THE EFFECTS OF A CONTINUING MEDICAL-EDUCATION PROGRAM IN INTERPERSONAL-COMMUNICATION SKILLS ON DOCTOR PRACTICE AND PATIENT SATISFACTION IN TRINIDAD-AND-TOBAGO

This study investigates the effects of a brief training programme on t he communication skills of doctors in ambulatory care settings in Trin idad and Tobago. Evaluation of doctor performance is based on analysis of audiotapes of doctors with their patients during routine clinic vi sits and on patient satisfaction ratings. A pre-test/post-test quasi-e xperimental study design was used to evaluate the effects of exposure to the training programme. Doctors were assigned to groups based on vo luntary participation in the programme. Audiotapes of the 15 participa ting doctors (nine trained and six control) with 75 patients at baseli ne and 71 patients at the post-training assessment were used in this a nalysis. The audiotapes were content-coded using the Roter Interaction Analysis System (RIAS). Doctors trained in communication skills used significantly more target skills post-training than their untrained co lleagues. Trained doctors used more facilitations in their visits and more open-ended questions than other doctors. There was also a trend t owards more emotional talk, and more close-ended questions. Patients o f trained doctors talked more overall, gave more information to their doctors and tended to use more positive talk compared to other patient s. Trained doctors were judged as sounding more interested and friendl y, while patients of trained doctors were judged as sounding more domi nant, responsive and friendly than patients of untrained doctors. Cons istent with these communication differences, patient satisfaction tend ed to be higher in visits of trained doctors.