: 10.3205/09rme57, urn:nbn:de:0183-09rme575

Published: May 5, 2009

© 2009 Ringel et al.
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Outline

Abstract

Question: The importance of patient physician communication has been well established and there is growing acceptance in Germany to teach and assess communication skills in medical schools. However studies assessing the acceptance and effects of communication skills training for hospital physicians are still very rare and so far the reported outcomes have been heterogeneous. Nevertheless certain components have been shown to be effective, e.g. role playing, feedback and individual coaching sessions. To further investigate the effectiveness und benefits from communication skills training within the medical profession, we used this evidence to design a novel training which not only includes the state-of-the-art components, but was also adapted to especially fit the precise setting.

Regarding the physician’s variables the objective of this novel training is to enhance the subjective competences, balance out empathy and to reduce burnout rates. We also want to evaluate the acceptance of the training.

Methods: 40 physicians currently working on an internal ward were randomized in an intervention and a waiting control group by matched pairs. The intervention group participated in a 3 day communication and interaction skills training including role play with standardized patients, a supervised ward round in between and an MSE (multi station exercise) to evaluate the effect of the intervention. The training contents were tailored to the particular needs and challenges of daily hospital work using focus groups. Questionnaire data were collected from 40 hospital physicians, 200 patients (modified Picker questionnaire, SF-36, PHQ) and their consulting general practitioners (patient’s adherence) at baseline and after intervention. Additionally patient physician consultations were videotaped to analyze communication skills (RIAS). The presented data will be limited to the physician self report variables: subjective competence, empathy (German version of the Jefferson Empathy scale) and burnout symptoms (Maslach Burnout Inventory) at baseline and after the intervention.

Results: The study design will be described and the initial results of the statistical evaluation regarding the acceptance of the training as well as physician self-assessment will be presented. Furthermore the challenges of a study, where all physicians working on an internal ward had to participate, are discussed.

Conclusions: The training was highly accepted by the participants and was evaluated as very helpful and useful to improve their communication- and interaction skills. Especially the ward round supervision was rated as a very good method to reflect on and improve the physician patient communication in everyday work, which allows a better transfer.

The study is assigned in ISRCTN60811508.