Improving interns’ patient–physician communication skills: Application of self-efficacy theory, a pilot study

Figures & data

Table 1. Details of each of the training sessions to increase the knowledge and self-efficacy of the interns in communicating with their patients (35 interns*)

Session	Interns (N)	Learning objectives	Time
			T*	F**
1^st	35	Apply his/her knowledge in building effective relationship with a patient in the presence of the observer, with at least 60% of the adequacy. Demonstrate his/her knowledge and skills in accordance with a patient’s specific needs and concerns, with at least 50% of the sufficiency, in the presence of the observer. Criticize his/her own relationship with a patient for the observer with at least 33% of accuracy	110–135	50–75
2^nd	33	Build relationship with a patient in small, logical and systematic steps. Explain how to deal with stress in communicating with the patient. List examples of professors or their assistants’ successful communication skills in building a relationship with patients. Compare his/her previous and current self-efficacy about building relationship with a patient.	95–105	35–45
3^rd	33	Share their experiences with their peers about how they increase their self-efficacy in effectively communicating with patients. Provide feedback to others’ experiences, which are shared in the session. Make recommendations for enhancing the effectiveness of their relationship with patients.	90–100	15

*Interns in the intervention group at Shariati teaching and treatment center, affiliated to Tehran University of Medical Sciences (TUMS), 2015.

T*: Total time of the session.

F**: Time allocated for feedback.

Table 2. Details on the assessment of educational intervention to increase interns’ knowledge and self-efficacy in communicating with patients

Level of evaluation	Assessment question in this study	Assessment measure
(1) Satisfaction	Did the interns’ enjoy the educational intervention?	Mean score of interns satisfaction score
(2) Learning	Did the interns’ learn the educational content?	(1) Mean score of interns’ knowledge (2) Mean score of self-efficacy (3) Interns ‘ satisfaction about provided feedback
(3) Impact	Was the educational content used by the interns?	Mean score of interns’ communication skills
(4) Results	Did the educational intervention make a difference?	Mean score of patients’ satisfaction
(5) ROI*	Did the educational intervention pay off?	Was not assessed in this study

*Return on investment.

Figure 1. All steps of the educational intervention to increase interns’* knowledge and self-efficacy about building effective relationship with patients *, with timing of intervention and assessment

At Shariati Teaching and Treatment Centre, affiliated to Tehran University of Medical Sciences (TUMS), 2015

Table 3. Baseline characteristics of interns (n = 67) assigned to intervention or control groups. Values are numbers (percentages) unless stated otherwise

Variable	Level of variable	Group
		Intervention	Control
		N (%)	N (%)
Age	23	1(3)	0/(0)
	24	19(57.6)	23(67.6)
	25	9(27.3)	7(20.6)
	26	3(9.1)	4(11.8)
	27	1(3)	0(0)
Gender	Male	13(39.4)	12(35.3)
	Female	20(60.6)	22(64.7)
Marriage	Single	32(97)	34(100)
	Married	1(3)	0(0)
	Others	0(0)	0(0)
Previous work experience in health system	Yes	1(3)	0(0)
	No	32(97)	34(100)
Fathers’ job	In health system	10(30.3)	12(35.3)
	Not in health system	23(69.7)	22(64.7)
Mothers’ job	In health system	8(24.2)	6(17.7)
	Not in health system	25(75.8)	28(82.3)

Table 4. Comparison of the mean score of interns’ knowledge, self-efficacy and communication skills at different times in two groups of intervention and control (n = 67)

Variables	Assessment method	Group	Baseline	Immediately after	2 weeks after	4 weeks after
			Mean ± SD	Mean ± SD	Mean ± SD	Mean ± SD
Knowledge score	Observers’ assessment	Experimental	39 ± 5.04	50.72 ± 4.82	47.15 ± 4.13	43.88 ± 4.29
		Control	39.59 ± 4.93	39.47 ± 4.89	40.23 ± 5.15	40.53 ± 5.11
		P-value(t)	0.61	0.00	0.00	0.00
Self-efficacy score	Observers’ assessment	Experimental	38.96 ± 4.64	50.33 ± 1.49	48.12 ± 2.48	45.33 ± 3.30
		Control	39.11 ± 4.28	38.91 ± 4.03	38.76 ± 4.33	39.73 ± 4.19
		P-value(t)	0.89	0.00	0.01	0.00
Communication skills score	Observers’ assessment	Experimental	134.60 ± 16.42	162.39 ± 6.38	156.45 ± 7.22	153.00 ± 7.56
		Control	134.50 ± 15.06	134.20 ± 14.42	134.08 ± 14.65	135.41 ± 15.14
		P-value(t)	0.97	0.00	0.02	0.02
	Self-assessment	Experimental	80.33 ± 12.34	101.06 ± 5.21	95.27 ± 5.40	89.21 ± 5.75
		Control	81.00 ± 11.81	80.94 ± 11.55	80.82 ± 11.72	81.61 ± 11.81
		P-value(t)	0.82	0.00	0.00	0.01

Figure 2. Comparison of the mean score of patients’ satisfaction* with interns’ communication skills, at different times in two groups of intervention and control

*Mean score of patients’ satisfaction is shown in rows in a range from 10 to 70.

Table

Practice points

A theory-driven educational intervention makes learning outcomes sustainable. Increasing medical interns’ self-efficacy improves their communication with their patients. Patients’ satisfaction can be considered a reliable outcome measure for evaluating interventions that concern interns’ communication skills. Observers’ feedback complemented with feedback by peers in group discussions increases interns’ satisfaction. Medical students’ should be continually trained to perform well on communication assessments.