title: Routine programs of health care systems as an opportunity toward communication skills training for family physicians: A randomized field trial.
abstract: BACKGROUND
  To have high-quality primary health care services, an adequate doctor-patient communication is necessary. Because of time restrictions and limited budget in health system, an effective, feasible, and continuous training approach is important. The aim of this study is to assess the appropriateness of a communication skills training program simultaneously with routine programs of health care system.
  
  
  METHODS
  It was a randomized field trial in two health network settings during 2013. Twenty-eight family physicians through simple random sampling and 140 patients through convenience sampling participated as intervention and control group. The physicians in the intervention group (n = 14) attended six educational sessions, simultaneous organization meeting, with case discussion and peer education method. In both the groups, physicians completed communication skills knowledge and attitude questionnaires, and patients completed patient satisfaction of medical interview questionnaire at baseline, immediately after intervention, and four months postintervention. Physicians and health network administrators (stakeholders), completed a set of program evaluation forms. Descriptive statistics and Chi-square test, t-test, and repeated measure analysis of variance were used to analyze the data.
  
  
  RESULTS
  Use of routine program as a strategy of training was rated by stakeholders highly on "feasibility" (80.5%), "acceptability" (93.5%), "educational content and method appropriateness" (80.75%), and "ability to integrating in the health system programs" (approximate 60%). Significant improvements were found in physicians' knowledge (P < 0.001), attitude (P < 0.001), and patients' satisfaction (P = 0.002) in intervention group.
  
  
  CONCLUSIONS
  Communication skills training program, simultaneous organization meeting was successfully implemented and well received by stakeholders, without considering extra time and manpower. Therefore it can be a valuable opportunity toward communication skills training.
authors.affiliation: Department of Community Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Ahmad Reza
authors.initials: AR
authors.lastname: Zamani
authors.affiliation: Department of Community Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Narges
authors.initials: N
authors.lastname: Motamedi
authors.affiliation: Department of Community Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Ziba
authors.initials: Z
authors.lastname: Farajzadegan
keywords: Case discussion; communication skills; opportunity finding; peer learning education; program evaluation