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Clinical Communication Skills

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Benjamin Djulbegovic, Shira Elqayam, Tea Reljic, Iztok Hozo, Branko Miladinovic, Athanasios Tsalatsanis, Ambuj Kumar, Jason Beckstead, Stephanie Taylor, Janice Cannon-Bowers
BACKGROUND: According to the threshold model, when faced with a decision under diagnostic uncertainty, physicians should administer treatment if the probability of disease is above a specified threshold and withhold treatment otherwise. The objectives of the present study are to a) evaluate if physicians act according to a threshold model, b) examine which of the existing threshold models [expected utility theory model (EUT), regret-based threshold model, or dual-processing theory] explains the physicians' decision-making best...
2014: BMC Medical Informatics and Decision Making
Ranjana Srivastava
He's the first patient of the day: admitted overnight, he's scheduled for surgery this morning. "Do you want to catch him before or after?" the resident asks. "Is there anything we need to do for him right away?" I say. When she says that the night resident mentioned some pain issues, I decide to..
January 24, 2013: New England Journal of Medicine
Christopher S Brunt, Gail A Jensen
Using 2008 physician survey data, we estimate the relationship between the generosity of fees paid to primary care physicians under Medicaid and Medicare and his/her willingness to accept new patients covered by Medicaid, Medicare, or both programs (i.e., dually enrolled patients). Findings reveal physicians are highly responsive to fee generosity under both programs. Also, their willingness to accept patients under either program is affected by the generosity of fees under the other program, i.e., there are significant spillover effects between Medicare and Medicare fee generosity...
December 2014: International Journal of Health Care Finance and Economics
Lawrence O Gostin, Aliza Y Glasner
No abstract text is available yet for this article.
August 13, 2014: JAMA: the Journal of the American Medical Association
David J Rothman
Until well into the 20th century in the United States, the appropriate place to die was a foregone conclusion: by expectation and practice, it was at home, surrounded by family and friends (Figure 1). A case in point was death from consumption (tuberculosis) in pre–Civil War New England. In..
June 26, 2014: New England Journal of Medicine
Colin P West, Liselotte N Dyrbye, Jeff T Rabatin, Tim G Call, John H Davidson, Adamarie Multari, Susan A Romanski, Joan M Henriksen Hellyer, Jeff A Sloan, Tait D Shanafelt
IMPORTANCE Despite the documented prevalence and clinical ramifications of physician distress, few rigorous studies have tested interventions to address the problem. OBJECTIVE To test the hypothesis that an intervention involving a facilitated physician small-group curriculum would result in improvement in well-being. DESIGN, SETTING, AND PARTICIPANTS Randomized clinical trial of 74 practicing physicians in the Department of Medicine at the Mayo Clinic in Rochester, Minnesota, conducted between September 2010 and June 2012...
April 2014: JAMA Internal Medicine
Martin von Fragstein, Jonathan Silverman, Annie Cushing, Sally Quilligan, Helen Salisbury, Connie Wiskin
CONTEXT: The teaching and assessment of clinical communication have become central components of undergraduate medical education in the UK. This paper recommends the key content for an undergraduate communication curriculum. Designed by UK educationalists with UK schools in mind, the recommendations are equally applicable to communication curricula throughout the world. OBJECTIVES: This paper is intended to assist curriculum planners in the design, implementation and review of medical communication curricula...
November 2008: Medical Education
Kevin P Windebank, John J Spinetta
Adolescence is a time of great physical change and maturing brain function. This leads to adolescents establishing independence and coming to terms with the implications of their own actions. Not surprisingly, this phase is characterized by experimentation with both constructive and destructive behavior. Studies in many areas of chronic illness have shown that adolescents frequently neglect their care and revolt against the rules established during their childhood. It is therefore to be expected that teenagers diagnosed with a life threatening illness, such as cancer, may on occasion not fully comply with their therapy...
May 2008: Pediatric Blood & Cancer
Elaine M Wittenberg-Lyles, Joy Goldsmith, Sandra Sanchez-Reilly, Sandra L Ragan
The goal of this study was to understand the use and effectiveness of current communication protocols in terminal prognosis disclosures. Data were gathered from an interdisciplinary palliative care consultation service team at a Veterans Hospital in Texas, USA. Medical communication guidelines, a consistent component in United States palliative care education, propose models for delivery of bad news. However, there is little empirical evidence that demonstrates the effectiveness of these guidelines in disclosures of a terminal prognosis...
June 2008: Social Science & Medicine
Bryan Jeffrey Weiner, Cherri Hobgood, Megan A Lewis
Safety experts contend that to make incident reporting work, healthcare organizations must establish a "just" culture-that is, an organizational context in which health professionals feel assured that they will receive fair treatment when they report safety incidents. Although healthcare leaders have expressed keen interest in establishing a just culture in their institutions, the patient safety literature offers little guidance as to what the term "just culture" really means or how one goes about creating a just culture...
January 2008: Social Science & Medicine
Eve Espey, Francis Nuthalapaty, Sue Cox, Nadine Katz, Tony Ogburn, Ted Peskin, Alice Goepfert, Maya Hammoud, Petra Casey, Sandra Emmons, James J Neutens
This article, the sixth in the ongoing To The Point Series produced by the Association of Professors of Gynecology and Obstetrics Undergraduate Medical Education Committee, reviews the Reporter-Interpreter-Manager-Educator (RIME) method for the evaluation of student clinical performance on the obstetrics and gynecology rotation. This article discusses the inherent challenges of descriptive narrative evaluation and the superiority of the RIME method in producing meaningful evaluation of and feedback for students...
August 2007: American Journal of Obstetrics and Gynecology
P Tovey, Alex Broom
High levels of use of complementary and alternative medicine (CAM) have been consistently reported amongst cancer patients over recent years. This is occurring in the context of an apparent increase in sources of information on therapeutic alternatives and a growth in the range of those claiming professional expertise in the field. To date there has been little research on patient experience of discussions about CAM with biomedical cancer specialists in this increasingly complex social environment. This paper addresses three issues: patient experience with cancer specialists; the significance of that experience for patient engagement with CAM; and the nature and significance of inter-professional dynamics...
June 2007: Social Science & Medicine
Nasreen Ali, Karl Atkin, Richard Neal
In this paper, we will examine the importance of culture and ethnicity in the general practice consultation process. Good communication is associated with positive health outcomes. We will, by presenting qualitative material from an empirical study, examine the way in which communication within the context of a general practitioner (GP) consultation may be affected by ethnicity and cultural factors. The aim of the study was to provide a detailed understanding of the ways in which white and South Asian patients communicate with white GPs and to explore any similarities and differences in communication...
November 2006: Ethnicity & Health
S Carr
The recent change in working patterns of doctors in training has meant that the traditional systems of education are under increasing pressure and that there is the need to maximise new opportunities for learning. One new opportunity may arise after the introduction of the mandatory assessment systems (Mini-CEX, DOPPS, Multi-source feedback, and Case based discussion) in the Foundation Programmes. In this review the new assessment procedures for the Foundation Programmes are outlined and the potential of these assessments (using Mini-CEX as main example) as an opportunity to give feedback to trainees discussed...
September 2006: Postgraduate Medical Journal
Richard Thomson, Adrian Edwards, Jenny Grey
Modern healthcare and modern societies are facing up to the need for greater engagement of patients in treatment decisions. Shared and informed decision-making is replacing traditional paternalistic approaches to decisions; health policy both reflects and drives these changes. A critical contribution to better informed decisions by patients is the effective communication of risk in the clinical consultation. This is not straightforward, but there is a growing evidence base to improve performance in this area to the benefit of both patients and clinicians...
September 2005: Clinical Medicine: Journal of the Royal College of Physicians of London
D L Elliot, D H Hickam
BACKGROUND: Although the case presentation is a frequent activity, little is known about the attributes that faculty members use when assessing case presentation ability. PURPOSE: Define the dimensions used by faculty when assessing students' case presentation abilities. METHODS: Eleven internal medicine faculty members independently assessed the same 17 videotaped student case presentations. Raters used an evaluation form assembled with 4 descriptors of content and 6 attributes of communication style...
1997: Teaching and Learning in Medicine
Knut Aspegren, Peter Lønberg-Madsen
Students in the last semester of medical school and experienced junior doctors with no or little training in communication skills were observed while interviewing or informing simulated patients. There was a remarkable similarity in behaviour between the two categories. Communication skills characteristic of common social conversation were learnt spontaneously, while important professional basic communication skills were not learnt despite 10 or more years of clinical work. These discrepancies and subsequent gaps should be the focus of future training courses at both pre- and postgraduate level...
September 2005: Medical Teacher
M Woloshynowych, S Rogers, S Taylor-Adams, C Vincent
OBJECTIVES: To carry out a review of published and unpublished work on the analysis on methods of accident investigation in high-risk industries, and of critical incidents in healthcare. To develop and pilot guidelines for the analysis of critical incidents in healthcare for the hospital sector, mental health and primary care. DATA SOURCES: Literature already available in the Clinical Risk Unit, University College London. Work by known experts in the field of accident investigation and analysis...
May 2005: Health Technology Assessment: HTA
Justin J Waring
The paper explores the attitudes of medical physicians towards adverse incident reporting in health care, with particular focus on the inhibiting factors or barriers to participation. It is recognised that there are major barriers to medical reporting, such as the 'culture of blame'. There are, however, few detailed qualitative accounts of medical culture as it relates to incident reporting. Drawing on a 2-year qualitative case study in the UK, this paper presents data gathered from 28 semi-structured interviews with specialist physicians...
May 2005: Social Science & Medicine
James Warner, Eamonn McKeown, Mark Griffin, Katherine Johnson, Angus Ramsay, Clive Cort, Michael King
BACKGROUND: There is a dearth of research into the mental health of gay men, lesbians and bisexual men and women in the UK. AIMS: To assess rates and possible predictors of mental illness in these groups. METHOD: A comprehensive assessment was made of the psychological and social well-being of a sample of gay men, lesbians and bisexual men and women, identified using 'snowball' sampling. RESULTS: Of the 1285 gay, lesbian and bisexual respondents who took part, 556 (43%) had mental disorder as defined by the revised Clinical Interview Schedule (CIS - R)...
December 2004: British Journal of Psychiatry: the Journal of Mental Science
2014-06-20 07:37:11
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