title: Are interventions to enhance communication performance in allied health professionals effective, and how should they be delivered? Direct and indirect evidence.
abstract: OBJECTIVE
  (1) To systematically review direct evidence about effects of interventions to improve communication performance amongst allied health professionals (AHPs). (2) To summarise indirect evidence pertinent to design, delivery, effects, and evaluation of such interventions.
  
  
  METHODS
  (1) Systematic search and narrative review of evaluations of interventions for AHPs. (2) Systematic search and narrative summary of reviews of corresponding interventions in medicine and nursing.
  
  
  RESULTS
  Five reports of interventions for AHPs were included. All reported positive effects of training. Strongest evidence was from two small-n within-subjects controlled studies that evaluated highly specific training for qualified therapists in brain injury rehabilitation environments. Indirect evidence from nine systematic reviews in medicine and nursing indicated positive effects of communication training. Robust designs yielded smallest effect sizes. Interventions based on strong conceptual and empirical foundations and targeting specific areas of practice appeared more effective. Strongest evidence is for performance-based training for clinicians already working with patients.
  
  
  CONCLUSIONS
  More empirical and conceptual understandings about AHPs' communication practices are required so as to improve the design, delivery and subsequent evaluation of communication training amongst these important healthcare workers.
  
  
  CONCLUSIONS
  Preliminary and indirect evidence suggest it is possible to positively influence AHP clinicians' performance and patients' outcomes if training interventions are specific, founded on evidence about effective practice and delivered using practical modalities.
authors.affiliation: University of Nottingham, Institute for Science and Society, Law and Social Sciences Building West Wing, University Park, Nottingham NG7 2RD, UK. ruth.parry@nottingham.ac.uk
authors.forename: Ruth
authors.initials: R
authors.lastname: Parry