scholarly journals Entrustment in physician-patient communication: a modified Delphi study using the EPA approach

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ayesha Younas ◽  
Rehan Ahmed Khan ◽  
Raheela Yasmin
Keyword(s):  
Delphi Study ◽  
Assessment Tool ◽  
Patient Communication ◽  
Extensive Literature ◽  
Assessment Framework ◽  
Specific Patient ◽  
Modified Delphi ◽  
Physician Patient Communication ◽  
Competency Based ◽  
Physician Patient

Abstract Background Competency based curricula across the globe stress on the importance of effective physician patient communication. A variety of courses have been used to train physicians for this purpose. However, few of them link competencies with practice resulting in confusions in implementation and assessment. This issue can be resolved by treating certain specific patient communication related tasks as acts of entrustment or entrustable professional activities (EPAs). In this study, we aimed to define a competency-based framework for assessing patient physician communication using the language of EPAs. Methods A modified Delphi study was conducted in three stages. The first stage was an extensive literature review to identify and elaborate communication related tasks which could be treated as EPAs. The second stage was content validation by medical education experts for clarity and representativeness. The third stage was three iterative rounds of modified Delphi with predefined consensus levels. The McNemar test was used to check response stability in the Delphi Rounds. Results Expert consensus resulted in development of 4 specific EPAs focused on physician-patient communication with their competencies and respective assessment strategies all aiming for level 5 of unsupervised practice. These include Providing information to the patient or their family about diagnosis or prognosis; Breaking Bad news to the patient or their family; Counseling a patient regarding their disease or illness; Resolving conflicts with patients or their families. Conclusions The EPAs for Physician-patient communication are a step toward an integrative, all-inclusive competency-based assessment framework for patient-centered care. They are meant to improve the quality of physician patient interaction by standardizing communication as a decision of entrustment. The EPAs can be linked to competency frameworks around the world and provide a useful assessment framework for effective training in patient communication. They can be integrated into any post graduate curriculum and can also serve as a self-assessment tool for postgraduate training programs across the globe to improve their patient communication curricula.

scholarly journals Entrustment in Physician -patient communication: a modified Delphi study using the EPA approach

2021 ◽  
Author(s):  
Ayesha Younas ◽  
Rehan Ahmed Khan ◽  
Raheela Yasmin
Keyword(s):  
Delphi Study ◽  
Assessment Tool ◽  
Patient Communication ◽  
Extensive Literature ◽  
Assessment Framework ◽  
Specific Patient ◽  
Modified Delphi ◽  
Physician Patient Communication ◽  
Competency Based ◽  
Physician Patient

Abstract Background Competency based curricula across the globe stress on the importance of effective physician patient communication. A variety of courses have been used to train physicians for this purpose. However, few of them link competencies with practice resulting in confusions in implementation and assessment. This issue can be resolved by treating certain specific patient communication related tasks as acts of entrustment or entrustable professional activities (EPAs). In this study, we aimed to define a competency-based framework for assessing patient physician communication using the language of EPAs. Methods A modified Delphi study was conducted in three stages. The first stage was an extensive literature review to identify and elaborate communication related tasks which could be treated as EPAs. The second stage was content validation by medical education experts for clarity and representativeness.The third stage was three iterative rounds of modified Delphi with predefined consensus levels. The McNemar test was used to check response stability in the Delphi Rounds Results Expert consensus resulted in development of 4 specific EPAs focused on physician-patient communication with their competencies and respective assessment strategies all aiming for level 5 of unsupervised practice. These include Providing information to the patient or their family about diagnosis or prognosis; Breaking Bad news to the patient or their family; Counseling a patient regarding their disease or illness; Resolving conflicts with patients or their families. Conclusions The EPAs for Physician-patient communication are a step toward an integrative, all-inclusive competency-based assessment framework for patient-centered care. They are meant to improve the quality of physician patient interaction by standardizing communication as a decision of entrustment. The EPAs can be linked to competency frameworks around the world and provide a useful assessment framework for effective training in patient communication. They can be integrated into any post graduate curriculum and can also serve as a self -assessment tool for postgraduate training programs across the globe to improve their patient communication curricula.

scholarly journals Impact of satisfaction with physician–patient communication on self-care and adherence in patients with hypertension: cross-sectional study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Natalia Świątoniowska-Lonc ◽  
Jacek Polański ◽  
Wojciech Tański ◽  
Beata Jankowska-Polańska
Keyword(s):  
Care Management ◽  
Assessment Tool ◽  
Self Care ◽  
Chronically Ill ◽  
Cross Sectional Study ◽  
Patient Communication ◽  
Cross Sectional ◽  
Patient’S Satisfaction ◽  
Physician Patient Communication ◽  
Physician Patient

Abstract Background Hypertension (HT) requires patients to continuously monitor their blood pressure, strictly adhere to therapeutic recommendations, and self-manage their illness. A few studies indicate that physician–patient communication and the patient’s satisfaction with the therapeutic relationship may affect the course and outcomes of the treatment process. Research is still lacking on the association between satisfaction with physician–patient communication and adherence to treatment or self-care in chronically ill patients. The aim of the study was to evaluate the relationship between satisfaction with physician–patient communication and self-care and adherence in patients with HT undergoing chronic treatment. Methods The following instruments were used: the Adherence to Refills and Medication Scale (ARMS) for evaluating adherence (12–48 points), the Self-Care of Hypertension Inventory (SCHI) for self-care level (0–100 points), and the Communication Assessment Tool (CAT) for evaluating satisfaction with physician–patient communication. Socio-demographic and clinical data were obtained from patients’ medical records. The research has a cross-sectional and observational study design. Inclusion criteria were as follows: age > 18 years, hypertension diagnosed per European Society of Hypertension (ESH) guidelines, treatment with at least one antihypertensive drug for the past 6 months, and informed consent. Cognitively impaired patients unable to complete the surveys without assistance were excluded (MMSE ≤18). Correlations between quantitative variables were analyzed using Pearson’s or Spearman’s correlation coefficient. Linear regression was performed. Variable distribution normality was verified using the Shapiro-Wilk test. Results The study included 250 patients (110 male, mean age 61.23 ± 14.34) with HT, treated at a hypertension clinic. In the CAT questionnaire individual questions pertaining to satisfaction with physician communication (on the CAT) were rated “excellent” 28.4–50.4% of the time. The best-rated aspects of communication included: letting the patient talk without interruptions (50.4% “excellent” ratings), speaking in a way the patient can understand (47.6%), and paying attention to the patient (47.2%). According to patient reports, physicians most commonly omitted such aspects as encouraging the patient to ask questions (28.4%), involving them in decisions (29.2%), and discussing the next steps (35.2%). The respondents had a low level of adherence to pharmaceutical treatment (16.63 ± 4.6). In terms of self-care, they scored highest in self-care management (64.17 ± 21.18), and lowest in self-care maintenance (56.73 ± 18.57). In correlation analysis, satisfaction with physician–patient communication (total CAT score) was positively correlated with all SCHI domains (self-care maintenance β = 0.276, self-care management β = 0.208, self-care confidence β = 0.286, p < 0.05), and negatively correlated with ARMS scores (indicating better adherence). Conclusions Satisfaction with physician–patient communication has a significant impact on self-care and pharmaceutical adherence in patients with hypertension. The more satisfied the patient is with communication, the better their adherence and self-care. Trial registration SIMPLE: RID.Z501.19.016.

scholarly journals Mapping Direct Observations From Objective Structured Clinical Examinations to the Milestones Across Specialties

2016 ◽  
Vol 8 (3) ◽  
pp. 429-434 ◽  
Author(s):  
Kimberly Baker-Genaw ◽  
Maria S. Kokas ◽  
Syed F. Ahsan ◽  
Deborah Darnley-Fisch ◽  
Sean Drake ◽  
...  
Keyword(s):  
Assessment Tool ◽  
Work Group ◽  
Phase 1 ◽  
Essential Elements ◽  
Patient Communication ◽  
Institutional Level ◽  
Physician Patient Communication ◽  
Next Accreditation System ◽  
Objective Structured Clinical Examinations ◽  
Physician Patient

ABSTRACT  Little is known about residents' performance on the milestones at the institutional level. Our institution formed a work group to explore this using an institutional-level curriculum and residents' evaluation of the milestones.Background  We assessed whether beginner-level milestones for interpersonal and communication skills (ICS) related to observable behaviors in ICS-focused objective structured clinical examinations (OSCEs) for postgraduate year (PGY) 1 residents across specialties.Objective  The work group compared ICS subcompetencies across 12 programs to identify common beginner-level physician-patient communication milestones. The selected ICS milestone sets were compared for common language with the ICS-OSCE assessment tool—the Kalamazoo Essential Elements of Communication Checklist–Adapted (KEECC-A). To assess whether OSCE scores related to ICS milestone scores, all PGY-1 residents from programs that were part of Next Accreditation System Phase 1 were identified; their OSCE scores from July 2013 to June 2014 and ICS subcompetency scores from December 2014 were compared.Methods  The milestones for 10 specialties and the transitional year had at least 1 ICS subcompetency that related to physician-patient communication. The language of the ICS beginner-level milestones appears similar to behaviors outlined in the KEECC-A. All 60 residents with complete data received at least a beginner-level ICS subcompetency score and at least a satisfactory score on all 3 OSCEs.Results  The ICS-OSCE scores for PGY-1 residents appear to relate to beginner-level milestones for physician-patient communication across multiple specialties.Conclusions

scholarly journals Designing and Psychometric Assessing of Physician-Patient Communication Skills Tool

2020 ◽  
Vol 10 (5) ◽  
pp. 329-338
Author(s):  
Omid Rasekhi ◽  
◽  
Rabiollah Farmanbar ◽  
Mandana Shirazi ◽  
◽  
...  
Keyword(s):  
Factor Analysis ◽  
Medical Students ◽  
Communication Skills ◽  
Content Validity ◽  
Assessment Tool ◽  
Patient Communication ◽  
Skills Assessment ◽  
Medical Sciences ◽  
Physician Patient Communication ◽  
Physician Patient

Background: Assessment of physicians’ communication skills with patients is essential to ensure effective treatment. Achieving such a goal requires the use of a valid, native, and culturally-based tool. This study aimed to design a physician-patient communication skills assessment tool and evaluate its validity and reliability among the medical students of Guilan University of Medical Sciences, Rasht City, Iran. Methods: In this cross-sectional, descriptive, and analytical study, out of 400 medical students (interns), 300 were selected by a stratified random sampling method. The initial tool with 30 items was evaluated by calculating the item impact index in the target group. Also, its ratio and content validity indexes were assessed by 10 experts’ views and factor analysis. The reliability of the research tool was confirmed by assessing the internal consistency by calculating the Cronbach alpha value.  Results: Out of the 30 initial items, after calculating the item impact score index of higher than 1.5, the content validity ratio greater than 0.51, the content validity index higher than 0.79, and exploratory factor analysis,18 items remained and were considered suitable for the physician-patient communication skills assessment tool. Then, these variables were loaded considering the amount of special value greater than 1 under four factors. The reliability of the research tool was confirmed by calculating the Cronbach alpha coefficient of 0.92. The instrument was also confirmed by confirmatory factor analysis regarding its appropriate fitness indices. This study provided a proper and native instrument with 18 valid and reliable items for the assessment of physician-patient communication skills in medical students.  Conclusion: The results of this study could be of interest to researchers in evaluating physician-patient communication skills in other medical sciences universities of Iran. 

Physician-patient communication in the primary care clinics

2019 ◽  
pp. 120-123 ◽  
Author(s):  
Arwa Aseeri ◽  
Abdulmajeed Alswat ◽  
nAbdulelah Alessa ◽  
Abdulrahman ALAql ◽  
Osama Alkhudhairi ◽  
...  
Keyword(s):  
Primary Care ◽  
Patient Communication ◽  
Primary Care Clinics ◽  
Physician Patient Communication ◽  
Physician Patient
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