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The Effectiveness of Intensive Training for Residents in Interviewing: A Randomized, Controlled Study
Abstract
BACKGROUND: Interviewing and the physician-patient relationship are crucial elements of medical care, but residencies provide little formal instruction in these areas. OBJECTIVE: To determine the effects of a training program in interviewing on 1) residents' attitudes toward and skills in interviewing and 2) patients' physical and psychosocial well-being and satisfaction with care. DESIGN: Randomized, controlled study. SETTING: Two university-based primary care residencies. PARTICIPANTS: 63 primary care residents in postgraduate year 1. INTERVENTION: A 1-month, full-time rotation in interviewing and related psychosocial topics. MEASUREMENTS: Residents and their patients were assessed before and after the 1-month rotation. Questionnaires were used to assess residents' commitment to interviewing and psychosocial medicine, estimate of the importance of such care, and confidence in their ability to provide such care. Knowledge of interviewing and psychosocial medicine was assessed with a multiple-choice test. Audiotaped interviews with real patients and videotaped interviews with simulated patients were rated for specific interviewing behaviors. Patients' anxiety, depression, and social dysfunction; role limitations; somatic symptom status; and levels of satisfaction with medical visits were assessed by questionnaires and telephone interviews. RESULTS: Trained residents were superior to untrained residents in knowledge (difference in adjusted post-test mean scores, 15.7% [95% CI, 11% to 20%]); attitudes, such as confidence in psychological sensitivity (difference, 0.61 points on a 7-point scale [CI, 0.32 to 0.91 points]); somatization management (difference, 0.99 points [CI, 0.64 to 1.35 points]); interviewing of real patients (difference, 1.39 points on an 11-point scale [CI, 0.32 to 2.45 points]); and interviewing (data gathering) of simulated patients (difference, 2.67 points [CI, 1.77 to 3.56 points]). Mean differences between the study groups were consistently in the appropriate direction for patient satisfaction and patient well-being, but effect sizes were too small to be considered meaningful. CONCLUSION: An intensive 1-month training rotation in interviewing improved residents' knowledge about, attitudes toward, and skills in interviewing.
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“Through discussion with the study author we have since identified that the two papers by Smith et al (Smith 1995; Smith 1998), which were reported as separate trials in the original review, were in fact reports of the same RCT.”
From Interventions for providers to promote a patient-centred approach in clinical consultations (2012) · cites this paper as Smith 1998
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Salmon, P., Wissow, L., Carroll, J., Ring, A., Humphris, G. M., Davies, J. C., & Dowrick, C. F. (2008) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2007.12.002 · Cited by 42
Primary care physicians treat somatization
Smith, R. C., Gardiner, J. C., Luo, Z., Schooley, S., Lamerato, L., & Rost, K. (2009) · Journal of General Internal Medicine · doi:10.1007/s11606-009-0992-y · Cited by 41
Self-citationMental health and psychiatry training in primary care residency programs
Leigh, H., Stewart, D., & Mallios, R. (2006) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2005.10.004 · Cited by 41
To Change or Not To Change: “Sounds Like You Have a Dilemma”
Levinson, W. S., Cohen, M. S., Brady, D. W., & Duffy, F. D. (2001) · Annals of Internal Medicine · doi:10.7326/0003-4819-135-5-200109040-00027 · Cited by 41
Noordman, J., Verhaak, P. F. M., & van Dulmen, S. (2010) · Patient Education and Counseling · doi:10.1016/j.pec.2010.11.003 · Cited by 40
Branch, W. T., Frankel, R. M., Hafler, J. P., Weil, A., Gilligan, M. C., Litzelman, D. K., Plews-Ogan, M., Rider, E. A., Osterberg, L. G., Dunne, D., et al. (2017) · Academic Medicine · doi:10.1097/acm.0000000000001940 · Cited by 40
Communication skills to improve patient satisfaction and quality of care.
Fortin, A. H. (2002) · PubMed · Cited by 39
Metadata
- Authors
- Smith, R. C., Lyles, J. S., Mettler, J., Stoffelmayr, B. E., Van Egeren, L. F., Marshall, A. A., Gardiner, J. C., Maduschke, K. M., Stanley, J. M., Osborn, G. G., Shebroe, V., & Greenbaum, R. B.
- Affiliations
- Michigan State University (US)
- From Michigan State University, East Lansing, Michigan.
- Venue
- Annals of Internal Medicine
- Publisher
- American College of Physicians
- Published
- 1998-01-15
- Volume
- 128
- Issue
- 2
- Pages
- 118-126
- ISSN
- 0003-4819 (ISSN-L)
- 1539-3704
- OpenAlex
- W2135185786
- Cited by
- 228
- References
- 61
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 3 · 2023: 1 · 2022: 1 · 2021: 5 · 2020: 8 · 2019: 6 · 2018: 5 · 2017: 10 · 2016: 9 · 2015: 4 · 2014: 7 · 2013: 10 · 2012: 6
- FWCI
- 39.27
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Social Sciences › Education › Innovations in Medical Education
- Health Sciences › Medicine › Psychiatry and Mental health › Empathy and Medical Education
- Keywords
- interviewing skills training, primary care residents, psychosocial medicine, resident attitudes, patient satisfaction, patient well-being, somatic symptoms, standardized patients, physician confidence, graduate medical education
- MeSH terms
- Attitude of Health Personnel, Clinical Competence, Family Practice, Humans, Internship and Residency, Interviews as Topic, Health Knowledge, Attitudes, Practice, Physician-Patient Relations, Surveys and Questionnaires, Patient Satisfaction
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