title: Intercultural doctor-patient communication in daily outpatient care: relevant communication skills.
abstract: BACKGROUND
  Intercultural communication (ICC) between doctors and patients is often associated with misunderstandings and dissatisfaction. To develop ICC-specific medical education, it is important to find out which ICC skills medical specialists currently apply in daily clinical consultations.
  
  
  METHODS
  Doctor-patient consultations of Dutch doctors with non-Dutch patients were videotaped in a multi-ethnic hospital in the Netherlands. The consultations were analyzed using the validated MAAS-Global assessment list in combination with factors influencing ICC, as described in the literature.
  
  
  RESULTS
  In total, 39 videotaped consultations were analyzed. The doctors proved to be capable of practising many communication skills, such as listening and empathic communication behaviour. Other skills were not practised, such as being culturally aware and checking the patient's language ability.
  
  
  CONCLUSIONS
  We showed that doctors did practice some but not all the relevant ICC skills and that the ICC style of the doctors was mainly biomedically centred. Furthermore, we discussed the possible overlap between intercultural and patient-centred communication. Implications for practice could be to implement the relevant ICC skills in the existing communication training or develop a communication training with a patient-centred approach including ICC skills.
authors.affiliation: Department of Healthcare Education, OLVG Hospital, Amsterdam, The Netherlands. emmapaternotte@gmail.com.
authors.forename: Emma
authors.initials: E
authors.lastname: Paternotte
authors.affiliation: Department of Healthcare Education, OLVG Hospital, Amsterdam, The Netherlands.|Medical School of Sciences, Vu University Medical Centre, Amsterdam, The Netherlands.
authors.forename: Fedde
authors.initials: F
authors.lastname: Scheele
authors.affiliation: Department of Social Medicine, University Medical Centre, Utrecht, The Netherlands.
authors.forename: Conny M
authors.initials: CM
authors.lastname: Seeleman
authors.affiliation: Department of Healthcare Education, OLVG Hospital, Amsterdam, The Netherlands.
authors.forename: Lindsay
authors.initials: L
authors.lastname: Bank
authors.affiliation: Institute for Medical Education, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
authors.forename: Albert J J A
authors.initials: AJ
authors.lastname: Scherpbier
authors.affiliation: NIVEL (Netherlands Institute for health services research), Utrecht, The Netherlands.|Department of Primary and Community Care, Radboud University Medical Centre, NIjmegen, The Netherlands.|Faculty of Health Sciences, University College of Southeast Norway, Drammen, Norway.
authors.forename: Sandra
authors.initials: S
authors.lastname: van Dulmen
keywords: Clinical practice; Communication behaviour; Communication skills; Doctor-patient communication; Intercultural communication; Medical education; Reflective practice