Communication skills training in obstetrics and gynaecology: whom should we train? A randomized controlled trial

Abstract

Objective: To determine whether patient-physician communication in obstetrics and gynaecology can be improved by a training program and to investigate if physicians with poorer performance before the training show greater improvement in communication skills scores over the course of the study.

Design: Intervention study with randomisation in training (n = 16) and control group (n = 16) and patient satisfaction and communication skills of physicians as outcome variables. Physicians' communication skills were assessed by independent raters using a standardised evaluation instrument (adapted version of the MAAS-R) to analyse video recorded interviews before and after the training. Patient satisfaction was assessed with a patient satisfaction questionnaire.

Results: Using general linear model (GLM) for repeated measures no group x time interaction nor time effects were found for physicians' communication skills. No group x time interaction was found for patients' satisfaction scores; however the significant time effect was mostly attributable to positive changes in patients' rating of the training group. Physicians with poorer performance at the beginning showed greater improvements over the course of the study, especially in the training group.

Conclusions: In this randomized controlled trial marginal intervention effects for the improvement of communication skills and only partial changes in patient satisfaction scores from pre to post training were shown. However, physicians with poorer performance at the beginning showed greater improvements, suggesting that competence levels were already relatively high at the beginning of the study. Also, formation of communication training groups should be based on specific skill deficits rather than being implemented unspecifically for an entire team of physicians.