Communication skills of tutors and family medicine physician residents in Primary Care clinics

Abstract

Aim: To determine the communicative profiles of family physicians and the characteristics associated with an improved level of communication with the patient. Design: A descriptive multicentre study. Location: Primary Healthcare Centres in Almeria, Granada, Jaen and Huelva. Participants: 119 family physicians (tutors and 4th year resident physicians) filmed and observed with patients. Principal measurements: Demographic and professional characteristics. Analysis of the communication between physicians and patients, using a CICAA (Connect, Identify, Understand, Agree and Assist, in English) scale. A descriptive, bivariate, multiple linear regression analysis was performed. Results: There were 436 valid interviews. Almost 100% of physicians were polite and friendly, facilitating a dialogue with the patient and allowing them to express their doubts. However, few physicians attempted to explore the state of mind of the patient, or enquire about their family situation or any important stressful events, nor did they ask open questions. Furthermore, few physicians summarised the information gathered. The mean score was 21.43 ± 5.91 points (maximum 58). There were no differences in the total score between gender, city, or type of centre. The linear regression verified that the highest scores were obtained from tutors (B: 2.98), from the duration of the consultations (B: 0.63), and from the age of the professionals (B: −0.1). Conclusion: Physicians excel in terms of creating a friendly environment, possessing good listening skills, and providing the patient with information. However the ability to empathise, exploring the psychosocial sphere, carrying out shared decision-making, and asking open questions must be improved. Being a tutor, devoting more time to consultations, and being younger, results in a significant improvement in communication with the patient.

Keywords

• Communication
• Physician–patient relations
• Internships and residencies
• Primary healthcare