title: Improving physician-patient communication through coaching of simulated encounters.
abstract: OBJECTIVE
  Effective communication between physicians and their patients is important in optimizing patient care. This project tested a brief, intensive, interactive medical education intervention using coaching and standardized psychiatric patients to teach physician-patient communication to family medicine trainees.
  
  
  METHODS
  Twenty-six family medicine trainees (9 PGY1, 11 PGY2, 6 fellows) from five university-affiliated hospitals conducted four once-weekly, 30-minute videotaped interviews with "difficult" standardized patients. After each interview, trainees received 1 hour of individual coaching that incorporated self-assessment and skills-teaching from experienced psychiatrists. Two follow-up interviews with standardized patients occurred 1 week and an average of 6 months post-intervention. Trainee self-reported physician-patient communication efficacy was measured as a control 1 month before the intervention; during the month of the intervention; and an average of 6 months after the intervention. Coach-rated physician-patient communication competence was measured each week of the intervention.
  
  
  RESULTS
  Improvements in physician-patient communication were demonstrated. Self-efficacy for physician-patient communication improved significantly during the intervention, in contrast to no improvement during the control period (i.e., training-as-usual). This improvement was sustained during the follow-up period.
  
  
  CONCLUSIONS
  This innovative educational intervention was shown to be highly effective in improving trainee communication competence and self-efficacy. Future applications of this brief model of physician training have potential to improve communication competence and, in turn, can improve patient care.
authors.affiliation: Dept. of Psychiatry, Mt. Sinai Hospital, Toronto, Ontario, Canada. pravitz@mtsinai.on.ca
authors.forename: Paula
authors.initials: P
authors.lastname: Ravitz
authors.forename: William J
authors.initials: WJ
authors.lastname: Lancee
authors.forename: Andrea
authors.initials: A
authors.lastname: Lawson
authors.forename: Robert
authors.initials: R
authors.lastname: Maunder
authors.forename: Jonathan J
authors.initials: JJ
authors.lastname: Hunter
authors.forename: Molyn
authors.initials: M
authors.lastname: Leszcz
authors.forename: Nancy
authors.initials: N
authors.lastname: McNaughton
authors.forename: Clare
authors.initials: C
authors.lastname: Pain
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D003142:Communication; D037001:Directive Counseling / Q000379:methods; D005194:Family Practice / Q000193:education*; D005260:Female; D006801:Humans; D008297:Male; D016544:Patient Simulation; D010817:Physician-Patient Relations; D011361:Professional Competence; D020377:Self Efficacy