EXACKTE2: Exploiting the clinical consultation as a knowledge transfer and exchange environment: a study protocol

Background While the evidence suggests that the way physicians provide information to patients is crucial in helping patients decide upon a course of action, the field of knowledge translation and exchange (KTE) is silent about how the physician and the patient influence each other during clinical interactions and decision-making. Consequently, based on a novel relationship-centered model, EXACKTE2 (EXploiting the clinicAl Consultation as a Knowledge Transfer and Exchange Environment), this study proposes to assess how patients and physicians influence each other in consultations. Methods We will employ a cross-sectional study design involving 300 pairs of patients and family physicians from two primary care practice-based research networks. The consultation between patient and physician will be audio-taped and transcribed. Following the consultation, patients and physicians will complete a set of questionnaires based on the EXACKTE2 model. All questionnaires will be similar for patients and physicians. These questionnaires will assess the key concepts of our proposed model based on the essential elements of shared decision-making (SDM): definition and explanation of problem; presentation of options; discussion of pros and cons; clarification of patient values and preferences; discussion of patient ability and self-efficacy; presentation of doctor knowledge and recommendation; and checking and clarifying understanding. Patients will be contacted by phone two weeks later and asked to complete questionnaires on decisional regret and quality of life. The analysis will be conducted to compare the key concepts in the EXACKTE2 model between patients and physicians. It will also allow the assessment of how patients and physicians influence each other in consultations. Discussion Our proposed model, EXACKTE2, is aimed at advancing the science of KTE based on a relationship process when decision-making has to take place. It fosters a new KTE paradigm by putting forward a relationship-centered perspective and has the potential to reveal unknown mechanisms that underline effective KTE in clinical contexts. This will result in better understanding of the mechanisms that may promote a new generation of knowledge transfer strategies

A quantitative survey of intern’s knowledge of communications skills: an Iranian exploration

Background It is a high priority that health care providers have effective communication skills. It has been well documented that the doctor-patient relationship is central to the delivery of high quality medical care, and it has been shown to affect patient satisfaction, to decrease the use of pain killers, to shorten hospital stays, to improve recovery from surgery and a variety of other biological, psychological and social outcomes. This study sought to quantify the current knowledge of interns in Iran about communication skills. Methods A cross-sectional study using a self-report questionnaire was conducted among interns. Data analysis was based on 223 questionnaires. The internal consistency of the items was 0.8979. Results Overall, knowledge levels were unsatisfactory. Results indicated that interns had a limited knowledge of communication skills, including identification of communication skills. In addition, there was a significant difference between the mean scores of interns on breaking bad news and sex education. The confidence of males about their communication skills was significantly higher than for females. Analysis of the total scores by age and sex showed that there was a statistically significant main effect for sex and the interaction with age was statistically significant. Free response comments of the interns are also discussed. Conclusions It is argued that there is a real need for integrating a communication skills course, which is linked to the various different ethnic and religious backgrounds of interns, into Iranian medical curricula. Some recommendations are made and the limitations of the study are discussed

The Italian Adaptation of Interpersonal Communication Competences Questionnaire

There has been a growing interest in assessing interpersonal communication competences, to understand how to empower them in specific domains. The aim of this study was to create an Italian adaptation of the Interpersonal Communication Competence Scale (ICCS), by Rubin & Martin. The study was designed to assess the structure of the ICCS and to determine the number of components needed to adequately describe the psychological constructs of Interpersonal Communication Competence in the Italian sample. The questionnaire was administered to 137 subjects. Adopting an analytic process using an exploratory factor analysis, the steps yield a seven factor solution composed of 26 items. We discussed results and future directions concerning interpersonal communication competence scale

Video feedback in education and training: putting learning in the picture

This meta-analysis demonstrates that the video feedback method has a statistically significant effect on the interaction skills of professionals in a range of contact professions. The aggregate effect, calculated on the basis of 217 experimental comparisons from 33 experimental studies involving a total of 1,058 people, was 0.40 standard deviation (SE = 0.07). The effects of training were greater for programs working with a standard observation form of target skills that were central to the program. Results were more positive for outcome measures that measured positive skills rather than negative ones. In addition, molar outcome measures, which were obtained by means of an assessment scale, showed larger effects than micromeasures, which were scored using event sampling. Finally, recommendations are made for video feedback design and for future research