THE EFFECTS OF 2 CONTINUING MEDICAL-EDUCATION PROGRAMS ON COMMUNICATION-SKILLS OF PRACTICING PRIMARY-CARE PHYSICIANS

Purpose: To evaluate and compare the effects of two types of continuin g medical education (CME) programs on the communication skills of prac ticing primary care physicians. Participants: Fifty-three community-ba sed general internists and family practitioners practicing in the Port land, Oregon, metropolitan area and 473 of their patients. Method: For the short program (a 4 1/2-hour workshop), 31 physicians were randomi zed to either the intervention or the control group. In the long progr am (a 2 1/2-day course), 20 physicians participated with no randomizat ion. A research assistant visited all physicians' offices both one mon th before and one month after the CME program and audiotaped five sequ ential visits each time. Data were based on analysis of the content an d the affect of the interviews, using the Roter Interactional Analysis Scheme. Results: Based on both t-test analysis and analysis of covari ance, no effect on communication was evident from the short program. T he physicians enrolled in the long program asked more open-ended quest ions, more frequently asked patients' opinions, and gave more biomedic al information than did the physicians in the short program. Patients of the physicians who attended the long program tended to disclose mor e biomedical and psychosocial information to their physicians. In addi tion, there was a decrease in negative affect for both patient and phy sician, and patients tended to demonstrate fewer signs of outward dist ress during the visit. Conclusion: This study demonstrates some potent ially important changes in physicians' and patients' communication aft er a 2 1/2-day CME program. The changes demonstrated in both content a nd affect may have important influences on both biologic outcome and p hysician and patient satisfaction.