Communications Skills Training for Health Care Providers and Patient Satisfaction

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The summary below is from the full report titled "Effect of Clinician Communication Skills Training on Patient Satisfaction. A Randomized, Controlled Trial." It is in the 7 December 1999 issue of Annals of Internal Medicine (volume 131, pages 822-829). The authors are J.B. Brown, M. Boles, J.P. Mullooly, and W. Levinson.

What is the problem and what is known about it so far?

Many health care organizations are investing resources in communication skills training for their staff. Little is known, however, about whether this type of training actually improves patients' satisfaction with their health care.

Why did the researchers do this particular study?

The researchers wanted to find out whether patients being cared for by providers who had completed a special course in communication skills were more satisfied with their health care than patients whose providers did not have this special training.

Who was studied?

The study included 52 doctors and 17 nonphysician providers (physician assistants or nurse practitioners) from a health maintenance organization in Portland, Oregon. It also included groups of patients who had seen each provider before and after the course.

How was the study done?

Half of the providers were assigned to the training program; the other half (the control group) took no special course. The researchers then looked at the results from a survey of up to 100 patients who had seen each provider over a 6-month period before the course and up to 100 of each provider's patients who had been seen during the 6 months after the course. The survey asked patients to rate seven of the provider's communication skills during a particular visit and their overall satisfaction with the care given by that provider. The providers who had taken the course were also asked how well they thought they communicated with their own patients, both before and after the course, and how useful they found the course.

What did the researchers find?

Satisfaction scores actually improved more for patients of the control group providers than for patients of providers who took the training course. However, the providers who took the course reported moderate improvement in their own skills.

What were the limitations of the study?

Many types of training in communication skills exist, but this study evaluated only one type. In addition, patients were generally very satisfied with their providers before the training program. It is also possible that office visits were more effective or efficient in ways that are not reflected in patients' satisfaction scores.

What are the implications of the study?

Special training in communication for health care providers does not guarantee greater patient satisfaction. Training programs may have to be more intensive or teach a broader range of skills if they are to be effective. However, such training may make providers more confident with their own skills and could improve care in ways that this study was not able to measure.