title: Introducing a partnership doctor-patient communication guide for teachers in the culturally hierarchical context of Indonesia.
abstract: BACKGROUND
  A guide for a partnership style of doctor-patient communication tailored to a Southeast Asian culture was previously developed and validated. We introduced the guide to clinical teachers in Indonesia through a participatory approach. Evaluation was based on teachers' demonstrated comprehension and ability to teach the guide.
  
  
  METHODS
  Three junior researchers invited twelve senior clinical teachers to learn about the guide by writing a chapter on doctor-patient communication using their clinical expertise, reflections on the guide, and the international literature. A participatory study comprised of two cycles (producing first and second drafts of the chapters) was conducted over 18 months with guidance from researchers and written feedback from an expert in communication skills. Qualitative content-analysis was used to assess the content of the submitted chapters.
  
  
  RESULTS
  The clinical teachers understood the concept of partnership style doctor-patient communication but demonstrated limited reflection on the Southeast Asian culture. Teachers had difficulty translating the guide into a written learning guide. However, teachers proposed an adapted guide with a simpler structure, tailored to their clinical environment characterized by high patient load and limited time for doctor-patient communications.
  
  
  CONCLUSIONS
  The adapted guide was proof of the teachers' willingness to learn about a partnership style of doctor-patient communications. However, the process of introducing the guide was hindered by the wide power distance between participants throughout all aspects of the study, including communication between senior teachers and more junior researchers.
authors.affiliation: Department of Medical Education, Faculty of Medicine, Gadjah Mada University, Yogyakarta, Indonesia, .
authors.forename: Mora
authors.initials: M
authors.lastname: Claramita
authors.forename: Astrid Pratidina
authors.initials: AP
authors.lastname: Susilo
authors.forename: Manik
authors.initials: M
authors.lastname: Kharismayekti
authors.forename: Jan
authors.initials: J
authors.lastname: van Dalen
authors.forename: Cees
authors.initials: C
authors.lastname: van der Vleuten
mesh_terms: D002982:Clinical Clerkship; D003142:Communication; D003469:Culture; D003479:Curriculum; D005180:Faculty, Medical; D005260:Female; D017408:Guidelines as Topic; D006801:Humans; D007214:Indonesia; D008297:Male; D010358:Patient Participation; D010817:Physician-Patient Relations; D036301:Qualitative Research; D012577:Schools, Medical; D013663:Teaching / Q000379:methods*