title: Transfer of communication skills to the workplace during clinical rounds: impact of a program for residents.
abstract: OBJECTIVE
  Communication with patients is a core clinical skill in medicine that can be acquired through communication skills training. Meanwhile, the importance of transfer of communication skills to the workplace has not been sufficiently studied. This study aims to assess the efficacy of a 40-hour training program designed to improve patients' satisfaction and residents' communication skills during their daily clinical rounds.
  
  
  METHODS
  Residents were randomly assigned to the training program or to a waiting list. Patients' satisfaction was assessed with a visual analog scale after each visit. Transfer of residents' communication skills was assessed in audiotaped actual inpatient visits during a half-day clinical round. Transcripted audiotapes were analyzed using content analysis software (LaComm). Training effects were tested with Mann-Whitney tests and generalized linear Poisson regression models.
  
  
  RESULTS
  Eighty-eight residents were included. First, patients interacting with trained residents reported a higher satisfaction with residents' communication (Median=92) compared to patients interacting with untrained residents (Median=88) (p=.046). Second, trained residents used more assessment utterances (Relative Risk (RR)=1.17; 95% Confidence intervals (95%CI)=1.02-1.34; p=.023). Third, transfer was also observed when residents' training attendance was considered: residents' use of assessment utterances (RR=1.01; 95%CI=1.01-1.02; p=.018) and supportive utterances (RR=0.99; 95%CI=0.98-1.00; p=.042) (respectively 1.15 (RR), 1.08-1.23 (95%CI), p<.001 for empathy and 0.95 (RR), 0.92-0.99 (95%CI), p=.012 for reassurance) was proportional to the number of hours of training attendance.
  
  
  CONCLUSIONS
  The training program improved patients' satisfaction and allowed the transfer of residents' communication skills learning to the workplace. Transfer was directly related to training attendance but remained limited. Future studies should therefore focus on the improvement of the efficacy of communication skills training in order to ensure a more important training effect size on transfer.
authors.affiliation: Institut Jules Bordet, Brussels, Belgium.
authors.forename: Aurore
authors.initials: A
authors.lastname: Liénard
authors.forename: Isabelle
authors.initials: I
authors.lastname: Merckaert
authors.forename: Yves
authors.initials: Y
authors.lastname: Libert
authors.forename: Isabelle
authors.initials: I
authors.lastname: Bragard
authors.forename: Nicole
authors.initials: N
authors.lastname: Delvaux
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Etienne
authors.forename: Serge
authors.initials: S
authors.lastname: Marchal
authors.forename: Julie
authors.initials: J
authors.lastname: Meunier
authors.forename: Christine
authors.initials: C
authors.lastname: Reynaert
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Slachmuylder
authors.forename: Darius
authors.initials: D
authors.lastname: Razavi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003142:Communication; D004493:Education; D004502:Education, Medical, Continuing; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008505:Medical Staff, Hospital / Q000193:education* / Q000523:psychology*; D008875:Middle Aged; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D055815:Young Adult