British Journal of Cancer · 2003 · 361 citations · 22 references
Social SciencesCommunicationOncologyHealth CommunicationInterpersonal CommunicationTherapeutic CommunicationCancer CommunicationCancer EducationCommunication CompetenceCommunication SkillsEmpathic CommunicationInterpersonal Communication SkillsClinician Communication SkillsCommunication Skills TrainingHealth Communication TrainingPatient Communication TrainingVerbal Communication Skills
A randomized trial demonstrated that a communication skills training programme improves clinicians’ communication. The study reports a 12‑month follow‑up of the training’s effects. Oncologists (N = 160) from 34 centres were randomized to four groups (feedback plus course, course alone, feedback alone, control) and each completed 6–10 videotaped patient interviews at baseline and 3 months. At 12–15 months post‑intervention, clinicians retained and expanded communication skills, with significant reductions in interruptions (81%) and increased summarizing (38%), though empathy expressions declined, indicating sustained but evolving skill transfer.
The efficacy of a communication skills training programme was shown through a randomised trial. Oncologists (N=160) from 34 cancer centres were allocated to written feedback plus course; course alone; written feedback alone or control. Each clinician had 6 – 10 interviews with patients videotaped at baseline and 3 months postintervention. Analysis of videotapes revealed improvements in the communication skills of clinicians randomised to training (n=80) compared with others (n=80). A 12-month follow-up assessment is reported here. Robust Poisson conditional analyses of counts of changes in communication behaviours revealed no demonstrable attrition in those who had shown improvement previously, including fewer leading questions, appropriate use of focused and open-ended questions and responses to patient cues. Additional skills, not apparent at 3 months, were now evident; the estimated effect sizes corresponded to 81% fewer interruptions (P=0.001) and increased summarising of information to 38% (P=0.038). However, expressions of empathy (54%, P=0.001) declined. The overall results show that 12 – 15 months postintervention, clinicians had integrated key communication skills into clinical practice and were applying others. This is the first RCT to show an enduring effect of communication skills training with transfer into the clinic.
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Self-efficacy: Toward a unifying theory of behavioral change.
Psychological Review · 1977 · 42.6K citations · Full text
Self-efficacy: Toward a unifying theory of behavioral change.
Albert Bandura · Psychological Review · 1977 · 35.5K citations
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