The impact of an intervention in intercultural communication on doctor-patient interaction in The Netherlands

Abstract

Objective: Findings of scarcely available studies indicate that there are substantial gaps in intercultural doctor-patient communication. In order to improve intercultural communication in medical practice in The Netherlands, an educational intervention was developed. The aim of the present study was to examine the effects of this intervention on doctor-patient communication.

Methods: Participants (general practitioners: n=38; patients: n=124) were assigned at random to an intervention or a control group. GPs in the intervention group received 2.5 days training on intercultural communication. Patients in the intervention group were exposed to a videotaped instruction in the waiting room, right before the consultation. Data were collected through videotapes of visits of ethnic minority patients to their GP and home interviews with the patients after their medical visit. Communication behaviour was assessed using the Roter interaction analysis system (RIAS). Interview length was assessed as well.

Results: The length of the medical encounter increased significantly after having received the intervention. Total number of GP utterances increased significantly too. When comparing relative frequencies on affective and instrumental verbal behaviour of both patients and doctors, no significant changes could be detected.

Conclusion: It is concluded that there seems to be some change in doctor-patient interaction, but RIAS may not be suitable to detect subtle changes in the medical communication process. It is recommended to use other analysis methods to assess cultural differences in medical communication.

Practice implications: Knowledge about possible antecedents of gaps in intercultural medical communication should be increased in order to be able to design effective interventions for intercultural doctor-patient communication.