Effect of clinician communication skills training on patient satisfaction - A randomized, controlled trial

Background: Although substantial resources have been invested in communicat ion skills training for clinicians, little research has been done to test t he actual effect of such training on patient satisfaction. Objective: To determine whether clinicians' exposure to a widely used commu nication skills training program increased patient satisfaction with ambula tory medical care visits. Design: Randomized, controlled trial. Setting: A not-for-profit group-model health maintenance organization in Po rtland, Oregon. Participants: 69 primary care physicians, surgeons, medical subspecialists, physician assistants, and nurse practitioners from the Permanente Medical Group of the Northwest. Intervention: "Thriving in a Busy Practice: Physician-Patient Communication ," a communication skills training program consisting of two 4-hour interac tive workshops. Between workshops, participants audiotaped office visits an d studied the audiotapes. Measurements: Change in mean overall score on the Art of Medicine survey (H ealthCare Research, Inc., Denver, Colorado), which measures patients' satis faction with clinicians' communication behaviors, and global visit satisfac tion. Results: Although participating clinicians' self-reported ratings of their communication skills moderately improved, communication skills training did not improve patient satisfaction scores. The mean score on the Art of Medi cine survey improved more in the control group (0.072 [95% Cl, -0.010 to 0. 154]) than in the intervention group (0.030 [Cl, -0.060 to 0.120]). Conclusions: "Thriving in a Busy Practice: Physician-Patient Communication, " a typical continuing medical education program geared toward developing c linicians' communication skills, is not effective in improving general pati ent satisfaction. To improve global visit satisfaction, communication skill s training programs may need to be longer and more intensive, teach a broad er range of skills, and provide ongoing performance feedback.