Improving Communication Skills-A Randomized Controlled Behaviorally Oriented Intervention Study for Residents in Internal Medicine

Langewitz, Wolf A.; Eich, Philipp; Kiss, Alexander; Wossmer, Brigitta

doi:10.1097/00006842-199805000-00009

Cited by 188Patient-Provider Communication in HealthcareInnovations in Medical EducationEmpathy and Medical Education

Improving Communication Skills-A Randomized Controlled Behaviorally Oriented Intervention Study for Residents in Internal Medicine

Langewitz, Wolf A., Eich, Philipp, Kiss, Alexander, Wossmer, Brigitta·1998·Psychosomatic Medicine

DOI 10.1097/00006842-199805000-00009

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Abstract

OBJECTIVE: We investigated whether patient-centered communication skills can be taught to residents in Internal Medicine by using a time-limited behaviorally oriented intervention. METHOD: Residents working at the Department of Internal Medicine were randomly assigned to an intervention group (IG; N = 19) or a control group (CG; N = 23). In addition to 6 hours of standard medical education per week, the IG received specific communication training of 22.5 hours duration within a 6-month period. Initially and 10 months later, participants performed interviews with simulated patients. Interviews were rated by blinded raters who used the Maastricht History and Advice Checklist-Revised. RESULTS: Compared with the CG, the IG improved substantially in many specific communication skills. Both groups improved in the "amount of medical information identified" and in the ability to "communicate about feasibility of treatment." CONCLUSION: Patient-centered communication skills such as those presented in this intervention study can be taught. The ability to gain medical information and the readiness to communicate about aspects of medical treatment seem to improve with more professional experience; however, they also profit from the intervention.

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Blinding was at low risk in Langewitz 1998 because raters were blind as to group assignment of residents.
“raters were blind as to group assignment of residents”
From Interventions for providers to promote a patient-centred approach in clinical consultations (2012) · cites this paper as Langewitz 1998

Assessing the Effects of Physician-Patient Interactions on the Outcomes of Chronic Disease
Kaplan, S. H., Greenfield, S., & Ware, J. E. (1989) · Medical Care · doi:10.1097/00005650-198903001-00010 · Cited by 2,043 · see citing works
Feedback in Clinical Medical Education
Ende, J. (1983) · JAMA · doi:10.1001/jama.1983.03340060055026 · Cited by 1,259 · see citing works
Patients’ participation in medical care
Greenfield, S., Kaplan, S. H., Ware, J. E., Yano, E. M., & Frank, H. J. L. (1988) · Journal of General Internal Medicine · doi:10.1007/bf02595921 · Cited by 1,117 · see citing works
The Doctor-Patient Relationship and Malpractice
Beckman, H. (1994) · Archives of Internal Medicine · doi:10.1001/archinte.1994.00420120093010 · Cited by 762 · see citing works
Why do people sue doctors? A study of patients and relatives taking legal action
Vincent, C. A., Phillips, A., & Young, M. (1994) · The Lancet · doi:10.1016/s0140-6736(94)93062-7 · Cited by 699 · see citing works
Patient Participation in the Patient-Provider Interaction: The Effects of Patient Question Asking on the Quality of Interaction, Satisfaction and Compliance
ROTER, D. L. (1977) · Health Education Monographs · doi:10.1177/109019817700500402 · Cited by 639 · see citing works
Characteristics of Physicians with Participatory Decision-Making Styles
Kaplan, S. H., Greenfield, S., Gandek, B., Rogers, W. H., & Ware, J. E., Jr. (1996) · Annals of Internal Medicine · doi:10.7326/0003-4819-124-5-199603010-00007 · Cited by 611 · see citing works
Incorporating Patients' Preferences into Medical Decisions
Kassirer, J. P. (1994) · New England Journal of Medicine · doi:10.1056/nejm199406303302611 · Cited by 415 · see citing works
What is a successful doctor-patient interview? a study of interactions and outcomes
Stewart, M. (1984) · Social Science & Medicine · doi:10.1016/0277-9536(84)90284-3 · Cited by 403 · see citing works
Obstetricians' Prior Malpractice Experience and Patients' Satisfaction With Care
Hickson, G. B. (1994) · JAMA · doi:10.1001/jama.1994.03520200039032 · Cited by 389 · see citing works
The effects of physician communications skills on patient satisfaction; Recall, and adherence
Bartlett, E. E., Grayson, M., Barker, R., Levine, D. M., Golden, A. S., & Libber, S. (1984) · Journal of Chronic Diseases · doi:10.1016/0021-9681(84)90044-4 · Cited by 361 · see citing works
Consultation skills of young doctors: I--Benefits of feedback training in interviewing as students persist.
Maguire, P., Fairbairn, S., & Fletcher, C. (1986) · BMJ · doi:10.1136/bmj.292.6535.1573 · Cited by 360 · see citing works
Patient perception of involvement in medical care
Brody, D. S., Miller, S. M., Lerman, C. E., Smith, D. G., & Caputo, G. C. (1989) · Journal of General Internal Medicine · doi:10.1007/bf02599549 · Cited by 340 · see citing works
Physician-patient communication. A key to malpractice prevention.
Levinson, W. (1994) · Journal of the American Medical Association (JAMA) · doi:10.1001/jama.1994.03520200075039 · Cited by 318 · see citing works
Failure of Physicians To Recognize Functional Disability in Ambulatory Patients
Calkins, D. R., Rubenstein, L. V., Cleary, P. D., Davies, A. R., Jette, A. M., Fink, A., Kosecoff, J., Young, R. T., Brook, R. H., & Delbanco, T. L. (1991) · Annals of Internal Medicine · doi:10.7326/0003-4819-114-6-451 · Cited by 305 · see citing works
The effects of two continuing medical education programs on communication skills of practicing primary care physicians
Levinson, W., & Roter, D. (1993) · Journal of General Internal Medicine · doi:10.1007/bf02600146 · Cited by 304 · see citing works
The patient's story: integrating the patient- and physician-centered approaches to interviewing.
Smith, R., & Hoppe, R. (1991) · Annals of Internal Medicine · doi:10.7326/0003-4819-115-6-470 · Cited by 293 · see citing works
Physician-patient communication. A key to malpractice prevention
Levinson, W. S. (1994) · JAMA · doi:10.1001/jama.272.20.1619 · Cited by 243 · see citing works
Enriching the Doctor-Patient Relationship by Inviting the Patient's Perspective
Delbanco, T. L. (1992) · Annals of Internal Medicine · doi:10.7326/0003-4819-116-5-414 · Cited by 231 · see citing works
The Medical Interview: A Core Curriculum for Residencies in Internal Medicine
Lipkin, M., QUILL, T. E., & NAPODANO, R. J. (1984) · Annals of Internal Medicine · doi:10.7326/0003-4819-100-2-277 · Cited by 200 · see citing works
The value of feedback in teaching interviewing skills to medical students
Maguire, P., Roe, P., Goldberg, D. P., Jones, S., Hyde, C. E., & O'Dowd, T. (1978) · Psychological Medicine · doi:10.1017/s0033291700018894 · Cited by 180 · see citing works
Internal medicine patients’ expectations for care during office visits
Kravitz, R. L., Cope, D., Bhrany, V., & LEAKE, B. D. (1994) · Journal of General Internal Medicine · doi:10.1007/bf02600205 · Cited by 178 · see citing works
Physicians’ interviewing styles and medical information obtained from patients
ROTER, D. L., & Hall, J. A. (1987) · Journal of General Internal Medicine · doi:10.1007/bf02596168 · Cited by 141 · see citing works
The fetal heart rate trace is normal, isn't it?
Grant, J. M. F. (1991) · The Lancet · doi:10.1016/0140-6736(91)92169-3 · Cited by 128 · see citing works
The Relationship Between Malpractice Claims History and Subsequent Obstetric Care
Entman, S. S. (1994) · JAMA · doi:10.1001/jama.1994.03520200044033 · Cited by 125 · see citing works
Why do doctors find some patients difficult to help?
Sharpe, M., Mayou, R., SEACROATT, V., Surawy, C., WARWICK, H., Bulstrode, C., Dawber, R. P. R., & Lane, D. J. (1994) · QJM · doi:10.1093/oxfordjournals.qjmed.a068914 · Cited by 117 · see citing works
Patients' desires and satisfaction in general medicine clinics.
Joos, S. K., Hickam, D. H., & Borders, L. M. (1993) · Europe PMC (PubMed Central) · Cited by 114 · see citing works
Can we talk? Inpatient discussions about advance directives in a community hospital. Attending physicians' attitudes, their inpatients' wishes, and reported experience
Reilly, B. M. (1994) · Archives of Internal Medicine · doi:10.1001/archinte.154.20.2299 · Cited by 113 · see citing works
Reliability and feasibility of measuring medical interviewing skills: the revised Maastricht History‐Taking and Advice Checklist
THIEL, J. V., Kraan, H. F., & van der Vleuten, C. P. M. (1991) · Medical Education · doi:10.1111/j.1365-2923.1991.tb00055.x · Cited by 110 · see citing works
The discussion of end-of-life medical care by primary care patients and physicians
Pfeifer, M., Sidorov, J. E., Smith, A. C., Boero, J., Evans, A. T., Settle, M. B., & the EOL Study Group (1994) · Journal of General Internal Medicine · doi:10.1007/bf02600206 · Cited by 103 · see citing works
The Three-Function Model of the Medical Interview
Bird, J., & Cohen‐Cole, S. A. (2015) · Advances in psychosomatic medicine · doi:10.1159/000418260 · Cited by 100 · see citing works
A communication skills programme for increasing patients' satisfaction with general practice consultations
Evans, B. J., Kiellerup, F. D., Stanley, R. O., Burrows, G. D., & Sweet, B. (1987) · British Journal of Medical Psychology · doi:10.1111/j.2044-8341.1987.tb02756.x · Cited by 95 · see citing works
The three-function model of the medical interview. An educational device.
Bird, J., & Cohen‐Cole, S. A. (1990) · PubMed · Cited by 85 · see citing works
Introduction of information during the initial medical visit: Consequences for patient follow-through with physician recommendations for medication
ROST, K. M., Carter, W., & Inui, T. S. (1989) · Social Science & Medicine · doi:10.1016/0277-9536(89)90032-4 · Cited by 78 · see citing works
Do physicians take into account patients’ expectations?
Sanchez-Menegay, C., & Stalder, H. (1994) · Journal of General Internal Medicine · doi:10.1007/bf02629524 · Cited by 76 · see citing works
A new instrument for patients’ ratings of physician performance in the hospital setting
Matthews, D. A., & Feinstein, A. R. (1989) · Journal of General Internal Medicine · doi:10.1007/bf02596484 · Cited by 71 · see citing works
Teaching the medical interview: An intervention study
Putnam, S. M., Stiles, W. B., Jacob, M. C., & James, S. A. (1988) · Journal of General Internal Medicine · doi:10.1007/bf02595755 · Cited by 70 · see citing works
The pre‐registration house officer year: a critical incident study
Calman, K. C., & Donaldson, M. S. (1991) · Medical Education · doi:10.1111/j.1365-2923.1991.tb00026.x · Cited by 67 · see citing works
Cardiopulmonary resuscitation: who makes the decision?
Hill, M., MacQuillan, G. C., Forsyth, M. R., et al. (1994) · BMJ · doi:10.1136/bmj.308.6945.1677 · Cited by 61 · see citing works
Comparison of questionnaires determining patient satisfaction with medical care.
Roberts, J., & Tugwell, P. (1987) · PubMed · Cited by 57 · see citing works
Common-Sense Models of Health and Disease
Gillick, M. R. (1985) · New England Journal of Medicine · doi:10.1056/nejm198509123131120 · Cited by 52 · see citing works
Physician Perception of Patient Satisfaction
Merkel, W. T. (1984) · Medical Care · doi:10.1097/00005650-198405000-00009 · Cited by 50 · see citing works
The efficacy of intensive biopsychosocial teaching programs for residents
Smith, R. C., Marshall, A. A., & Cohen‐Cole, S. A. (1994) · Journal of General Internal Medicine · doi:10.1007/bf02629520 · Cited by 47 · see citing works
[The Patient Satisfaction Questionnaire: a suitable tool for quality control in the physician-patient relationship?].
Langewitz, W. A., Keller, A., Denz, M., Wössmer, B., & Kiss, A. (1995) · PubMed · Cited by 36 · see citing works
Self-citation
Transference Phenomena in Medical Practice: Being Whom the Patient Needs
Zinn, W. M. (1990) · Annals of Internal Medicine · doi:10.7326/0003-4819-113-4-293 · Cited by 36 · see citing works
An evaluation of residency training in interviewing skills and the psychosocial domain of medical practice
Roter, D., Cole, K. A., Kern, D., Barker, L., & Grayson, M. (1990) · Journal of general internal medicine · doi:10.1007/bf02600404 · Cited by 36 · see citing works
A critical incident study of general practice trainees in their basic general practice term
Diamond, M. R., Kamien, M., Sim, M., et al. (1995) · The Medical Journal of Australia · doi:10.5694/j.1326-5377.1995.tb139913.x · Cited by 26 · see citing works
Psychiatric education improves internistsʼ knowledge: a three-year randomized, controlled evaluation.
Cohen‐Cole, S. A., Boker, J. R., Bird, J., Folks, D., Raczynski, J., Hain, J., Palmer, R. C., Lorish, C. D., & Freeman, A. (1993) · Psychosomatic Medicine · doi:10.1097/00006842-199303000-00010 · Cited by 25 · see citing works
Patient satisfaction with family physicians and general internists: is there a difference?
Dc, C., Hart, L. G., & Rosenblatt, R. A. (1988) · PubMed · Cited by 23 · see citing works
Improving residents’ confidence in using psychosocial skills
Smith, R. C., Mettler, J., Stoffelmayr, B., Lyles, J., Marshall, A. A., Egeren, L. V., Osborn, G. G., & Shebroe, V. (1995) · Journal of general internal medicine · doi:10.1007/bf02599950 · Cited by 20 · see citing works
The Impact of Discussion of Non-Medical Problems in the Physician's Office
MARTIN, F. J., & Bass, M. J. (1989) · Family Practice · doi:10.1093/fampra/6.4.254 · Cited by 17 · see citing works
Sources of Occupational Stress for Australian GPs, and their Implications for Postgraduate Training
Winefield, H. R., Murrell, T. G. C., & Clifford, J. (1994) · Family Practice · doi:10.1093/fampra/11.4.413 · Cited by 16 · see citing works
Anthropology and the theory of medicine
Uexk�ll, T. (1995) · Metamedicine · doi:10.1007/bf00993789 · Cited by 9 · see citing works
When doctor and patient disagree
Sox, H. C., & Nease, R. F. (1993) · Journal of General Internal Medicine · doi:10.1007/bf02599645 · Cited by 1 · see citing works
Untitled work
Wooten (1993) · doi:10.1002/1097-0142(19931201)72:11

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Authors: Langewitz, W. A., Eich, P., Kiss, A., & Wossmer, B.
Affiliations: University Hospital of Basel (CH)
ORCID: Langewitz, Wolf A.
Kiss, Alexander
Venue: Psychosomatic Medicine
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 1998
Volume: 60
Issue: 3
Pages: 268-276
ISSN: 0033-3174 (ISSN-L)
DOI: 10.1097/00006842-199805000-00009
OpenAlex: W2329211228
Cited by: 188
References: 55
Citations by year: 2026: 1 · 2025: 6 · 2024: 1 · 2023: 1 · 2022: 2 · 2021: 5 · 2020: 3 · 2019: 3 · 2018: 6 · 2017: 4 · 2016: 8 · 2015: 5 · 2014: 4 · 2013: 12 · 2012: 10
FWCI: 17.35
Type: journal article
Language: en
Open access: closed
Locations: Psychosomatic Medicine (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
Health Sciences › Medicine › Psychiatry and Mental health › Empathy and Medical Education
Keywords: patient-centered communication, communication skills training, internal medicine residents, standardized patients, physician-patient communication, medical education
MeSH terms: Adult, Behavior Therapy, Communication, Curriculum, Female, Humans, Internal Medicine, Internship and Residency, Male, Physician-Patient Relations, Patient Simulation, Patient Satisfaction

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Improving Communication Skills-A Randomized Controlled Behaviorally Oriented Intervention Study for Residents in Internal Medicine

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