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Context matters! How to train future GPs in skilled doctor-patient communication

Projectomschrijving

Communicatie is een kerncompetentie in de curricula van medische opleidingen. Uit onderzoek blijkt dat communicatie afhankelijk is van de context van het consult, zowel qua medische klacht, als arts- en patiënt kenmerken. Dit maakt een creatieve en flexibele inzet noodzakelijk. De huisartsopleidingen in Nederland hebben recent context-specifieke communicatie geïntegreerd in het onderwijscurriculum. Er is een nood aan onderzoek, dat deze ‘skilled communication’ benadering wetenschappelijk onderbouwt met betrekking tot het stimuleren van een optimale transfer tussen de training-setting en de klinische praktijk.

Onderzoeksplan

Er wordt gedefinieerd wat ‘skilled communication’ inhoudt en wat de kenmerken zijn van een ‘skilled communicator’. Aios worden 6 maanden gevolgd om te onderzoeken hoe communicatie wordt geleerd in de praktijk en context-specifieke communicatiestrategieën worden ontwikkeld voor 2 huisartsgeneeskundige thema’s: korte episode en chronische zorg. Deze vormen de basis voor de ontwikkeling, pilot en evaluatie van een training voor docenten om aios en huisartsopleiders te trainen in ‘skilled communication’.

Producten

Titel: Vaardig communiceren met patiënten: Wat zijn eigenschappen van een vaardige communicator? Journal Club UvA, Amsterdam,
Auteur: Michelle Verheijden
Titel: A Nominal Group Study to identify characteristics of a skilled communicator in the clinical encounter. Pelerin Symposium 2022, Maastricht, Oral Presentation.
Auteur: Verheijden M, Giroldi E, van den Eertwegh V, Luijkx M, van der Weijden T, de Bruin Anique, Timmerman A
Titel: How to formulate and reach consensus about the concept ‘skilled communication’? Interuniversity Centre for Educational Sciences (ICO) 2020. Round Table discussion.
Auteur: Michelle Verheijden
Titel: Context matters! How to train future GPs in skilled doctor patient communication. Interuniversity Centre for Educational Sciences (ICO) 2020.
Auteur: Michelle Verheijden
Titel: A Nominal Group Study to identify characteristics of a skilled communicator in the patient encounter. ICCH 2022, Glasgow. Oral presentation.
Auteur: Verheijden M, Giroldi E, van den Eertwegh V, Luijkx M, van der Weijden T, de Bruin Anique, Timmerman A
Titel: Vaardig communiceren met patiënten: Wat zijn eigenschappen van een vaardige communicator? Patient-Provider Interaction (PPI) Network, Nivel Utrecht.
Auteur: Michelle Verheijden
Titel: Context matters! How to train future GPs in skilled doctor patient communication. SHE Presents 2020, Maastricht University. Oral Presentation.
Auteur: Michelle Verheijden
Titel: Identifying characteristics of a skilled communicator in the clinical encounter: a nominal group technique study. ICO Spring School, 2022
Auteur: Verheijden M, Giroldi E, van den Eertwegh V, Luijkx M, van der Weijden T, de Bruin Anique, Timmerman A
Titel: Identifying characteristics of a skilled communicator in the clinical encounter
Auteur: Verheijden M, Giroldi E, van den Eertwegh V, Luijkx M, van der Weijden T, de Bruin Anique, Timmerman A
Magazine: Medical Education

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Samenvatting van de aanvraag

BACKGROUND Doctor-patient communication is a core medical competency involving complex behaviour. Communication training has been increasingly integrated in medical curricula over the past decades. In communication research, there has been a shift from ‘communication skills’ towards ‘skilled communication’. The latter approach states that communicative behaviours are highly context-dependent and integrated with medical expertise in the consultation. Instead of training and assessing generic communication skills, the complexity of communication would be better addressed by an integrated approach that takes this context into account and allows for more practice-based learning, stimulating the needed flexibility and creativity. In the Netherlands, the GP specialty training has recognised this need for contextual communication training and has initiated a curriculum reform towards integrating a skilled communication approach, structured around Entrustable Professional Activities (EPA’s). However, there is a need for more evidence that will inform and underpin an effective implementation of ‘skilled communication’ in training and assessment, aimed at bridging the training setting and the workplace. DESIGN, AIM AND RESEARCH QUESTIONS The objective of this project is to underpin and operationalise the skilled communication approach in postgraduate medical training. The project will therefore address the following research questions: 1) How can we describe and concretise the concept of skilled doctor-patient communication and what are underlying characteristic attributes of a skilled (GP) communicator? 2) How can trainees be optimally supported in becoming skilled communicators? a. How do trainees learn to become skilled communicators in actual practice? b. What learning strategies are needed to support trainees’ learning process? 3) How can the EPA’s for two themes (i.e. Short episodic care and Chronic care) formulated in the national GP educational plan become operationalised into: a. Contextualised communication strategies for training skilled communication? b. An assessment instrument to monitor the development of skilled communication? 4) What is the impact of a skilled communication training programme in terms of experienced feasibility, acceptability, and learning transfer to clinical practice? WORKPLAN This 6-year project will be based on the design-based research (DBR) methodology and includes the following four studies: 1) Conceptualisation of ‘skilled communication’: We will perform a literature study combined with expert interviews to assemble ideas from the current scientific discourse, followed by expert discussion using a nominal group technique (NGT) to reach consensus on properties that define the concept of skilled communication and the characteristic attributes of a skilled communicator. 2) Validation of learning processes & strategies: We will refine and validate an existing conceptual learning model in a longitudinal qualitative study of trainees’ communication learning in actual practice during six months of their GP training programme. To gain an in-depth understanding of the involved learning processes and supporting learning strategies, we will triangulate data from audio-diaries, observations of consultations, and stimulated recall interviews. 3) Operationalisation of communication strategies in a medical context: Using participatory action research, researchers and stakeholders will together as co-researchers elaborate the EPA’s of a selection of two national GP themes (i.e. ‘Short episodic care’, and ‘Chronic care’) into contextualised communication strategies, to serve as a basis for training skilled communication and an instrument for assessment and feedback. 4) Development and pilot evaluation of a skilled communication training: A train-the-trainer programme for the two GP themes will be developed for teachers, who will then train supervisors and trainees. The feasibility, acceptability, and learning transfer of the pilot training will be evaluated using an evaluation questionnaire for all involved stakeholders, reflection reports and observations of the training sessions. DELIVERABLES 1) Definition and concretisation of the concept of skilled doctor-patient communication and the required attributes of a skilled (GP) communicator. 2 a) A validated theoretical model of the learning process through which trainees become skilled communicators. b) A range of practice-based learning strategies that support trainees in becoming skilled communicators. 3 a) An operationalisation of the themes ‘Short episodic care’, and ‘Chronic care’ and associated EPA’s into contextualised communication strategies. b) A contextual, goal-directed assessment instrument for skilled communication within the themes ‘Short episodic care’, and ‘Chronic care’. 4) A piloted skilled communication training programme evaluated by stakeholders in terms of experienced feasibility, acceptability, and learning transfer.

Kenmerken

Projectnummer:
839130013
Looptijd: 66%
Looptijd: 66 %
2019
2026
Gerelateerde subsidieronde:
Projectleider en penvoerder:
dr. A.A. Timmerman
Verantwoordelijke organisatie:
Maastricht Universitair Medisch Centrum Plus
Afbeelding

Onderzoek van onderwijs

Om de kwaliteit van de opleidingen tot huisarts en specialist ouderengeneeskunde te verbeteren, financieren we onderzoek van onderwijs. Dit project is één van die onderzoeken. Bekijk de andere projecten.