Effectiveness of a learner-centred training programme for primary care physicians in using a patient-centred consultation style

Objective. The aim of the present study was to find out if a training progr amme adapted to family physicians with several years of clinical experience changes their behaviour when they deal with fibromyalgic patients in the s ense of introducing the communication skills that define the 'patient-centr ed' approach. Methods. A randomized, and simple blind, educative study was carried out. T wenty full-time family physicians were invited to participate. They were al located randomly to two groups: an intervention and a control group. A tota l of 110 patients were recruited from people attending physicians' surgerie s for the first time and who complained of generalized pain that finally fu lfilled criteria for generalized musculoskeletal chronic pain/fibromyalgia. Th is was done for an entire year. The intervention group received an 18 h our intensive course. One week after the course, all doctors carried out a video-recorded encounter with a patient who played the part of a typical fi bromyalgia clinical case. The interviews were coded by an observer blind to the training status of the participants, using the GATHARES-CP questionnai re. All patients were contacted by telephone during a 1-2-month period by a different interviewer who was 'blinded' to the patient's experimental stat us. They were asked to respond to three questions that represent the key co mponents of patient-centred style. Results. The average score on the GATHARES-CP questionnaire was 11.3 +/- 0. 9 and 9 +/- 2.3, for doctors from the intervention and control groups, resp ectively (P < 0.01). For 11 items, scores were higher in the intervention g roup. The patients' answers to all three questions showed statistically sig nificant differences in a positive direction for the trained doctors. Conclusions. The doctors improved the use of strategies and skills for carr ying out patient-centred consultations after they had received an interacti ve course. The doctors' behaviour appeared to have changed as much in a mor e experimental situation as in the actual consultations. Moreover, the gain was observed inmediately after the intervention was completed, and after h aving run for a variable period of time up to 1 year.