Can communication skills training alter physicians' beliefs and behavior in clinics?

PURPOSE

To measure the psychosocial attitudes and beliefs of physicians working within oncology in the United Kingdom and to examine whether beliefs alter after communication skills training. Additionally, to investigate whether physicians' attitudes are reflected in communication behaviors with patients during interviews.

METHODS

Ninety-three physicians completed a 32-item Physician Psychosocial Belief (PPSB) questionnaire at baseline (T1) before randomization to attendance at a 3-day residential communication skills course (n = 48) or a control group (n = 45). Three months later (T2), both groups completed another PPSB and a self-assessment questionnaire recording perceived changes in communication with patients. At both time points, physicians' consultations with two consenting patients were videotaped. Communication behaviors were measured using the Medical Interaction Processing System.

RESULTS

Physicians who attended the course showed significantly improved attitudes and beliefs toward psychosocial issues compared with controls (P =.002). This improvement was reflected in the analysis of the videotaped recordings of their communication behaviors with patients. Expressions of empathy were more likely for the course group at T2 than the controls (P =.02), as were open questions (P =.001), appropriate responses to patient cues (P =.005), and psychosocial probing (P =.041). These objective findings were supported by physicians' self report of changes in communication style during interviews with patients.

CONCLUSION

Our results show that a communication skills training intervention using behavioral, cognitive, and affective components not only increases potentially beneficial and more effective interviewing styles but can also alter attitudes and beliefs, thus increasing the likelihood that such skills will be used in the clinical setting.