title: Building bridges between doctors and patients: the design and pilot evaluation of a training session in argumentation for chronic pain experts.
abstract: BACKGROUND
  Shared decision-making requires doctors to be competent in exchanging views with patients to identify the appropriate course of action. In this paper we focus on the potential of a course in argumentation as a promising way to empower doctors in presenting their viewpoints and addressing those of patients. Argumentation is the communication process in which the speaker, through the use of reasons, aims to convince the interlocutor of the acceptability of a viewpoint. The value of argumentation skills for doctors has been addressed in the literature. Yet, there is no research on what a course on argumentation might look like. In this paper, we present the content and format of a training session in argumentation for doctors and discuss some insights gained from a pilot study that examined doctors' perceived strengths and limitations vis-à-vis this training.
  
  
  METHODS
  The training session (eight hours) combined different aspects from prominent theories of argumentation and was designed to strengthen doctors' argumentative discussion skills. A convenient, self-selected sample of 17 doctors who were experts in the field of chronic pain participated in the training and evaluated it via a feedback form and semi-structured interviews.
  
  
  RESULTS
  The participants found that the training session gave a structure to types of communication they use to interact with their patients, and taught them techniques that can increase their effectiveness. Moreover, it provided tools to help address some of the challenges of modern doctor-patient interactions, including dealing with patients' unrealistic expectations and medically inaccurate beliefs, and reaching agreement when there are differences of opinion.
  
  
  CONCLUSIONS
  This study enriches the research in the field of medical education. In line with the findings of studies that explore the value of argumentation in different fields, argumentative discussion skills can be applied by doctors to express their views and to account for the views of patients without patronizing the interaction. In this paper, we provide a basis to reflect on the value of argumentation in enhancing patients' right to autonomy and self-determination in interactions with their doctors.
authors.affiliation: Department of Health Sciences and Health Policy, University of Lucerne and Swiss Paraplegic Research, Lucerne, Nottwil, Switzerland. claudia.zanini@paraplegie.ch.|Swiss Paraplegic Research, Lucerne, Nottwil, Switzerland. claudia.zanini@paraplegie.ch.
authors.forename: Claudia
authors.initials: C
authors.lastname: Zanini
authors.affiliation: Rheumatology Unit, L. Sacco University Hospital, Milan, Italy. sarzi.piercarlo@hsacco.it.
authors.forename: Piercarlo
authors.initials: P
authors.lastname: Sarzi-Puttini
authors.affiliation: Rheumatology Unit, L. Sacco University Hospital, Milan, Italy. atzenifabiola@hotmail.com.
authors.forename: Fabiola
authors.initials: F
authors.lastname: Atzeni
authors.affiliation: Department of Internal Medicine, Sapienza University of Rome, Rome, Italy. Manuela.Difranco@uniroma1.it.
authors.forename: Manuela
authors.initials: M
authors.lastname: Di Franco
authors.affiliation: Department of Health Sciences and Health Policy, University of Lucerne and Swiss Paraplegic Research, Lucerne, Nottwil, Switzerland. sara.rubinelli@paraplegie.ch.|Swiss Paraplegic Research, Lucerne, Nottwil, Switzerland. sara.rubinelli@paraplegie.ch.
authors.forename: Sara
authors.initials: S
authors.lastname: Rubinelli
mesh_terms: D059350:Chronic Pain / Q000628:therapy*; D003142:Communication; D003479:Curriculum; D004502:Education, Medical, Continuing / Q000379:methods*; D006801:Humans; D010817:Physician-Patient Relations; D010865:Pilot Projects