ABSTRACT
BACKGROUND: In medical education, teaching methods offering intensive practice without high utilization of faculty resources are needed. We investigated whether simulated patients' (SPs') satisfaction with a consultation could predict professional observers' assessment of young doctors' communication skills. METHODS: This was a comparative cross-sectional study of 62 videotaped consultations in a general practice setting with young doctors who were finishing their internship. The SPs played a female patient who had observed blood when using the toilet, which had prompted a fear of cancer. Immediately afterwards, the SP rated her level of satisfaction with the consultation, and the scores were dichotomized into satisfaction or dissatisfaction. Professional observers viewed the videotapes and assessed the doctors' communication skills using the Arizona Communication Interview Rating Scale (ACIR). Their ratings of communication skills were dichotomized into acceptable versus unacceptable levels of competence. RESULTS: The SPs' satisfaction showed a predictive power of 0.74 for the observers' assessment of the young doctors and whether they reached an acceptable level of communication skills. The SPs' dissatisfaction had a predictive power of 0.71 for the observers' assessment of an unacceptable communication level. The two assessment methods differed in 26% of the consultations. When SPs felt relief about their cancer concern after the consultation, they assessed the doctors' skills as satisfactory independent of the observers' assessment. CONCLUSIONS: Accordance between the dichotomized SPs' satisfaction score and communication skills assessed by observers (using the ACIR) was in the acceptable range. These findings suggest that SPs' satisfaction scores may provide a reliable source for assessing communication skills in educational programs for medical trainees (students and young doctors). Awareness of the patient's concerns seems to be of vital importance to patient satisfaction.
Subject(s)
Internship and Residency/standards , Patient Satisfaction , Patient Simulation , Physician-Patient Relations , Adult , Aged , Communication , Cost Savings/methods , Cross-Sectional Studies , Educational Measurement/methods , Educational Measurement/standards , Faculty, Medical , Female , Humans , Internship and Residency/methods , Male , Middle Aged , Norway , Videotape Recording , Young AdultABSTRACT
The article describes a simple method for self-assessment and group-assessment of video recordings from the reception area in a general practice. In a group setting, the method was found to increase the receptionists' confidence in their own professional skills and revealed the need to pay more attention to communication between patients and receptionists. The layout of the reception area was rearranged and changes in the daily routines in the practice were suggested.
Subject(s)
Family Practice , Medical Receptionists/standards , Professional-Patient Relations , Self-Assessment , Communication , Family Practice/organization & administration , Family Practice/standards , Female , Humans , Medical Receptionists/psychology , Norway , Professional Competence , Video Recording , WorkforceABSTRACT
Doctors and professional health administrators have been the principal decision-makers and the patients have hardly had any direct influence on the planning and organization of primary health care in Norway. In 1987, in order to draw attention to patient opinions, the Institute of Community Medicine, University of Tromsø, conducted a questionnaire survey among patients attending general practices in North Norway. The question were selected to cover issues in the contemporary debate on the ideology, organization and standards of services of general practitioners. 36 teaching practices in the region were included in the survey. Altogether 3,739 questionnaires were returned, a response rate of over 60%. The respondents reported more than 16,000 consultations during the last year. This paper presents the methods used and the main findings concerning the representativeness of the results and the potential for generalization. Subsequent publications will present detailed results from the study within the framework of patient experiences, preferences and expectations.
Subject(s)
Consumer Behavior , Family Practice , Primary Health Care , Adolescent , Adult , Aged , Attitude to Health , Family Practice/organization & administration , Family Practice/standards , Family Practice/statistics & numerical data , Female , Humans , Male , Middle Aged , Norway , Primary Health Care/organization & administration , Primary Health Care/standards , Public Opinion , Surveys and QuestionnairesABSTRACT
Patients and general practitioners in northern Norway were asked their opinion on the doctors' use of a white coat in the consultation. 51.9% of the patients wanted their doctor not to wear a white coat, whereas 11.7% of the doctors never wore one. 5.7% of the doctors' staff members never wore a white coat. The patients' preferences were to some extent related to their own doctors' use of a white coat, and there was a significant increase in the demand for a white coat with increasing age of the patients.
