TY - JOUR
T1 - Impact of supervision and self-assessment on doctor-patient communication in rural Mexico
AU - Kim, Young M.I.
AU - Figueroa, Maria Elena
AU - Martin, Antonieta
AU - Silva, Ricardo
AU - Acosta, Sixto F.
AU - Hurtado, Manuel
AU - Richardson, Paul
AU - Kols, Adrienne
N1 - Funding Information:
The study was carried out by the Quality Assurance Project (QAP), Instituto Mexicano del Seguro Social/Solidaridad (IMSS/S), and Johns Hopkins University Center for Communication Programs (JHU/CCP), a sub-contractor of QAP. QAP is managed by the Center for Human Services (CHS; Bethesda, MD), and funded by the U.S. Agency for International Development (USAID) contract number HRN-C-00-96-900013. The authors thank Javier Cabral, Celia Es-candon, Jesus Castellanos, Maribel Rodriguez (IMSS/S); Phyllis Piotrow, Elizabeth Costenbader, Gary Lewis, (JHU/CCP); Debra Roter, Susan Larson (Johns Hopkins School of Public Health); Jim Heiby (USAID); and David Nicholas, Bart Burkhalter, and Paula Tavrow (QAP/CHS) for their assistance.
PY - 2002/10
Y1 - 2002/10
N2 - Objective. To determine whether supervision and self-assessment activities can improve doctor-patient communication. Setting and participants. Six supervisors, 60 doctors in their last year of training, and 232 primary health care patients at rural health clinics in Michoacan, Mexico. Design. The main evaluation compared post-intervention measures in control and intervention groups. A small panel study also examined changes from baseline to post-intervention rounds in both groups. Intervention. Over a 4-month period, specially trained supervisors added 1 hour of supervision on interpersonal communication and counseling (IPC/C) to regular site visits. Doctors, who had received prior IPC/C training, periodically audiotaped and assessed their own consultations. Main outcome measures. These comprised frequency of doctors' facilitative communication, doctors' biomedical information-giving, and patients' active communication. Results. The performance of all doctors improved markedly over the study period, but gains in facilitative communication and information-giving were significantly greater in the intervention than the control group. No single component of the intervention was responsible for the improvement; it resulted from the combination of activities. The doctors appreciated the more supportive relationship with supervisors that resulted from the intervention and found listening to themselves on audiotape a powerful, although initially stressful, experience. Conclusion. Supportive supervision and self-assessment activities can reinforce IPC/C training, prompt reflection and learning, and help novice doctors improve their interpersonal communication skills.
AB - Objective. To determine whether supervision and self-assessment activities can improve doctor-patient communication. Setting and participants. Six supervisors, 60 doctors in their last year of training, and 232 primary health care patients at rural health clinics in Michoacan, Mexico. Design. The main evaluation compared post-intervention measures in control and intervention groups. A small panel study also examined changes from baseline to post-intervention rounds in both groups. Intervention. Over a 4-month period, specially trained supervisors added 1 hour of supervision on interpersonal communication and counseling (IPC/C) to regular site visits. Doctors, who had received prior IPC/C training, periodically audiotaped and assessed their own consultations. Main outcome measures. These comprised frequency of doctors' facilitative communication, doctors' biomedical information-giving, and patients' active communication. Results. The performance of all doctors improved markedly over the study period, but gains in facilitative communication and information-giving were significantly greater in the intervention than the control group. No single component of the intervention was responsible for the improvement; it resulted from the combination of activities. The doctors appreciated the more supportive relationship with supervisors that resulted from the intervention and found listening to themselves on audiotape a powerful, although initially stressful, experience. Conclusion. Supportive supervision and self-assessment activities can reinforce IPC/C training, prompt reflection and learning, and help novice doctors improve their interpersonal communication skills.
KW - Communication
KW - Physician-patient relations
KW - Quality of care
KW - Self-assessment
KW - Supervision
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U2 - 10.1093/intqhc/14.5.359
DO - 10.1093/intqhc/14.5.359
M3 - Article
C2 - 12389802
AN - SCOPUS:0036799156
SN - 1353-4505
VL - 14
SP - 359
EP - 367
JO - International Journal for Quality in Health Care
JF - International Journal for Quality in Health Care
IS - 5
ER -