General practice registrar responses to the use of different risk communication tools in simulated consultations: a focus group study

Objectives To pilot the use of a range of complementary risk communication tools in simulated general practice consultations; to gauge the responses o f general practitioners in training to these new consultation aids. Design Qualitative study based on focus group discussions. Setting General practice vocational training schemes in South Wales. Participants 39 general practice registrars and eight course organisers att ended four sessions; three simulated patients attended each time. Method Registrars consulting with simulated patients used verbal or "qualit ative" descriptions of risks, then numerical data, and finally graphical pr esentations of the same data. Responses of doctors and patients were explor ed by semistructured discussions that had been audiotaped for transcription and analysis. Results The process of using risk communication tools in simulated consulta tions was acceptable to general practitioner registrars. Providing doctors with information about risks and benefits of treatment options was generall y well received. Both doctors and patients found it helped communication. T here were concerns about the lack of available, unbiased, and applicable ev idence and a shortage of time in the consultation to discuss treatment opti ons adequately Graphical presentation of information was often favoured-an approach that also has the potential to save consultation time. Conclusions A range of risk communication "tools" with which to discuss tre atment options is likely to be more applicable than a single ne rv strategy . These tools should include both absolute and relative risk information fo rmats, presented in an unbiased way. Using risk communication tools in simu lated consultations provides a model for training in risk communication for professional groups.