Reflections of pharmacy students on experiential education in providing health services to people with history of substance use disorders in Malaysia

Introduction: Accreditation standards for pharmacy students’ education include the requirement for experiential education (EE) and acknowledge, in building life-long learning skills, the need to develop students’ skills in analysing their practice-based performance. The goal of this qualitative study was to assess students’ ability to reflect on their experience providing face-to-face care to patients with a history of substance use disorders (PHSUDs). Materials and methods: Interviews were conducted with undergraduate pharmacy students who provided care to PHSUDs in an EE programme. An interview guide was used to explore students’ experiences and their perceptions regarding the challenges they encountered, changes in their attitude towards PHSUDs and ways to improve their ability to care for PHSUDs. Data relevant to the study was extracted from interview transcripts, manually sorted and coded using Microsoft Excel and subjected to thematic analysis. Results: The themes identified were 1) Increased self-confidence in face-to-face interactions with PHSUDs 2) Increased empathy towards PHSUDS 3) Reduction in stigmatised attitudes towards PHSUDs 4) Positive nature of the interactions with PHSUDs 5) Appreciation for the opportunity to apply knowledge in practice 6) Recognition of the need for improved communication skill training 7) Recognition of the need to improve training for dealing with unexpected questions and situations. Conclusion: Pharmacy students demonstrated reflective skills in identifying multiple positive learning outcomes stemming from a one-day EE programme involving PHSUDs. In addition, they provided insights useful to faculty in curriculum planning.

NeoAct: A Randomized Prospective Pilot Study on Communication Skill Training of Neonatologists

Background: This randomized interventional study evaluated the impact of a 1-day experiential communication skills training on neonatologists' performance in doctor-parents-communication.Methods: 17 neonatologists with different levels of professional experience from the Medical University of Vienna were randomized into one of two study groups: The intervention group (IG) as opposed to the control group (CG) participated in a 1-day experiential communication training. Eight weeks after the training, participants' communication skills were assessed during an objective structured clinical examination (OSCE). Neonatologists were assessed in a simulated conversation by how effectively they performed when conveying complex health-related information to parents of ill infants. Participants in the control group (CG) were assessed first during the OSCE and received their communication training later on. Self-assessment questionnaires before and after the workshop and OSCE were completed.Results: The study determined that neonatologists in the IG subjectively perceived that their competence level regarding their communication skills had increased after the workshop, while this was not reflected by their performance during the OSCE assessment.Discussion: A 1-day experiential communication skills training significantly increased physicians' self-evaluation concerning their communicative competence. This perceived competence did not manifest itself in increased communication skills during the OSCE.Conclusion: Repeated training is needed.

The Weight of Words: A Mixed Methods Study to Understand Indian Doctors’ Perspectives and Experiences of Patient Communication

Background: Effective doctor communication can lead to increased treatment adherence and improved self-management among individuals living with diabetes. Yet, there is limited research in India which examines how doctors communicate, especially in terms of verbal and nonverbal communication. Aims: (1) To examine communication in clinic (verbal, nonverbal and basic content) among Indian doctors specialized in diabetes and endocrine care, and (2) to explore doctors’ styles of verbal and nonverbal communication. Methods: Using a mixed methods design, a survey containing quantitative (n=834) and qualitative (n=648) elements was filled out by doctors specialized in the fields of diabetes and endocrinology in India. Questions in the quantitative section included questions such as addressing patients’ illness-related concerns, acknowledging challenges of using insulin, and non-verbal behaviours. The qualitative section focussed on elaborating some responses made to the quantitative section, such as questions about explaining the cause of illness, listing words and phrases that may potentially impact patients, and explaining why the patients need to be initiated on insulin. The data was analysed using descriptive statistics and qualitative content analysis, respectively. Results: The findings of the quantitative study showed that the majority of the doctors (i) always greeted their patient as they entered the room (43.2%), (ii) addressed the risk of developing diabetes with patients’ siblings/children (87.9%), (iii) always acknowledged the challenges of using insulin (42.8%), and (iv) never asked patients’ experiences at the end of the consultation (31.9%). All common communication cues were rated as extremely important; eye contact (48.7%), tone of voice (41.5%), body language (39.6%), and words and phrases (41.8%). The qualitative findings revealed that doctors preferred to use verbal communication such as using authoritative language, educating patients using facts, analogies and behavioural information, employing empathetic language on occasion. Doctors also reported using negative words that portrayed fear, blame and disengagement in order to promote adherence. Discussion and Conclusion: The findings suggest that doctors rely on verbal rather than nonverbal communication when interacting with patients, with fear messages being a favoured means of ensuring adherence. It is possible that this may be because, while recognizing the value of nonverbal methods, doctors lack training in using these techniques in communication. Therefore, developing a communication skill training program for Indian doctors focussed on empathic and nonverbal communication can help to improve consultation and patient outcomes (e.g., adherence, patient satisfaction).

Family caregivers’ perceived communication self-efficacy with physicians

Objective Family-centered health care requires successful communication between patient, family caregivers, and healthcare providers. Among all providers, physicians are most likely to interact with caregivers. Using the Family Caregiver Communication Typology, this study examined perceived communication self-efficacy with physicians among four types of caregivers: Manager, Partner, Carrier, and Lone. Method A cross-sectional online survey included the Family Communication Typology Tool, Communication Perceived Self-Efficacy Scale, the Caregiver Quality of Life-Revised Index, and the Generalized Anxiety Disorder (GAD-2) questionnaire. Results An online survey of 220 family caregivers currently caring for an adult family member revealed significant differences in communication self-efficacy among family caregiver communication types, revealing that Partner caregivers have the highest perceived communication self-efficacy, and that for some caregiver types, higher perceived communication self-efficacy is associated with certain quality of life dimensions. Significance of results Differences in communication self-efficacy with physicians among the four caregiver communication types (Manager, Partner, Carrier, and Lone) provide further evidence that the typology represents variance in caregiver communication abilities. Development of future medical curricula targeting communication skill training should include an overview of the typology and communication strategies as these may increase effective communication between physicians and caregivers.

Pelatihan Keterampilan Berkomunikasi Bahasa Inggris Bagi Pramusaji Kedai di Kawasan Wisata Aik Berik

The English communication skill training for shop waiters in the tourism area of Aik Berik aims to provide theoretical and practical knowledge about the use of a variety of tourism English, expressions and vocabulary commonly used in providing services especially to foreign tourists. This training activity involved the shop waiters around the tourism area of Aik Berik. The mentors of this training were lectures and students majoring in English who had proficient English skills. The training activity took a place around the shop location in the tourism area of Aik Berik, Central Lombok. The training method included material presentation including greetings, showing the way, kinds of food and beverage, menus, price lists, fruits, expressions, mini conversations and the practice of making short conversations among participants regarding the materials that had been taught. The results of the evaluation during the training showed high interest and enthusiasm of the shop waiters in participating in the whole series of training activities ranging from socialization to the implementation of the training. The shop waiters also showed an increase in the capability of using the language, expressions and vocabularies as well as better self-confidence in providing services for tourists. Participants also gave high appreciation to the presence of lectures and students as trainers and hoped that similar activities could continue to be carried out in order to enrich insight and improve communication skills and confidence of tourism activists, especially shop waiters in the Aik Berik tourism area.

Outcome of Training on “Doctor-Patient Communication Skill” for the Pre-intern Physicians

Background: Communication is the way how a physician interacts with the patient; it should have nonverbal, verbal and para-verbal components. This study was designed for communication skill training on newly graduated medical and dental physicians and to compare the outcomes of training in terms of pretest and post-test results among experimental group and control groups. Materials & methods: It was a randomized, prospective, interventional study performed on newly graduated medical and dental physicians, recruited from four participating centres: Chittagong Medical College, Chattagram Maa-O-Shishu Hospital Medical College, Southern Medical College & Hospital and Chattagram International Dental College. Duration of study was from 1st January 2017 to 30th August 2017. After selecting 60 participants (experimental group: 50; control group: 10) by lottery method, informed consent was taken and all the participants of both groups appeared at a pre-test. Only experimental group attended the training program and both the groups appeared at post-test. Results: When pre-test and post-test values of experimental group was compared by t-test, the p values for proper introduction, verbal, non-verbal, para-verbal and total scores were 0.00, 0.00, 0.00, 0.00 and 0.00 respectively. During comparison post-test scores in experimental and control groups by ANCOVA, the p values for proper introduction, verbal, non-verbal, para-verbal and total scores were 0.00, 0.00, 0.00, 0.00 and 0.00 respectively. Conclusions: There was significant improvement in communication skill of physicians after receiving the training with no possibility of occurring those changes by chance. If appropriate, the results can be utilized to approach for formal introduction of communication skills training for pre-intern physicians. J MEDICINE JAN 2020; 21 (1) : 3-7