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Communication Skills Training to Enhance Patient Adherence

  • R. Ellen PearlmanEmail author
  • Calvin Chou
Chapter

Abstract

Generations of physicians were assumed to possess effective communication skills. We now know this is not the case. Ample evidence demonstrates that physicians receive little training in this critical skill set, as measured by patient experience scores, visit length, disenrollment from practices, malpractice claims, and nonadherence to treatment. Fortunately, the weight of the data about communication skills training shows that training improves quality of care, outcomes, patient experience, and adherence. We review the literature in this burgeoning new field of study, describe effective methods of communication skills training, and report current ways of teaching and assessing trainees, using the Zucker School of Medicine at Hofstra/Northwell as an exemplar.

Keywords

Communication skills training Evidence-based research Enhancing adherence 

References

  1. 1.
    Lipkin M Jr, Putnam SM, Lazare A, editors. The medical interview: clinical care, education, and research. New York: Springer; 1995.Google Scholar
  2. 2.
    Beckman HB, Frankel RM. The effect of physician behavior on the collection of data. Ann Intern Med. 1984;101:692–6.CrossRefGoogle Scholar
  3. 3.
    Marvel MK, Epstein RM, Flowers K, Beckman HB. Soliciting the patient’s agenda: have we improved? JAMA. 1999;281:283–7.CrossRefGoogle Scholar
  4. 4.
    Burack RC, Carpenter RR. The predictive value of the presenting complaint. J Fam Pract. 1983;16(4):749–54.PubMedGoogle Scholar
  5. 5.
    Starfield B, Wray C, et al. The influence of patient-practitioner agreement on outcome of care. Am J Public Health. 1981;71:127–32.CrossRefGoogle Scholar
  6. 6.
    Singh Ospina N, Phillips KA, Rodriguez-Gutierrez R, et al. Eliciting the patient’s agenda- secondary analysis of recorded clinical encounters. J Gen Intern Med. 2018;34(1):36–40.  https://doi.org/10.1007/s11606-018-4540-5.CrossRefPubMedGoogle Scholar
  7. 7.
    Stewart MA, McWhinney IR, Buck CW. The doctor/patient relationship and its effect upon outcome. J R Coll Gen Pract. 1979;29:77–82.PubMedPubMedCentralGoogle Scholar
  8. 8.
    Levinson W, Gorawara-Bhat R, Lamb J. A study of patient clues and physician responses in primary care and surgical settings. JAMA. 2000;284:1021–7.CrossRefGoogle Scholar
  9. 9.
    Suchman AL, Markakis K, Beckman HB, Frankel R. A model of empathic communication in the medical interview. JAMA. 1997;277:678–82.CrossRefGoogle Scholar
  10. 10.
    Deuster L, Christopher S, Donovan J, Farrell M. A method to quantify residents’ jargon use during counseling of standardized patients about cancer screening. J Gen Intern Med. 2008;23:1947–52.CrossRefGoogle Scholar
  11. 11.
    Nagraj S, Abel G, Paddison C, et al. Changing practice as a quality indicator for primary care: analysis of data on voluntary disenrollment from the English GP Patient Survey. BMC Fam Pract. 2013;14:89.CrossRefGoogle Scholar
  12. 12.
    Acher AW, LeCaire TJ, Hundt AS, et al. Using human factors and systems engineering to evaluate readmission after complex surgery. J Am Coll Surg. 2015;221:810–20.CrossRefGoogle Scholar
  13. 13.
    Levinson W, Roter DL, Mullooly JP, et al. Physician-patient communication: the relationship with malpractice claims among primary care physicians and surgeons. JAMA. 1997;277:553–9.CrossRefGoogle Scholar
  14. 14.
    Ambady N, LaPlante D, Nguyen T, et al. Surgeons’ tone of voice: a clue to malpractice history. Surgery. 2002;132:5–9.CrossRefGoogle Scholar
  15. 15.
    Vincent C, Young M, Phillips A. Why do people sue doctors? A study of patients and relatives taking legal action. Lancet. 1994;343:1609–13.CrossRefGoogle Scholar
  16. 16.
    Meterko M, et al. Mortality among patients with acute myocardial infarction: the influences of patient-centered care and evidence-based medicine. Health Serv Res J. 2010;45:1188–204.CrossRefGoogle Scholar
  17. 17.
    Hojat M, Louis DZ, Markham FW, et al. Physicians’ empathy and clinical outcomes for diabetic patients. Acad Med. 2001;86:359–64.CrossRefGoogle Scholar
  18. 18.
    Schoenthaler A, et al. Provider communication affects medication adherence in hypertensive African Americans. Pat Educ Couns. 2009;75:185–91.CrossRefGoogle Scholar
  19. 19.
    Temel JS, et al. Early palliative care for patients with metastatic non-small-cell lung cancer. NEJM. 2010;363:733–42.CrossRefGoogle Scholar
  20. 20.
    Flickinger TE, Saha S, Roter D, et al. Clinician empathy is associated with differences in patient-clinician communication behaviors and higher medication self-efficacy in HIV care. Patient Educ Couns. 2016;99:220–6.CrossRefGoogle Scholar
  21. 21.
    Smith RC, Lyles JS, Gardiner JC, et al. Primary care clinicians treat patients with medical unexplained symptoms: a randomized controlled trial. J Gen Intern Med. 2006;21:671–7.CrossRefGoogle Scholar
  22. 22.
    Smith RC, Gardiner JC, Luo Z, et al. Primary care clinicians treat somatization. J Gen Intern Med. 2009;24:829–32.CrossRefGoogle Scholar
  23. 23.
    Kelley JM, Kraft-Todd G, Sciapira L, et al. The influence of the patient-clinician relationship on healthcare outcomes: a systematic review and meta-analysis of randomized controlled trials. PLoS One. 2014;9:e94207.CrossRefGoogle Scholar
  24. 24.
    Zolnierek KB, DiMatteo MR. Physician communication and adherence to treatment- a meta-analysis. Med Care. 2009;47(8):826–34.  https://doi.org/10.1097/MLR.0b013e31819a5acc.CrossRefPubMedGoogle Scholar
  25. 25.
    Safran DG, Taira DA, et al. Linking primary care performance to outcomes of care. J Fam Pract. 1998;47(3):213–28.PubMedGoogle Scholar
  26. 26.
    Jerant A, Lichte M, Kravitz RL, Tancredi DJ, Magnan EM, Hudnut A, Franks P. Physician training in self-efficacy enhancing interviewing techniques (SEE IT): effects on patient psychological health behavior change mediators. Patient Educ Couns. 2016;99:1865–72.CrossRefGoogle Scholar
  27. 27.
    Arnold RM, Back AL, Barnato AE, Prendergast TJ, Emlet LL, Karpov I, White PH, Nelson JE. The critical care communication project: improving fellows’ communication skills. J Crit Care. 2015;30:250–4.CrossRefGoogle Scholar
  28. 28.
    Rucker B, Browning DM. Practicing end-of-life conversations: physician communication training program in palliative care. J Soc Work End Life Palliat Care. 2015;11:132–46.CrossRefGoogle Scholar
  29. 29.
    Beach MC, Price EG, Gary TL, et al. Cultural competency: a systematic review of health care provider educational interventions. Med Care. 2005;43(4):356–73.CrossRefGoogle Scholar
  30. 30.
    Rodriguez HP, Anastario MP, Frankel RM, et al. Can teaching agenda-setting skills to physicians improve clinical interaction quality? A controlled intervention. BMC Med Educ. 2008;8:3.CrossRefGoogle Scholar
  31. 31.
    Boissy A, Windover AK, Bokar D, et al. Communication skills training for physicians improves patient satisfaction. J Gen Intern Med. 2016;31:755–61.CrossRefGoogle Scholar
  32. 32.
    Ericsson KA. An expert-performance perspective of research on medical expertise: the study of clinical performance. Med Educ. 2007;41:1124–30.CrossRefGoogle Scholar
  33. 33.
    Berkhof M, van Rijssen HJ, Schellart AJM, et al. Effective training strategies for teaching communication skills to physicians: an overview of systematic reviews. Patient Educ Couns. 2011;84:152–62.CrossRefGoogle Scholar
  34. 34.
    Cole SA, Bird J. The medical interview: the three function approach. 3rd ed. Philadelphia: Elsevier Inc/Saunders; 2014.Google Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Donald and Barbara Zucker School of Medicine at Hofstra/NorthwellHempsteadUSA
  2. 2.University of CaliforniaSan FranciscoUSA

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