Typing skills of physicians in training.
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ABSTRACT:
SUBMITTER: Kalava A
PROVIDER: S-EPMC3963776 | biostudies-other | 2014 Mar
REPOSITORIES: biostudies-other
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Project description:BackgroundSkilled 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.ObjectiveWe aimed to examine the impact of experiential relationship-centered physician communication skills training on patient satisfaction and physician experience.DesignThis was an observational study.SettingThe study was conducted at a large, multispecialty academic medical center.ParticipantsParticipants 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.InterventionAn 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 measuresHospital 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 resultsFollowing 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.ConclusionsSystem-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.
| S-EPMC4907940 | biostudies-literature
Project description:ObjectivesThe objectives were to describe the current procedural skill practices, attitudes toward procedural skill competency, and the role for educational skills training sessions among emergency medicine (EM) physicians within a geographic health zone.MethodsThis is a multicenter descriptive cross-sectional survey of all EM physicians working at 12 emergency departments (EDs) within the Edmonton Zone in 2019. Survey items addressed current procedural skill performance frequency; perceived importance and confidence; current methods to maintain competence; barriers and facilitating factors to participation in a curriculum; preferred teaching methods; and desired frequency of practice for each procedural skill.ResultsSurvey response rate was 53.6%. Variability in frequency of performed procedures was seen across the type of hospital sites. For the majority of skills, there was a significantly positive correlation between the frequency at which a skill was performed and the perceived confidence performing said skill. There was inconsistency and no significant correlation with perceived importance, perceived confidence or frequency performing a given skill, and the desired frequency of training for that skill. Course availability (76.2%) and time (72.8%) are the most common identified barriers to participation in procedural skills training.ConclusionsThis study summarized the current ED procedural skill practices among EM physicians in the Edmonton Zone and attitudes toward an educational curriculum for procedural skill competency. This represents a step toward targeted continuing professional development in staff physicians.
| S-EPMC8019211 | biostudies-literature
Project description:BACKGROUND: Pediatricians and family physicians are responsible for providing newborn resuscitation, yet Accreditation Council for Graduate Medical Education requirements for training in this area during residency differ markedly for the two specialties. Our objectives were to determine (1) the extent to which neonatal resuscitation training differs for pediatric and family medicine residents; (2) the extent to which general pediatricians and family physicians engage in newborn resuscitation in their practice; and (3) whether use of resuscitation skills differs between urban/suburban and rural providers. METHODS: We surveyed a national cohort of pediatricians and family physicians who obtained board certification between 2001 and 2005. Data were analyzed based on type of physician and setting of current practice. RESULTS: Survey response rate was 22% (382 of 1736). Compared with family medicine physicians, pediatricians received more neonatal resuscitation training during residency. Most members of both groups had attended no deliveries in the year prior to the survey (75% [111 of 148] versus 74% [114 of 154]). In their current practice, the groups were equally likely to have provided a newborn bag and mask ventilation, chest compressions, and resuscitation medications. Pediatricians were more likely than family physicians to have attempted to either intubate a newborn (20% [28 of 148] versus 10% [16 of 153]; P = .0495) or insert umbilical catheters (15% [22 of 148] versus 5% [8 of 153]; P = .005). Regardless of specialty, rural physicians were much more likely to report that they attended deliveries (61% [41 of 67] versus 15% [36 of 234]; P < .001). Among rural pediatricians attending deliveries, 44% (7 of 16) reported feeling inadequately prepared for at least one delivery in the past year. CONCLUSIONS: Few primary care pediatricians and family physicians provide newborn resuscitation after residency. For those who do attend deliveries, current training 5 provide insufficient preparation. Flexible, individualized residency curricula could target intensive resuscitation training to individuals who plan to practice in rural areas and/or attend deliveries after graduation.
| S-EPMC3244311 | biostudies-other
Project description:BackgroundPhysicians require specific communication skills, because the face-to-face contact with their patients is an important source of information. Although physicians who perform work disability assessments attend some communication-related training courses during their professional education, no specialised and evidence-based communication skills training course is available for them. Therefore, the objectives of this study were: 1) to systematically develop a training course aimed at improving the communication skills of physicians during work disability assessment interviews with disability claimants, and 2) to plan an evaluation of the training course.MethodsA physician-tailored communication skills training course was developed, according to the six steps of the Intervention Mapping protocol. Data were collected from questionnaire studies among physicians and claimants, a focus group study among physicians, a systematic review of the literature, and meetings with various experts. Determinants and performance objectives were formulated. A concept version of the training course was discussed with several experts before the final training course programme was established. The evaluation plan was developed by consulting experts, social insurance physicians, researchers, and policy-makers, and discussing with them the options for evaluation.ResultsA two-day post-graduate communication skills training course was developed, aimed at improving professional communication during work disability assessment interviews. Special focus was on active teaching strategies, such as practising the skills in role-play. An adoption and implementation plan was formulated, in which the infrastructure of the educational department of the institute that employs the physicians was utilised. Improvement in the skills and knowledge of the physicians who will participate in the training course will be evaluated in a randomised controlled trial.ConclusionsThe feasibility and practical relevance of the communication skills training course that was developed seem promising. Such a course may be relevant for physicians in many countries who perform work disability assessments. The development of the first training course of this type represents an important advancement in this field.
| S-EPMC3138427 | biostudies-literature
Project description:BACKGROUND:Improving the training of physicians about communication skills and patient health literacy (HL) is a major priority that remains an open question. We aimed to examine the effectiveness of communication skills training for physicians on the hypertension outcomes and the health literacy skills, self-efficacy and medication adherence in patients with uncontrolled blood pressure (BP). METHODS:A randomized, controlled trial method was conducted on 240 hypertensive patients and 35 physicians presenting to healthcare clinics in the Mashhad, Iran, from 2013 to 2014. Using stratified blocking with block sizes of 4 and 6, eligible patients with uncontrolled blood pressure were randomly allocated to the intervention and control groups. Physicians in the intervention group received educational training over 3 sessions of Focus -Group Discussion and 2 workshops. The control group received the routine care. The primary outcome was a reduction in systolic and diastolic BP from baseline to 6?months. The secondary outcome was promoting HL skills in hypertensive patients. Data were analyzed using the regression model and bivariate tests. RESULTS:After the physician communication training, there was a significant improvement in physicians-patient communication skills, hypertension outcomes, medication adherence, and self-efficacy among the patients being managed by the physicians receiving training, compared to the control group. CONCLUSION:The educational intervention leads to better BP control; it may have been sufficient training of physicians change to impact counseling, HL and self-efficacy and adherence. The quality of physician-patient communication is an important modifiable element of medical communication that may influences health outcomes in hypertensive Iranian patients. TRIAL REGISTRATION:Iranian Registry of Clinical Trials (IRCT), IRCT20160710028863N24. Registered April 4, 2018 [retrospectively registered].
| S-EPMC6979365 | biostudies-literature
Project description:OBJECTIVES:Teamwork and interprofessional team training are fundamental to ensuring the continuity of care and high-quality outcomes for patients in a complex clinical environment. Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) is an evidence-based team training programme intended to facilitate healthcare professionals' teamwork skills. The aim of this study is to describe healthcare professionals' experiences with teamwork in a surgical ward before and during the implementation of a longitudinal interprofessional team training programme. DESIGN:A qualitative descriptive study based on follow-up focus group interviews. SETTING:A combined gastrointestinal surgery and urology ward at a hospital division in a Norwegian hospital trust. PARTICIPANTS:A convenience sample of 11 healthcare professionals divided into three professionally based focus groups comprising physicians (n=4), registered nurses (n=4) and certified nursing assistants (n=3). INTERVENTIONS:The TeamSTEPPS programme was implemented in the surgical ward from May 2016 to June 2017. The team training programme included the three phases: (1) assessment and planning, (2) training and implementation and (3) sustainment. RESULTS:Before implementing the team training programme, healthcare professionals were essentially satisfied with the teamwork skills within the ward. During the implementation of the programme, they experienced that team training led to greater awareness and knowledge of their common teamwork skills. Improved teamwork skills were described in relation to a more systematic interprofessional information exchange, consciousness of leadership-balancing activities and resources, the use of situational monitoring tools and a shared understanding of accountability and transparency. CONCLUSIONS:This study suggests that the team training programme provides healthcare professionals with a set of tools and terminology that promotes a common understanding of teamwork, hence affecting behaviour and communication in their daily clinical practice at the surgical ward. TRIAL REGISTRATION NUMBER:ISRCTN13997367.
| S-EPMC7348475 | biostudies-literature
Project description:BackgroundOne of the primary goals of simulation-based education is to enable long-term retention of training gains. However, medical literature has poorly contributed to understanding the best timing for repetition of simulation sessions. There is heterogeneity in re-training recommendations.ObjectivesThis study assessed, through simulation-based training in different groups, the long-term retention of rare pediatric technical procedures.MethodsThis multicenter observational study included 107 emergency physicians and residents. Eighty-eight were divided into four groups that were specifically trained for pediatric emergency procedures at different points in time between 2010 and 2015 (< 0.5 year prior for G1, between 0.5 and 2 years prior for G2, between 2 and 4 years prior for G3, and ≥ 4 years prior for G4). An untrained control group (C) included 19 emergency physicians. Participants were asked to manage an unconscious infant using a low-fidelity mannequin. Assessment was based on the performance at 6 specific tasks corresponding to airway (A) and ventilation (B) skills. The performance (scored on 100) was evaluated by the TAPAS scale (Team Average Performance Assessment Scale). Correlation between performance and clinical level of experience was studied.ResultsThere was a significant difference in performance between groups (p < 0.0001). For G1, 89% of the expected tasks were completed but resulted in longer delays before initiating actions than for the other groups. There was no difference between G4 and C with less than half of the tasks performed (47 and 43% respectively, p = 0.57). There was no correlation between clinical level of experience and performance (p = 0.39).ConclusionPerformance decreased at 6 months after specific training for pediatric emergency skills, with total loss at 4 years after training, irrespective of experience. Repetition of simulation sessions should be implemented frequently after training to improve long-term retention and the optimal rate of refresher courses requires further research.
| S-EPMC6739955 | biostudies-literature
Project description:BackgroundThe Brazilian undergraduate medical course is six years long. As in other countries, a medical residency is not obligatory to practice as a doctor. In this context, this paper aims to clarify what and when competencies in communication and professionalism should be addressed, shedding light on the role of university, residency and post-residency programmes.MethodsBrazilian family physicians with diverse levels of medical training answered a questionnaire designed to seek a consensus on the competencies that should be taught (key competencies) and when students should achieve them during their medical training. The data were analysed using descriptive statistics and correlation tests.ResultsA total of seventy-four physicians participated; nearly all participants suggested that the students should achieve communication and professionalism competencies during undergraduate study (twenty out of thirty competencies - 66.7%) or during residency (seven out of thirty competencies - 23.33%). When competencies were analysed in domains, the results were that clinical communication skills and professionalism competencies should be achieved during undergraduate medical education, and interpersonal communication and leadership skills should be reached during postgraduate study.ConclusionThe authors propose that attainment of clinical communication skills and professionalism competencies should be required for undergraduate students. The foundation for Leadership and Interpersonal Abilities should be particularly formed at an undergraduate level and, furthermore, mastered by immersion in the future workplace and medical responsibilities in residency.
| S-EPMC5859538 | biostudies-literature
Project description:IntroductionThere is a need for innovative workshops designed to teach students and residents the basics of clinical medical education. Resident physicians often spend a significant portion of their training teaching others and frequently have very little formal instruction on teaching techniques. Other teaching tools exist but are often either entirely lecture based or too extensive to easily incorporate into a residency teaching session. There is a need for the facilitated practice of teaching methods to improve the resident educational experience.MethodsThis 80-minute workshop blends interactive role-play case studies with quick lectures on the ARCH feedback model, the RIME model of medical information mastery, and the One-Minute Preceptor. This workshop includes three short PowerPoint lectures, four case studies, a handout, a pre-/posttest, and a session evaluation form.ResultsResident and student learners were engaged for the entirety of this session. Pre-/posttest results showed an improvement in understanding of basic teaching and feedback techniques, and survey results showed a higher likelihood of the learners wanting to incorporate teaching into their future practice.DiscussionThis workshop is quick and overall quite effective in teaching basic feedback and teaching techniques. It provides a much-needed opportunity for residents to practice teaching techniques immediately after they have learned the concepts. This training is ideal for a residency program looking to provide new senior residents with the teaching tools they need for success.
| S-EPMC7394347 | biostudies-literature
Project description:BACKGROUND: Improving quality of primary care is a key focus of international health policy. Current quality improvement efforts place a large focus on technical, clinical aspects of quality, but a comprehensive approach to quality improvement should also include interpersonal care. Two methods of improving the quality of interpersonal care in primary care have been proposed. One involves the feedback of patient assessments of interpersonal care to physicians, and the other involves brief training and education programmes. This study therefore reviewed the efficacy of (i) feedback of real patient assessments of interpersonal care skills, (ii) brief training focused on the improvement of interpersonal care (iii) interventions combining both (i) and (ii) METHODS: Systematic review of randomised controlled trials. Three electronic databases were searched (CENTRAL, Medline and Embase) and augmented by searches of the bibliographies of retrieved articles. The quality of studies was appraised and results summarised in narrative form. RESULTS: Nine studies were included (two patient based feedback studies and seven brief training studies). Of the two feedback studies, one reported a significant positive effect. Only one training study reported a significant positive effect. CONCLUSION: There is limited evidence concerning the effects of patient based feedback. There is reasonable evidence that brief training as currently delivered is not effective, although the evidence is not definitive, due to the small number of trials and the variation in the training methods and goals. The lack of effectiveness of these methods may reflect a number of issues, such as differences in the effectiveness of the interventions in experienced practitioners and those in training, the lack of theory linking feedback to behaviour change, failure to provide sufficient training or to use a comprehensive range of behaviour change techniques. Further research into both feedback and brief training interventions is required before these interventions are routinely introduced to improve patient satisfaction with interpersonal care in primary care. The interventions to be tested in future research should consider using insights from the wider literature on communication outside primary care, might benefit from a clearer theoretical basis, and should examine the use of combined brief training and feedback.
| S-EPMC2542366 | biostudies-literature