THE EFFECTS OF 2 CONTINUING MEDICAL-EDUCATION PROGRAMS ON COMMUNICATION-SKILLS OF PRACTICING PRIMARY-CARE PHYSICIANS

被引：224

作者：

LEVINSON, W

ROTER, D

机构：

[1] the Good Samaritan Hospital and Medical Center, Oregon Health Sciences University, Portland, Oregon

[2] the Department of Behavioral Science, Johns Hopkins University, Baltimore, Maryland

来源：

JOURNAL OF GENERAL INTERNAL MEDICINE | 1993年 / 8卷 / 06期

关键词：

CONTINUING MEDICAL EDUCATION; PHYSICIAN PATIENT COMMUNICATION; PRIMARY CARE PHYSICIANS;

D O I：

10.1007/BF02600146

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

Purpose: To evaluate and compare the effects of two types of continuing medical education (CME) programs on the communication skills of practicing primary care physicians. Participants: Fifty-three community-based general internists and family practitioners practicing in the Portland, Oregon, metropolitan area and 473 of their patients. Method: For the short program (a 4 1/2-hour workshop), 31 physicians were randomized to either the intervention or the control group. In the long program (a 2 1/2-day course), 20 physicians participated with no randomization. A research assistant visited all physicians' offices both one month before and one month after the CME program and audiotaped five sequential visits each time. Data were based on analysis of the content and the affect of the interviews, using the Roter Interactional Analysis Scheme. Results: Based on both t-test analysis and analysis of covariance, no effect on communication was evident from the short program. The physicians enrolled in the long program asked more open-ended questions, more frequently asked patients' opinions, and gave more biomedical information than did the physicians in the short program. Patients of the physicians who attended the long program tended to disclose more biomedical and psychosocial information to their physicians. In addition, there was a decrease in negative affect for both patient and physician, and patients tended to demonstrate fewer signs of outward distress during the visit. Conclusion: This study demonstrates some potentially important changes in physicians' and patients' communication after a 2 1/2-day CME program. The changes demonstrated in both content and affect may have important influences on both biologic outcome and physician and patient satisfaction.

引用

页码：318 / 324

页数：7

共 34 条

[1] Waitzkin H., Doctor-patient communication: clinical implications of social scientific research, JAMA, 252, pp. 2441-6, (1984)
[2] DiMatteo, DiNicola D.D., Achieving Patient Compliance, pp. 35-40, (1982)
[3] Mumford E., Schlesinger H.J., Glass G.V., The effects of psychological intervention on recovery from surgery and heart attacks: an analysis of the literature, Am J Public Health, 72, pp. 141-51, (1982)
[4] Greenfield S., Kaplan S., Ware J.E., Expanding patient involvement in care, Ann Intern Med, 102, pp. 520-8, (1985)
[5] Korsch B.M., Gozzi E.K., Francis V., Gaps in doctor-patient communication. I. Doctor-patient interaction and patient satisfaction, Pediatrics, 42, pp. 855-71, (1968)
[6] Shapiro R.S., Simpson D.E., Lawrence S.L., A survey of sued and nonsued physicians and suing patients, Ann Intern Med, 149, pp. 2190-6, (1989)
[7] Adaon T.E., Tschann J.M., Guillion D.S., Oppenberg A.A., Health care delivery: physician communication skills and malpractice claims. A complex relationship, West J Med, 150, 3, pp. 356-60, (1989)
[8] Applegate W.B., Physician management of patients with adverse outcomes, Arch Intern Med, 146, pp. 2249-52, (1986)
[9] Verby V., Holden P., Davis R., Peer review of consultations in primary care: the use of audiovisual recordings, B M J, 1, pp. 1686-8, (1979)
[10] Gask L., Goldberg D., Lesser A.L., Millar T., Improving the psychiatric skills of the general practice trainee: an evaluation of a group training course, Med Educ, 22, pp. 132-8, (1988)

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