title: Does patient feedback improve the consultation skills of general practice trainees? A controlled trial.
abstract: BACKGROUND
  This study aimed to assess if an additional patient feedback training programme leads to better consultation skills in general practice trainees (GPTs) than regular communication skills training, and whether process measurements (intensity of participation in the programme) predict the effect of the intervention.
  
  
  METHODS
  We carried out a controlled trial in which two sub-cohorts of GPTs were allocated to an intervention group (n = 23) or a control group (n = 30), respectively. In 2006, allocated first-year GPTs in the VU University Medical Centre attended a patient feedback training programme in addition to the regular communication skills training. The control group attended only regular communication skills training. Trainees were assessed by simulated patients who visited the practices and videotaped the consultations at baseline and after 3 months. The videotapes were randomly assigned to eight trained staff members. The MAAS-Global Instrument (range 0-6) was used to assess (a change in) trainee consultation skills.
  
  
  RESULTS
  were analysed using a multi-level, linear mixed-model analysis. Results Data on 50 GPTs were available for the follow-up analysis. Both intervention group and control group GPTs improved their consultation skills: mean MAAS-Global scores for all participants were 3.29 (standard deviation [SD] 0.75) at baseline and 3.54 (SD 0.66) at follow-up (P = 0.047). The improvement in MAAS-Global scores in the intervention group did not differ significantly from the improvement in the control group. The analysis showed a trend for intensity of participation in the patient feedback programme to predict greater improvement in MAAS-Global scores.
  
  
  CONCLUSIONS
  Although the baseline scores were already in the high range, consultation skills in both groups improved significantly. This is reassuring for current teaching methods. The patient feedback programme did not improve consultation skills more than regular communication skills training. However, a subgroup of GPTs who participated intensively in the programme did improve their consultation skills further in comparison with the less motivated subgroup.
authors.affiliation: EMGO Institute for Health and Care Research, Vrije Universiteit (VU) University Medical Centre, Amsterdam, The Netherlands. marcel.reinders@vumc.nl
authors.forename: Marcel E
authors.initials: ME
authors.lastname: Reinders
authors.forename: A H
authors.initials: AH
authors.lastname: Blankenstein
authors.forename: H E
authors.initials: HE
authors.lastname: van der Horst
authors.forename: D L
authors.initials: DL
authors.lastname: Knol
authors.forename: P L
authors.initials: PL
authors.lastname: Schoonheim
authors.forename: H W J
authors.initials: HW
authors.lastname: van Marwijk
mesh_terms: D000328:Adult; D002983:Clinical Competence; D015331:Cohort Studies; D004503:Education, Medical, Graduate / Q000458:organization & administration*; D005194:Family Practice / Q000193:education* / Q000592:standards; D005240:Feasibility Studies; D030141:Feedback, Psychological; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D009426:Netherlands; D017060:Patient Satisfaction; D012017:Referral and Consultation / Q000592:standards; D011795:Surveys and Questionnaires