Improving the efficiency of patients' comprehension monitoring: a way of increasing patients' participation in general practice consultations.

The aim of the investigations reported was to examine the effects of helping patients to check their understanding of instructions and advice given during their consultations with general practitioners. Three groups of patients were both tape recorded during their consultation and interviewed immediately afterwards. The groups differed in the written information they were given prior to their consultations. The 'Normal' group were informed only that the researcher was interested in how well doctors and patients understand each other. The 'Permission' group was explicitly invited to raise queries with the doctor during their consultation. The 'Guidance' group was asked to use two specified strategies to check their understanding of instructions and advice given by the doctor. We coded the frequency of questions and comments about treatment which patients produced during their consultations, and the accuracy and completeness of their subsequent accounts of the recommended treatment. The Normal and Permission groups did not differ in either respect. The Guidance group produced significantly more questions and comments than the Normal group and gave more complete and accurate accounts of the recommended treatment. A partial replication in a different practice produced consistent results.