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7 December 1999 | Volume 131 Issue 11 | Pages 822-829
Background: Although substantial resources have been invested in communication skills training for clinicians, little research has been done to test the actual effect of such training on patient satisfaction.
Objective: To determine whether clinicians' exposure to a widely used communication skills training program increased patient satisfaction with ambulatory medical care visits.
Design: Randomized, controlled trial.
Setting: A not-for-profit group-model health maintenance organization in Portland, Oregon.
Participants: 69 primary care physicians, surgeons, medical subspecialists, physician assistants, and nurse practitioners from the Permanente Medical Group of the Northwest.
Intervention: "Thriving in a Busy Practice: Physician-Patient Communication," a communication skills training program consisting of two 4-hour interactive workshops. Between workshops, participants audiotaped office visits and studied the audiotapes.
Measurements: Change in mean overall score on the Art of Medicine survey (HealthCare Research, Inc., Denver, Colorado), which measures patients' satisfaction with clinicians' communication behaviors, and global visit satisfaction.
Results: Although participating clinicians' self-reported ratings of their communication skills moderately improved, communication skills training did not improve patient satisfaction scores. The mean score on the Art of Medicine survey improved more in the control group (0.072 [95% CI, –0.010 to 0.154]) than in the intervention group (0.030 [CI, –0.060 to 0.120]).
Conclusions: "Thriving in a Busy Practice: Physician-Patient Communication," a typical continuing medical education program geared toward developing clinicians' communication skills, is not effective in improving general patient satisfaction. To improve global visit satisfaction, communication skills training programs may need to be longer and more intensive, teach a broader range of skills, and provide ongoing performance feedback.
Author and Article Information
Acknowledgments: The authors thank the many persons whose generosity and expertise made this project possible, including Ron Potts, MD; Tom Janisse, MD; Wendy Ray; Meg Graue; Phil Brenes, MD; Chris Overton; and Greg Nichols, PhD. The authors also thank Christopher Kelleher for his organizational and editorial contributions.
Grant Support: By Kaiser Permanente's Sidney Garfield Memorial Fund (grant no. 101-9087). The Art of Medicine survey was produced by HealthCare Research, Inc., and is a registered trademark of that company.
Requests for Reprints: Jonathan Betz Brown, MPP, PhD, Center for Health Research, 3800 North Interstate Avenue, Portland, OR 97227-1098; e-mail, jonathan.brown{at}kp.org. For reprint orders in quantities exceeding 100, please contact the Reprints Coordinator; phone, 215-351-2657; e-mail, reprints{at}mail.acponline.org.
Current Author Addresses: Drs. Brown, Boles, and Mullooly: Center for Health Research, 3800 North Interstate Avenue, Portland, OR 97227-1098.
Dr. Levinson: General Internal Medicine, University of Chicago, 5841 South Maryland Avenue, MC 6098, Chicago, IL 60637. ARTICLE
Effect of Clinician Communication Skills Training on Patient Satisfaction
A Randomized, Controlled Trial
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