The effectiveness of intensive training for residents in interviewing. A randomized, controlled study.
BACKGROUND
Interviewing and the physician-patient relationship are crucial elements of medical care, but residencies provide little formal instruction in these areas.


OBJECTIVE
To determine the effects of a training program in interviewing on 1) residents' attitudes toward and skills in interviewing and 2) patients' physical and psychosocial well-being and satisfaction with care.


METHODS
Randomized, controlled study.


METHODS
Two university-based primary care residencies.


METHODS
63 primary care residents in postgraduate year 1.


METHODS
A 1-month, full-time rotation in interviewing and related psychosocial topics.


METHODS
Residents and their patients were assessed before and after the 1-month rotation. Questionnaires were used to assess residents' commitment to interviewing and psychosocial medicine, estimate of the importance of such care, and confidence in their ability to provide such care. Knowledge of interviewing and psychosocial medicine was assessed with a multiple-choice test. Audiotaped interviews with real patients and videotaped interviews with simulated patients were rated for specific interviewing behaviors. Patients' anxiety, depression, and social dysfunction; role limitations; somatic symptom status; and levels of satisfaction with medical visits were assessed by questionnaires and telephone interviews.


RESULTS
Trained residents were superior to untrained residents in knowledge (difference in adjusted post-test mean scores, 15.7% [95% CI, 11% to 20%]); attitudes, such as confidence in psychological sensitivity (difference, 0.61 points on a 7-point scale [CI, 0.32 to 0.91 points]); somatization management (difference, 0.99 points [CI, 0.64 to 1.35 points]); interviewing of real patients (difference, 1.39 points on an 11-point scale [CI, 0.32 to 2.45 points]); and interviewing (data gathering) of simulated patients (difference, 2.67 points [CI, 1.77 to 3.56 points]). Mean differences between the study groups were consistently in the appropriate direction for patient satisfaction and patient well-being, but effect sizes were too small to be considered meaningful.


CONCLUSIONS
An intensive 1-month training rotation in interviewing improved residents' knowledge about, attitudes toward, and skills in interviewing.
Smith
R C
RC
Lyles
J S
JS
Mettler
J
J
Stoffelmayr
B E
BE
Van Egeren
L F
LF
Marshall
A A
AA
Gardiner
J C
JC
Maduschke
K M
KM
Stanley
J M
JM
Osborn
G G
GG
Shebroe
V
V
Greenbaum
R B
RB
D001291:Attitude of Health Personnel; D002983:Clinical Competence; D005194:Family Practice / Q000193:education*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007396:Internship and Residency; D007407:Interviews as Topic; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011795:Surveys and Questionnaires