title: Physicians are different when they learn communication skills: influence of the locus of control.
abstract: OBJECTIVE
  Although it is widely recognised that educational interventions may be more effective for people with an 'internal' Locus of Control (who believe that life outcomes are controlled by their own characteristics or actions) compared to people with an 'external' Locus of Control (who believe that life outcomes are controlled by external forces such as luck, fate or others), no study has yet assessed the influence of physicians' Locus of Control (LOC) on communication skills learning. This study aims to test the hypothesis that, in a communication skills training program, physicians with an 'internal' LOC would demonstrate communication skills acquisition to a greater degree than those with an 'external' LOC.
  
  
  METHODS
  A non-randomised longitudinal intervention study was conducted between January 1999 and April 2001. Sixty-seven volunteer physicians from private and institutional practice in Belgium participated in a learner-centred, skills-focused, practice-oriented communication skills training program. Communication skills changes were assessed in 2 standardised simulated interviews before and after training (one two-person and one three-person interview). Communication skills were assessed using the Cancer Research Campaign Workshop Evaluation Manual. Physicians' LOC was assessed using the Rotter I-E scale. Communication skills changes of the upper and lower third of physicians in respect of their scores on this scale were compared using group by time repeated measures of variance.
  
  
  RESULTS
  In the two-person and three-person interviews, changes in the use of open directive questions were more important among physicians with an "internal" LOC compared with changes observed among physicians with an 'external' LOC (P=0.066 and P=0.004, respectively). In the three-person interview, changes in the use of directive questions, assessing functions and moderate feelings stated explicitly were more important among physicians with an 'internal' LOC compared with changes observed among physicians with an 'external' LOC (P= 0.001; P=0.002 and P=0.011 respectively).
  
  
  CONCLUSIONS
  This study shows that physicians' LOC is a psychological characteristic that could influence the efficacy of a communication skills training program. This evidence supports the idea that a psychological characteristic such as 'internal' LOC may facilitate communication skills acquisition through physicians' belief that communication with patients may be controlled by physicians themselves.
authors.affiliation: Université Libre de Bruxelles, Belgium.
authors.forename: Yves
authors.initials: Y
authors.lastname: Libert
authors.forename: Isabelle
authors.initials: I
authors.lastname: Merckaert
authors.forename: Christine
authors.initials: C
authors.lastname: Reynaert
authors.forename: Nicole
authors.initials: N
authors.lastname: Delvaux
authors.forename: Serge
authors.initials: S
authors.lastname: Marchal
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Etienne
authors.forename: Jacques
authors.initials: J
authors.lastname: Boniver
authors.forename: Jean
authors.initials: J
authors.lastname: Klastersky
authors.forename: Pierre
authors.initials: P
authors.lastname: Scalliet
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Slachmuylder
authors.forename: Darius
authors.initials: D
authors.lastname: Razavi
mesh_terms: D000328:Adult; D001530:Belgium; D003142:Communication; D004502:Education, Medical, Continuing; D004521:Educational Measurement; D005260:Female; D006801:Humans; D007389:Internal-External Control; D007858:Learning; D008297:Male; D008495:Medical Oncology / Q000193:education; D015999:Multivariate Analysis; D010817:Physician-Patient Relations