Does the structure of the medical consultation align with an educational model of clinical communication? A study of physicians' consultations from a postgraduate examination.

Objective: This study examined whether the structure of consultations in which physicians were tasked with sharing information corresponded to the chronological stages proposed by an established educational model of clinical communication.

Method: Seventy six simulated consultations from a postgraduate examination for general medical hospital physicians were transcribed verbatim and converted into diagrams showing consultation structure. All doctor-patient/relative talk was allocated into six phases: Initiating, Gathering information, Summary, Explanation, Planning and Closing, using the 'communication process skills' from the Calgary-Cambridge Guide to the Medical Interview.

Chinese doctors' views on workplace-based assessment: trainee and supervisor perspectives of the mini-CEX.

: This study investigated whether the mini-clinical evaluation exercise (mini-CEX) has been successfully integrated into the Chinese context, following its introduction as part of the national general training programme. : Online questionnaires (N = 91) and interviews (N = 22) were conducted with Year 1 trainee doctors and clinical supervisors at a cancer hospital in China to explore users' experiences, attitudes and opinions of the mini-CEX. " Trainees were more likely than supervisors to report understanding the purpose of the mini-CEX and agree that it encouraged reflection and helped improve overall performance.

What does the structure of a medical consultation look like? A new method for visualising doctor-patient communication.

Objective: This project developed an innovative methodology for visualising consultation structure by categorising doctor-patient talk into the phases proposed by an established educational model of clinical communication.

Method: Consultation phases were identified from verbatim transcripts using the tasks and process skills of the Calgary-Cambridge Guide to the Medical Interview. Seventy-eight simulated consultations from a 'History-taking' station of a postgraduate examination for physicians were analysed by two independent raters.

Footprints of Birth: An Innovative Educational Intervention Foregrounding Women's Voices to Improve Empathy and Reflective Practice in Maternity Care.

Introduction: A global movement on respectful maternity care has arisen because of widespread accounts of dehumanized maternity care. This article considers the use of a transformative learning approach to highlight patient agency and personhood in health care. An educational intervention using patient narratives was introduced in a maternity unit to foster a culture of listening and responsiveness to women's voices.

Patient autonomy in the consultation: How signalling structure can facilitate patient-centred care.

Objective: To identify types and functions of doctors' verbal signalling behaviours used to share consultation structure with patients.

Method: Doctors' verbal utterances signalling what would happen in the consultation were identified by two independent raters from transcripts of 78 simulated consultations from a postgraduate examination for physicians. In total, 974 behaviours were categorised as informing, inviting or instructing.

Treatment fidelity in the Camden Weight Loss (CAMWEL) intervention assessed from recordings of advisor-participant consultations.

Background: Variations in the delivery of content and process can alter the effectiveness of complex interventions. This study examined the fidelity of a weight loss intervention (Camden Weight Loss) from recorded consultations by assessing advisors' delivery of content, use of motivational interviewing approach and therapeutic alliance.

Methods: A process evaluation was conducted of advisor-participant consultations in a 12-month randomised controlled trial of an intervention for adult volunteers with a body mass index categorised as overweight or obese.

Consensus statement on an updated core communication curriculum for UK undergraduate medical education.

Objectives: Clinical communication is a core component of undergraduate medical training. A consensus statement on the essential elements of the communication curriculum was co-produced in 2008 by the communication leads of UK medical schools. This paper discusses the relational, contextual and technological changes which have affected clinical communication since then and presents an updated curriculum for communication in undergraduate medicine.

The impact of injection anxiety on education of travelers about common travel risks.

Background: Despite many travelers receiving at least one vaccination during the pre-travel consultation, little is known about travelers' fear of injections and the impact this may have on educating travelers about health risks associated with their trip. This study aimed to investigate: (1) the prevalence of injection anxiety in travelers attending a pre-travel consultation, (2) whether anxiety due to anticipating a vaccination adversely affects recall of information and advice, and (3) whether clinicians can recognize travelers' anxiety, and how they respond to anxious travelers.

Methods: Consecutive adult travelers (N = 105) attending one of two inner-city travel clinics completed self-report measures of state anxiety, injection anxiety, and symptoms of needle phobia immediately before and after their pre-travel consultation.

Travel clinic consultation and risk assessment.

A significant number of travellers sustain travel-related injury or illness, despite receiving pretravel advice. This appears to be due to a combination of inconsistent guidance about risks and recommendations, and partial adherence. This article considers perceptions and attitudes to risk, factors affecting uptake of advice, and features of an effective consultation.

Travel clinic communication and non-adherence to malaria chemoprophylaxis.

Many travellers fail to take malaria chemoprophylaxis, despite receiving pre-travel advice. This study examined whether non-adherence could be predicted from verbal communication in the pre-travel consultation, and whether non-adherence was related to the quality of clinician-traveller communication. The consultations of one hundred and thirty consecutive travellers at a UK travel clinic were audiotaped and a follow-up telephone interview was used to assess adherence to malaria chemoprophylaxis.

Does the inclusion of 'professional development' teaching improve medical students' communication skills?

Background: This study investigated whether the introduction of professional development teaching in the first two years of a medical course improved students' observed communication skills with simulated patients. Students' observed communication skills were related to patient-centred attitudes, confidence in communicating with patients and performance in later clinical examinations.

Methods: Eighty-two medical students from two consecutive cohorts at a UK medical school completed two videoed consultations with a simulated patient: one at the beginning of year 1 and one at the end of year 2.

The effect of professional skills training on patient-centredness and confidence in communicating with patients.

Objectives: The effect of introducing professional skills training on students' patient-centred attitudes and perceptions of ability to communicate was examined. The professional skills training included weekly training in communication skills, ethics and law, and clinical skills.

Methods: Consecutive cohorts of medical students receiving a traditional pre-clinical curriculum (n = 199) and a new curriculum including professional skills training (n = 255) were compared.

The effectiveness of problem-based learning compared to traditional teaching in undergraduate psychiatry.

Objectives: A change from traditional to problem-based learning (PBL) methods in a psychiatry attachment was evaluated by comparing the learning styles, attitudes to psychiatry and examination performance of 2 cohorts of students. It was hypothesised that the PBL curriculum would result in increased deep learning, decreased surface learning, more favourable attitudes to psychiatry and improved examination performance. It was predicted that students' examination success would be related to the use of deep and strategic learning and favourable attitudes.

Health beliefs and communication in the travel clinic consultation as predictors of adherence to malaria chemoprophylaxis.

Objectives: The objectives were, first, to determine whether adherence to malaria prophylaxis could be predicted by (i) health beliefs specified by the Health Belief Model and the Theory of Planned Behaviour, and (ii) communication during the consultation in a travel clinic; and secondly, to examine the impact of the consultation in changing travellers' health beliefs.

Design: A prospective study using regression analysis.

Methods: The participants were 130 consecutive travellers attending a travel medicine clinic.

Improving patients' communication with doctors: a systematic review of intervention studies.

A systematic review of the literature examined intervention studies designed to increase patients' participation in medical consultations. Twenty-five papers describing twenty studies met the inclusion criteria. About half of the intervention studies were randomised placebo controlled experimental designs.

The effect of a psychiatric attachment on students' attitudes to and intention to pursue psychiatry as a career.

Objectives: This study examined determinants of students' attitudes to psychiatry and intentions to pursue psychiatry as a career, considering: (1) experiences during the clinical attachment; (2) type of curriculum (traditional or problem-based), and (3) student characteristics (age and gender). The relationships between attitudes, career intentions and academic performance were examined.

Method: Fourth year medical students (n = 379) completed questionnaires at the beginning and end of an 8-week psychiatry attachment to assess their attitudes to psychiatry, career intentions and experiences during the attachment.