Can teaching agenda-setting skills to physicians improve clinical interaction quality? A controlled intervention.

Publisher: BioMed Central Country of Publication: England NLM ID: 101088679 Publication Model: Electronic Cited Medium: Internet ISSN: 1472-6920 (Electronic) Linking ISSN: 14726920 NLM ISO Abbreviation: BMC Med Educ Subsets: MEDLINE

Original Publication: London : BioMed Central, [2001-

Clinical Competence* ; Communication* ; Patient Satisfaction* ; Physician-Patient Relations*; Education, Medical, Continuing/*methods; Attitude of Health Personnel ; California ; Female ; Health Care Surveys ; Humans ; Male ; Middle Aged ; Patient-Centered Care/methods ; Physicians/psychology ; Program Evaluation ; Regression Analysis ; Reimbursement, Incentive ; Surveys and Questionnaires ; Telecommunications

Background: Physicians and medical educators have repeatedly acknowledged the inadequacy of communication skills training in the medical school curriculum and opportunities to improve these skills in practice. This study of a controlled intervention evaluates the effect of teaching practicing physicians the skill of "agenda-setting" on patients' experiences with care. The agenda-setting intervention aimed to engage clinicians in the practice of initiating patient encounters by eliciting the full set of concerns from the patient's perspective and using that information to prioritize and negotiate which clinical issues should most appropriately be dealt with and which (if any) should be deferred to a subsequent visit.
Methods: Ten physicians from a large physician organization in California with baseline patient survey scores below the statewide 25th percentile participated in the agenda-setting intervention. Eleven physicians matched on baseline scores, geography, specialty, and practice size were selected as controls. Changes in survey summary scores from pre- and post-intervention surveys were compared between the two groups. Multilevel regression models that accounted for the clustering of patients within physicians and controlled for respondent characteristics were used to examine the effect of the intervention on survey scale scores.
Results: There was statistically significant improvement in intervention physicians' ability to "explain things in a way that was easy to understand" (p = 0.02) and marginally significant improvement in the overall quality of physician-patient interactions (p = 0.08) compared to control group physicians. Changes in patients' experiences with organizational access, care coordination, and office staff interactions did not differ by experimental group.
Conclusion: A simple and modest behavioral training for practicing physicians has potential to positively affect physician-patient relationship interaction quality. It will be important to evaluate the effect of more extensive trainings, including those that work with physicians on a broader set of communication techniques.

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Date Created: 20080116 Date Completed: 20080307 Latest Revision: 20220409

20240829

PMC2245937

10.1186/1472-6920-8-3

18194559