Bariatric Times

AUG 2016

A peer-reviewed, evidence-based journal that promotes clinical development and metabolic insights in total bariatric patient care for the healthcare professional

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22 Journal Watch Bariatric Times • August 2016 Assessing effective physician- patient communication skills: "Are y ou listening to me, doc?" Berman AC, Chutka DS. Korean J Med Educ. 2016;28(2):243–249. Epub 2016 Feb 25. Synopsis: In this article, the authors discuss communication skills in forming the foundation for a more positive patient-provider relationship. They discuss the use of an interview assessment tool developed have developed an interview assessment tool that they use with medical students at their facility. The rubric is presented to students prior to their initial interview experience in order to provide them with the aculty members' expectations for effective communication skills and patient- centered interviews. The rubric contains the following categories: • Introduction • Eye contact with patient • Nonverbal communication • Listening • Questions • Wait-time • Concern • Organization • Information gathering • Focus, Empathy • Awareness of unspoken issues • Closure The authors concluded that this rubric can be effective in helping physicians become comfortable with the use of patient-centered interviews, and that in order for providers to develop positive relationships with their patients, it is important for them to practice their communication skills with the assistance of an appropriate assessment tool. PMID: 26913771 Interprofessional training enhances collaboration between nursing and medical students: A pilot study. Turrentine FE, Rose KM, Hanks JB, et al. Nurse Educ Today. 2016;40:33–38. Epub 2016 Feb 4. Synopsis: To enhance interprofessional education between n ursing students and medical students in a clinical environment, the authors modeled the desired behavior and skills needed for interprofessional preoperative geriatric assessment for students, then provided an opportunity for students to practice skills in nurse/physician pairs on standardized patients. This experience culminated with students performing skills independently in a clinic setting. Nine nursing students and six medical students completed the pilot project. At baseline and after the final clinic visit we administered a ten question geriatric assessment test. Post-test scores (M=90.33, SD=11.09) were significantly higher than pre-test scores (M=72.33, SD=12.66, t(14)=- 4.50, p<0.001. Nursing student post- test scores improved a mean of 22.0 points and medical students a mean of 11.7 points over pre-test scores. Analysis of observational notes provided evidence of interprofessional education skills in the themes of shared problem solving, conflict resolution, recognition of patient needs, shared decision making, knowledge and development of one's professional role, communication, transfer of interprofessional learning, and identification of learning needs. The authors found that having nursing and medical students "learn about, from and with each other" while conducting a preoperative geriatric assessment offered a unique collaborative educational experience for students that better prepares them to integrate into interdisciplinary clinic teams. PMID: 27125147 The "Handling" of power in the physician-patient encounter: perceptions from experienced physicians. Nimmon L, Stenfors-Hayes T. BMC Med Educ. 2016 Apr 18;16:114. Synopsis: This study explored how power is perceived and exerted in the physician-patient encounter from the perspective of experienced physicians. T hirty physicians with a minimum five years' experience practicing medicine in the disciplines of Internal Medicine, Surgery, Pediatrics, Psychiatry, and Family Medicine were recruited. The authors analyzed semi- structured interview data using LeCompte and Schensul's three stage process: Item analysis, Pattern analysis, and Structural analysis. Theoretical notions from Bourdieu's social theory served as analytic tools for achieving an understanding of physicians' perceptions of power in their interactions with patients. The analysis of data highlighted a range of descriptions and interpretations of relational power. Physicians' responses fell under three broad categories: 1) Perceptions of holding and managing power, 2) Perceptions of power as waning, and 3) Perceptions of power as non- existent or irrelevant. The authors concluded that although the "sharing of power" is an overarching goal of modern patient- centered healthcare, this study highlights how this concept does not fully capture the complex ways experienced physicians perceive, invoke, and redress power in the clinical encounter. Based on the insights, the authors suggest that physicians learn to enact ethical patient-centered therapeutic communication through reflective, effective, and professional use of power in clinical encounters. PMID: 27091146 Communication in healthcare: a narrative review of the literature and practical recommendations. Vermeir P, Vandijck D, Degroote S, et al. Int J Clin Pract. 2015;69(11):1257- 67. Epub 2015 Jul 6. Synopsis: In this article, the researchers review the literature on the quality of written communication, the impact of communication inefficiencies, and recommendations to improve written communication in healthcare. A search was carried out on the databases PubMed, Web of Science and The Cochrane Library by means of the (MeSH)terms 'communication', 'primary health care', 'correspondence', 'patient safety', 'patient handoff' and 'continuity of patient care'. Reviewers screened 4,609 records and 462 full texts were checked according following inclusion criteria: 1) publication between January 1985 and March 2014, 2) availability as full text in English, 3) categorisation as original research, reviews, meta-analyses or letters to the editor. A total of 69 articles were included in this review. The researchers found that poor communication can lead to various negative outcomes: discontinuity of care, compromise of patient safety, patient dissatisfaction and inefficient use of valuable resources, both in unnecessary investigations and physician worktime as well as economic consequences. They concluded that there is room for improvement of both content and timeliness of written communication. The delineation of ownership of the communication process should be clear. Peer review, process indicators and follow-up tools are required to measure the impact of quality improvement initiatives. Communication between caregivers should feature more prominently in graduate and postgraduate training, to become engraved as an essential skill and quality characteristic of each caregiver. PMID: 26147310 'Becoming a Physician'-medical students get acquainted with disadvantaged populations, and practise sensitive and effective communication. Riskin A, Kerem NC, Van-Raalte R, et al. Perspect Med Educ. 2015 Oct 19. [Epub ahead of print] Synopsis: The authors discuss the A q u i c k l o o k a t t h e n o t e w o r t h y a r t i c l e s i n b a r i a t r i c a n d m e t a b o l i c r e s e a rc h THIS MONTH'S TOPIC: ASSESSING COMMUNICATION SKILLS IN THE HEALTHCARE SETTING Journal Watch

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