Document Type : Original Article
Authors
- . Sharon A. Bentley 1
- . Betty Tellis 2
- . Kelly L. Michel 3
- . Patricia O’Connor 4
- . Caroline Clarke 5
- . Jill E. Keeffe 6
1 Australian College of Optometry, National Vision Research Institute, Carlton, Centre for Eye Research Australia, University of Melbourne
2 Centre for Eye Research Australia, University of Melbourne
3 Royal Victorian Eye and Ear Hospital, East Melbourne
4 School of Social Science, University of Western Sydney, Penrith, Australia,
5 Royal Victorian Eye and Ear Hospital, East Melbourne,
6 Centre for Eye Research Australia, University of Melbourne,L V Prasad Eye Institute, Hyderabad, Telangana, India
Abstract
Purpose: Patient and family involvement in the education and training of medical practitioners
increases the likelihood that the care delivered will meet the needs of service users and
carers. The purpose of this study was to determine the effect of a consumer informed
educational program on knowledge and attitude to patient‑centered care among hospital
clinical trainees. Methods: A total of 66 junior medical staff and 35 orthoptists in training
were invited to participate in a controlled before‑and‑after trial at the Royal Victorian Eye
and Ear Hospital from October to November, 2011. Thirty‑eight participants were allocated
to the intervention program (interactive workshop) and 63 to the control program (assigned
reading). Questionnaires regarding knowledge, attitude, and practice, patient‑practitioner
orientation and communication were administered. Differences between groups and
differences before and after the program were evaluated using the t‑test or Chi‑square test, as
appropriate. Narrative data obtained from the questionnaires were analyzed using Grounded
Theory qualitative analysis techniques. Results: A total of 24 participants (63%) completed
the intervention program and eight (13%) the control program. The intervention group felt
more prepared to introduce themselves and their role (Chi‑square = 11.19, P = 0.01) and
to acknowledge patients’ waiting time prior to consultation (Chi‑square 8.52, P = 0.04)
compared with the control group. For the intervention group, there was an improvement
in mean score on the Communication Assessment Tool (mean change = 0.55, P = 0.01).
Conclusion: There were minor improvements in self‑perceived knowledge and attitude to
patient‑centered care and communication among hospital clinicians‑in‑training following
a consumer informed education program. The majority of participants who received this
program agreed it would influence how they conducted future consultations. Further work
is required to determine if these improvements translate to sustainable changes in clinical
practice and patient satisfaction.
Keywords
Patient and Consumer Centred Care. Available from: http://www.
safetyandquality.gov.au/internet/safety/publishing.nsf/Content/
PCCC. [Last accessed on 2012 Feb 01].
2. Brown JB, Boles M, Mullooly JP, Levinson W. Effect of clinician
communication skills training on patient satisfaction. A randomized,
controlled trial. Ann Intern Med 1999;131:822‑9.
3. DiMatteo MR. The role of the physician in the emerging health care
environment. West J Med 1998;168:328‑33.
4. LaineC, Davidoff F. The patient physician relationship‑Patient‑Centred
Medicine: A professional evolution. JAMA 1996;275:152‑6.
5. Institute for Patient‑ and Family‑Centred Care. Advancing the
Practice of Patient‑and Family‑Centred Care: How to Get Started.
Bethesda: Institute for Patient‑ and Family‑Centred Care; 2008.
6. The Commonwealth Fund. In focus: Health care institutions
are slowly learning to listen to customers. Available from:
http://www.commonwealthfund.org/Content/Newsletters/
Quality‑Matters/2010/February‑March‑2010/In‑Focus.aspx.
[Last accessed on 2011 Jul 14].
7. Repper J, Breeze J. User and carer involvement in the training and
education of health professionals: A review of the literature. Int J
Nurs Stud 2007;44:511‑9.
8. Longtin Y, Sax H, Leape LL, Sheridan SE, Donaldson L, Pittet D.
Patient participation: Current knowledge and applicability to patient
safety. Mayo Clin Proc 2010;85:53‑62.
9. Yedidia MJ, Gillespie CC, Kachur E, Schwartz MD, Ockene J,
Chepaitis AE, et al. Effect of communications training on medical
student performance. JAMA 2003;290:1157‑65.
10. Lau FL. Can communication skills workshops for emergency
department doctors improve patient satisfaction? J Accid Emerg
Med 2000;17:251‑3.
11. Harms C, Young JR, Amsler F, Zettler C, Scheidegger D, Kindler CH.
Improving anaesthetists’ communication skills. Anaesthesia
2004;59:166‑72.
12. Bensing JM, Sluijs EM. Evaluation of an interview training course
for general practitioners. Soc Sci Med 1985;20:737‑44.
13. Department of Health. Victorian Patient Satisfaction Monitor, in Rural
and Regional Health and Aged Care Services Division. Victoria:
Department of Health; 2008.
14. National Survey Programme. Outpatient Core Questionnaire.
United Kingdom: Picker Institute Europe; 2009.
15. Krupat E, Rosenkranz SL, Yeager CM, Barnard K, Putnam SM,
Inui TS. The practice orientations of physicians and patients: The
effect of doctor‑patient congruence on satisfaction. Patient Educ
Couns 2000;39:49‑59.
16. Makoul G, Krupat E, Chang CH. Measuring patient views of
physician communication skills: Development and testing of
the Communication Assessment Tool. Patient Educ Couns
2007;67:333‑42.
17. CharmazK. Grounded theory. In: EmersonRM, editor. Contemporary
Field Research: Perspectives and Formulations. Prospect Heights:
Waveland Press Inc.; 2001.
18. Strauss A. Basics of qualitative research: Techniques and
procedures for developing grounded theory. 2nd ed. Thousand
Oaks: Sage Publications Inc.; 1998.
19. Glaser BG. Emergence vs Forcing: Basics of Grounded Theory
Analysis. Mill Valley: Sociology Press; 1992.
20. Stewart M. Towards a global definition of patient centred care ‑ The
patient should be the judge of patient centred care. Br Med J
2001;322:444‑5.
21. Irish JT. Deciphering the physician‑older patient interaction. Int J
Psychiatry Med 1997;27:251‑67.
22. Glass RM. The patient‑physician relationship. JAMA focuses on the
center of medicine. JAMA 1996;275:147‑8.
23. Kovacs Burns K. Canadian patient safety champions: Collaborating
on improving patient safety. Healthc Q 2008;11:95‑100.
24. Australian Commission on Safety and Quality in Health Care.
Patient‑centred care: Improving quality and safety through
partnerships with patients and consumers. Canberra: Australian
Commission on Safety and Quality in Health Care; 2011.
25. Institute for Patient‑ and Family‑Centred Care. Advancing the
practice of patient‑ and family‑centred care in hospitals: How to
get started. Bethesda: Institute for Patient‑and Family‑Centred Care;
2011.
26. Frampton S, Guastello S, Hale CB, Horowitz S, Smith SB, Stone S.
Patient‑Centred Care Improvement Guide. Derby, CT: Plantree and
Picker Institute; 2008.
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