title: Doctor-patient communication skills training in mainland China: a systematic review of the literature.
abstract: OBJECTIVE
  To conduct a systematic review of studies on doctor-patient communication skills training (CST) for medical students and physicians in mainland China.
  
  
  METHODS
  We retrieved articles from six electronic databases, and searched additional eligible papers by checking reference lists. Chinese or English-language studies focused on CST and implemented in mainland China were applied to the pre-determined criteria. Articles included were further reviewed under the following categories: participant; training strategy; assessment; and outcome.
  
  
  RESULTS
  20 studies met the inclusion criteria. 90% of the CST improved trainees' communication skills using a strategy which included a didactic component combined with practical rehearsal and feedback. The duration of training varied substantially. A lack of enhancement in empathy, and the use of open-ended questions were reported. 83% of the assessment instruments were self-designed and most lacked reliability and validity testing. Only two of the included studies evaluated patient satisfaction.
  
  
  CONCLUSIONS
  The majority of included studies attained statistically significant improvements. Chinese doctors and medical students' communication skills can be enhanced through CST.
  
  
  CONCLUSIONS
  Future studies in China should place stronger emphasis on the development of training strategies, validation of the assessment instruments, and evaluation of patient satisfaction affected by CST.
authors.affiliation: Department of Social Medicine & Health Management, School of Public Health, Central South University, Changsha, China; Third Xiangya Hospital of Central South University, Changsha, China.
authors.forename: Xinchun
authors.initials: X
authors.lastname: Liu
authors.affiliation: Graduate School of Public Health, University of Pittsburgh, Pittsburgh, USA.
authors.forename: Wesley
authors.initials: W
authors.lastname: Rohrer
authors.affiliation: Third Xiangya Hospital of Central South University, Changsha, China. Electronic address: angelaliu23@gmail.com.
authors.forename: Aijing
authors.initials: A
authors.lastname: Luo
authors.affiliation: Swanson School of Engineering, University of Pittsburgh, USA.
authors.forename: Zhou
authors.initials: Z
authors.lastname: Fang
authors.affiliation: School of Medicine, TsingHua University, Beijing, China; School of Medicine, University of Pittsburgh, USA.
authors.forename: TianHua
authors.initials: T
authors.lastname: He
authors.affiliation: Third Xiangya Hospital of Central South University, Changsha, China.
authors.forename: Wenzhao
authors.initials: W
authors.lastname: Xie
mesh_terms: D006801:Humans; D002681:China; D002983:Clinical Competence; D003142:Communication; D004504:Education, Medical, Undergraduate; D006282:Health Personnel / Q000193:education; D010817:Physician-Patient Relations; D010820:Physicians; D013663:Teaching
keywords: China; Doctor–patient communication skills; Medical student; Physician; Systematic review; Training