THE EFFECTIVENESS OF INTENSIVE TRAINING FOR RESIDENTS IN INTERVIEWING- A RANDOMIZED, CONTROLLED-STUDY

Background: Interviewing and the physician-patient relationship are cr ucial elements of medical care, but residencies provide little formal instruction in these areas. Objective: To determine the effects of a t raining program in interviewing on 1) residents' attitudes toward and skills in interviewing and 2) patients' physical and psychosocial well -being and satisfaction with care. Design: Randomized, controlled stud y. Setting: Two university-based primary care residencies. Participant s: 63 primary care residents in postgraduate year 1. Intervention: A 1 -month, full-time rotation in interviewing and related psychosocial to pics. Measurements: Residents and their patients were assessed before and after the 1-month rotation. Questionnaires were used to assess res idents' commitment to interviewing and psychosocial medicine, estimate of the importance of such care, and confidence in their ability to pr ovide such care. Knowledge of interviewing and psychosocial medicine w as assessed with a multiple-choice test. Audiotaped interviews with re al patients and videotaped interviews with simulated patients were rat ed for specific interviewing behaviors. Patients' anxiety, depression, and social dysfunction; role limitations; somatic symptom status; and levels of satisfaction with medical visits were assessed by questionn aires and telephone interviews. Results: Trained residents were superi or to untrained residents in knowledge (difference in adjusted post-te st mean scores, 15.7% [95% CI, 11% to 20%]); attitudes, such as confid ence in psychological sensitivity (difference, 0.61 points on a 7-poin t scale [CI, 0.32 to 0.91 points]); somatization management (differenc e, 0.99 points [CI, 0.64 to 1.35 points]); interviewing of real patien ts (difference, 1.39 points on an 11-point scale [CI, 0.32 to 2.45 poi nts]); and interviewing (data gathering) of simulated patients (differ ence, 2.67 points [CI, 1.77 to 3.56 points]). Mean differences between the study groups were consistently in the appropriate direction for p atient satisfaction and patient well-being, but effect sizes were too small to be considered meaningful. Conclusion: An intensive 1-month tr aining rotation in interviewing improved residents' knowledge about, a ttitudes toward, and skills in interviewing.