Psychodynamic aspects of communication skills training: a pilot study.
OBJECTIVE
Communication between patients and oncology clinicians is a key element of cancer care. Emotionally charged consultations may trigger clinicians' defense mechanisms, protecting them from painful emotions. Defense mechanisms, however, may also hamper the recognition of patients' suffering. This pilot study aims to explore clinicians' defense mechanisms observed in communication skills training (CST).


METHODS
A verbatim transcription of videotaped interviews with simulated patients were evaluated before (N=10) and after CST (N=10) with the defense mechanism rating scales (DMRS).


RESULTS
A wide variety of defense mechanisms were observed such as obsessional (e.g. intellectualisation) or disavowal (e.g. denial or projection). Immature defense mechanisms decreased after CST.


CONCLUSIONS
A wide variety of defense mechanisms are operant in oncology clinicians facing challenging interviews with simulated patients. Defense mechanisms may be modified by CST.
Favre
Nathalie
N
Psychiatry Service, University Hospital (CHUV), Lausanne, Switzerland.
Despland
Jean-Nicolas
JN
de Roten
Yves
Y
Drapeau
Martin
M
Bernard
Mathieu
M
Stiefel
Friedrich
F
D000223:Adaptation, Psychological; D000328:Adult; D002983:Clinical Competence; D003142:Communication; D003674:Defense Mechanisms; D004502:Education, Medical, Continuing; D005260:Female; D006801:Humans; D007318:Inservice Training; D007407:Interviews as Topic; D008297:Male; D008495:Medical Oncology / Q000193:education; D008875:Middle Aged; D009726:Nurses / Q000523:psychology*; D016544:Patient Simulation; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology*; D010865:Pilot Projects; D015203:Reproducibility of Results; D018709:Statistics, Nonparametric; D013557:Switzerland