A randomized controlled trial of communication training with primary care providers to improve patient-centeredness and health risk communication

Abstract

Objective: to determine the efficacy and effectiveness of training to improve primary care providers' patient-centered communication skills and proficiency in discussing their patients' health risks.

Methods: twenty-eight primary care providers participated in a baseline simulated patient interaction and were subsequently randomized into intervention and control groups. Intervention providers participated in training focused on patient-centered communication about behavioral risk factors. Immediate efficacy of training was evaluated by comparing the two groups. Over the next 3 years, all providers participated in two more sets of interactions with patients. Longer term effectiveness was assessed using the interaction data collected at 6 and 18 months post-training.

Results: The intervention providers significantly improved in patient-centered communication and communication proficiencies immediately post-training and at both follow-up time points.

Conclusions: this study suggests that the brief training produced significant and large differences in the intervention group providers which persisted 2 years after the training.

Practice implications: the results of this study suggest that primary care providers can be trained to achieve and maintain gains in patient-centered communication, communication skills and discussion of adverse childhood events as root causes of chronic disease.

Figure 1

Provider Assignment, Training and Measurements. (Dotted lines indicate assessment activities; shadow boxes indicate intervention trainings) ¹Recoding error resulted in lost data ²Attrition rates analyzed for between-group differences using a chi-square test and found to be non-significant. ³All “N’s” reported here reflect providers who had ≥1 patients enrolled; however providers who had only 1 patient visit are not included in the analysis.