Residents' attitudes towards and skills in counseling: using undetected standardized patients.
OBJECTIVE
To identify the frequency and quality of certain prevention-oriented counseling skills of resident physicians and to compare these skills with the residents' attitudes towards and knowledge about primary prevention.


METHODS
Longitudinal descriptive study.


METHODS
54 PGY-1-3 internal medicine and family practice residents enrolled in three training programs affiliated with Michigan State University's College of Human Medicine.


METHODS
Trainees' attitudes towards and knowledge about certain prevention activities were captured by an instrument designed for this study using 127 Likert scales. Counseling skills were assessed with one of two standardized patients. Residents were unaware of the simulation, which occurred in their routinely scheduled ambulatory care setting. Audiotapes of the interactions were rated by blinded, independent raters. Residents had strong positive beliefs about the role of primary care physicians in counseling patients, high levels of knowledge about what the counseling should entail, and high self-assessment about the frequency and quality of their own counseling interventions. Skill levels, however, were at or below a level defined as minimally acceptable.


CONCLUSIONS
Resident physicians' skill levels, as measured in this study, are inadequate to accomplish routine counseling interventions in the primary care setting. These results suggest that more reliance should be placed on direct observation of physicians, ideally in nonreactive settings, for purposes of drawing conclusions about physician performance. Further, these results have implications for the training of students and residents in the area of counseling for prevention.
Hoppe
R B
RB
Department of Medicine, College of Human Medicine, Michigan State University, East Lansing 48824-1317.
Farquhar
L J
LJ
Henry
R
R
Stoffelmayr
B
B
D001291:Attitude of Health Personnel; D002784:Cholesterol / Q000097:blood; D002983:Clinical Competence; D003376:Counseling; D004650:Employee Performance Appraisal; D005194:Family Practice / Q000193:education; D005260:Female; D006293:Health Promotion; D006801:Humans; D007388:Internal Medicine / Q000193:education; D007396:Internship and Residency; D008297:Male; D008824:Michigan; D010353:Patient Education as Topic; D010817:Physician-Patient Relations; D000074606:Smoking Prevention
D002784:Cholesterol