Limits...
Can the feedback of patient assessments, brief training, or their combination, improve the interpersonal skills of primary care physicians? A systematic review.

Cheraghi-Sohi S, Bower P - BMC Health Serv Res (2008)

Bottom Line: Of the two feedback studies, one reported a significant positive effect.Only one training study reported a significant positive effect.The interventions to be tested in future research should consider using insights from the wider literature on communication outside primary care, might benefit from a clearer theoretical basis, and should examine the use of combined brief training and feedback.

View Article: PubMed Central - HTML - PubMed

Affiliation: National Primary Care Research and Development Centre, University of Manchester, Oxford Road, Manchester, M13 9PL, UK. sudeh.cheraghi-sohi@manchester.ac.uk

ABSTRACT

Background: Improving quality of primary care is a key focus of international health policy. Current quality improvement efforts place a large focus on technical, clinical aspects of quality, but a comprehensive approach to quality improvement should also include interpersonal care. Two methods of improving the quality of interpersonal care in primary care have been proposed. One involves the feedback of patient assessments of interpersonal care to physicians, and the other involves brief training and education programmes. This study therefore reviewed the efficacy of (i) feedback of real patient assessments of interpersonal care skills, (ii) brief training focused on the improvement of interpersonal care (iii) interventions combining both (i) and (ii)

Methods: Systematic review of randomised controlled trials. Three electronic databases were searched (CENTRAL, Medline and Embase) and augmented by searches of the bibliographies of retrieved articles. The quality of studies was appraised and results summarised in narrative form.

Results: Nine studies were included (two patient based feedback studies and seven brief training studies). Of the two feedback studies, one reported a significant positive effect. Only one training study reported a significant positive effect.

Conclusion: There is limited evidence concerning the effects of patient based feedback. There is reasonable evidence that brief training as currently delivered is not effective, although the evidence is not definitive, due to the small number of trials and the variation in the training methods and goals. The lack of effectiveness of these methods may reflect a number of issues, such as differences in the effectiveness of the interventions in experienced practitioners and those in training, the lack of theory linking feedback to behaviour change, failure to provide sufficient training or to use a comprehensive range of behaviour change techniques. Further research into both feedback and brief training interventions is required before these interventions are routinely introduced to improve patient satisfaction with interpersonal care in primary care. The interventions to be tested in future research should consider using insights from the wider literature on communication outside primary care, might benefit from a clearer theoretical basis, and should examine the use of combined brief training and feedback.

Show MeSH
Overview of searching process.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC2542366&req=5

Figure 1: Overview of searching process.

Mentions: The electronic search identified 20,840 citations (see figure 1). Screening of the titles and abstracts reduced this to 103 after excluding 20,737 ineligible articles. In addition to the electronic search, hand-searching located two further studies. These 105 studies were retrieved and reviewed by both SCS and PB. In total, nine studies were found to meet all four inclusion criteria, comprising two feedback and seven training studies. No studies combining both feedback with training were identified. Two of the included studies were reported across two separate publications respectively [23-26]. For an overview of the characteristics of included studies see additional file 2.


Can the feedback of patient assessments, brief training, or their combination, improve the interpersonal skills of primary care physicians? A systematic review.

Cheraghi-Sohi S, Bower P - BMC Health Serv Res (2008)

Overview of searching process.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2542366&req=5

Figure 1: Overview of searching process.
Mentions: The electronic search identified 20,840 citations (see figure 1). Screening of the titles and abstracts reduced this to 103 after excluding 20,737 ineligible articles. In addition to the electronic search, hand-searching located two further studies. These 105 studies were retrieved and reviewed by both SCS and PB. In total, nine studies were found to meet all four inclusion criteria, comprising two feedback and seven training studies. No studies combining both feedback with training were identified. Two of the included studies were reported across two separate publications respectively [23-26]. For an overview of the characteristics of included studies see additional file 2.

Bottom Line: Of the two feedback studies, one reported a significant positive effect.Only one training study reported a significant positive effect.The interventions to be tested in future research should consider using insights from the wider literature on communication outside primary care, might benefit from a clearer theoretical basis, and should examine the use of combined brief training and feedback.

View Article: PubMed Central - HTML - PubMed

Affiliation: National Primary Care Research and Development Centre, University of Manchester, Oxford Road, Manchester, M13 9PL, UK. sudeh.cheraghi-sohi@manchester.ac.uk

ABSTRACT

Background: Improving quality of primary care is a key focus of international health policy. Current quality improvement efforts place a large focus on technical, clinical aspects of quality, but a comprehensive approach to quality improvement should also include interpersonal care. Two methods of improving the quality of interpersonal care in primary care have been proposed. One involves the feedback of patient assessments of interpersonal care to physicians, and the other involves brief training and education programmes. This study therefore reviewed the efficacy of (i) feedback of real patient assessments of interpersonal care skills, (ii) brief training focused on the improvement of interpersonal care (iii) interventions combining both (i) and (ii)

Methods: Systematic review of randomised controlled trials. Three electronic databases were searched (CENTRAL, Medline and Embase) and augmented by searches of the bibliographies of retrieved articles. The quality of studies was appraised and results summarised in narrative form.

Results: Nine studies were included (two patient based feedback studies and seven brief training studies). Of the two feedback studies, one reported a significant positive effect. Only one training study reported a significant positive effect.

Conclusion: There is limited evidence concerning the effects of patient based feedback. There is reasonable evidence that brief training as currently delivered is not effective, although the evidence is not definitive, due to the small number of trials and the variation in the training methods and goals. The lack of effectiveness of these methods may reflect a number of issues, such as differences in the effectiveness of the interventions in experienced practitioners and those in training, the lack of theory linking feedback to behaviour change, failure to provide sufficient training or to use a comprehensive range of behaviour change techniques. Further research into both feedback and brief training interventions is required before these interventions are routinely introduced to improve patient satisfaction with interpersonal care in primary care. The interventions to be tested in future research should consider using insights from the wider literature on communication outside primary care, might benefit from a clearer theoretical basis, and should examine the use of combined brief training and feedback.

Show MeSH