[The dialogue of prescribing. Gaps and possibilities for improvement with a brief interactive seminar]. / Le dialogue de prescription. Lacunes et possibilité d'amélioration par un bref enseignement interactif.

The recordings of 24 medical consultations at an outpatient clinic show that residents can explain quite well the rationale and modalities of treatment. While being founded on secure knowledge in the biomedical domain fewer bases were encountered regarding the affective side of doctor-patient interactions. In this respect residents often neglect important elements for a prescription during consultation such as reiterations of complaints, mention of the diagnosis, explanation of the patients' role for control of therapy and repetition of specific points of the conversation in order to check the patients' understanding. Control tests three months after a special training seminar revealed that important progress was realized in all deficient domains.

[Swiss educational experience with a prescription dialogue in ambulatory medicine]. / Expérience suisse de formation au dialogue de prescription en médecine ambulatoire.

Teaching seminars on the topic of medical prescriptions were organized in Switzerland with the cooperation of 34 independent practitioners and residents from outpatient clinics in Basel, Geneva, Neuchâtel and Berne. Taped recordings from 230 consultations revealed strong points (biomedical aspects) and weaknesses (insufficient appraisal of the affective side and the participation of patients) in such conversations. These observations permit to compare the five groups of doctors participating in this study.

[Better listening, better information, better teaching. Lessons of our incompetence]. / Mieux écouter, mieux informer, mieux former. Les leçons de nos maladresses.

Short excerpts of conversations held during medical consultations permit analysis of a whole range of poorly adapted attitudes and thus demonstrate the possibility for improvement of affective contact, confidence and efficacy. It is recommended to: listen more attentively, avoid interruptions, excuses, simplifications, interpretations and premature information and to learn to repeat the flow of thoughts of the patient; inform more adequately without usage of medical terminology, abstain from confused explications, frequent change of subject, imprecision and attitudes forcing the patient into an inferior role; improve teaching of the patient by proposing distinct goals and by inviting him to find solutions to his problems by learning from errors, this without patronising and under consideration of the attitude of the patient towards his disease.