The impact of patient and physician computer mediated communication skill training on reported communication and patient satisfaction.

OBJECTIVE: The objective was to evaluate parallel patient and physician computer-mediated communication skill training on participants' report of skill use and patient satisfaction. METHODS: Separate patient and clinician web-tools comprised of over 500, 10-s video clips demonstrating patient-centered skills in various ways. Four clinician members of the American Academy of Family Physicians National Research Network participated by enrolling 194 patients into a randomized patient trial and 29 physicians into a non-randomized clinician trial of respective interventions. All participants completed baseline and follow-up self-report measures of visit communication and satisfaction. RESULTS: Intervention patients reported using more skills than controls in five of six skill areas, including identification of problems/concerns, information exchange, treatment adherence, shared decision-making and interpersonal rapport (all p<.05); post intervention, physicians reported using more skills in the same 5 areas (all p<.01). Intervention group patients reported higher levels of satisfaction than controls in five of six domains (all p<.05). CONCLUSION: Communication skill training delivered in a computer mediated format had a positive and parallel impact on both patient and clinician reported use of patient-centered communication and in patient satisfaction. PRACTICE IMPLICATIONS: Computer-mediated interventions are cost and time effective thereby increasing patient and clinician willingness to undertake training.

Physicians' and patients' views of cancer care by family physicians: a report from the American Academy of Family Physicians National Research Network.

BACKGROUND AND OBJECTIVES: There has been little research describing the role of family physicians in the care of patients with an active diagnosis of cancer. METHODS: Using qualitative methods, we interviewed 15 family physicians and 15 of their cancer patients. We asked physicians about care of cancer patients in general and of the specific patient included in this study. Patient interviews focused on the role their family physician played in their care and their satisfactions and frustrations with that care. RESULTS: The physicians reported coordinating referrals, providing general medical care, helping with decisions, and providing emotional support. Their involvement was more intense at the time of diagnosis and near death. The patients gave similar responses and also said they valued clear explanations and spending time with and feeling comfortable with their family physicians. CONCLUSIONS: Family physicians fulfill a number of important roles in caring for their patients with an active diagnosis of cancer. More research using representative samples is needed to determine the generalizability of these findings, but this study gives us some preliminary insight into the role family physicians play in cancer care.