Title: Impact of Training Courses on Participant’s Patient Centred Attitudes
Authors: Mudiyanse RM, de Silva SL, Pallegama R
DOI: http://dx.doi.org/10.18535/jmscr/v3i9.48
Introduction - Patient centred attitudes are valuable attributes of doctors that should be preserved and enhanced during education programs. Curriculum related deterioration of attitudes has been recorded in literature. Relevant data on the impact of short-term training courses conducted in Sri Lanka is not available. Objective - To compare and evaluate the impact of three different short-term training courses on the attitudinal changes of participants. Methodology - All the participants of three workshops in advance life support (APLS), neonatal life support (NLS) and communication conducted in Anuradhapura in September 2012 were evaluated. Validated Sinhala version of the Patient Practitioner Orientation Scale (PPOS) was administered before and after training to assess the patient centeredness on Sharing and Caring sub-scales. Proportions showing improvements on total, sharing and caring scores were compared using Chi-square statistics across the three groups. Results - Numbers of participants in APLS, NLS and Communication workshops were 25, 21 and 24 respectively. The response rates were 72%(18/25), 57%(12/21) and 75%(18/24). Improvement on the total PPOS was seen in 44%(8/18), 42% (5/12) and 72%(13/18), while deterioration was seen in 56%(10/18), 50%(6/12) and 28%(5/18) of APLS, NLS and Communication workshops participants. Improvement on the Sharing was seen in 50%(9/18), 25%(3/12) and 83%(15/18) and improvement on the Caring was seen in 33%(6/18), 42%(5/18) and 56(10/18) of the participants in APLS, NLS and Communication workshops. Among the communication group the number of participants improved on Sharing was significant compared to the improvement observed in other two groups on the same aspect (Pearson Chi-Square=13.04, P=0.01). Conclusions - Communication workshop enhances attitudes reemphasising its worth. Some Participants of APLS and NLS courses have deteriorated their attitudes more significantly on sharing domain calling for attention on the design of those training courses. Sustainability of this immediate impact on the attitudes needs further evaluation. Keywords – attitudes, short term training courses, patient centeredness, advanced paediatric life support, Communication workshops, neonatal life support courses 1. Bullock I, Davis M, Lockey A, Jones KM. Packet Guide to teaching for Medical instructors. Second Edition. Pages 57- 67 BMJ Books, Blackwell Publishing 2. Haidet P. Patient-centredness and its challenge of prevailing professional norms . Med Educ. 2010;44:643-644. 3. Balint E. The possibilities of patient-centered medicine. J.ROY.COLL.GEN.PRACTT. 1969;17: 269-276. 4. Krupat E, Hiam CM, Fleming MZ, Freeman P. Patient-centeredness and its correlates among first year medical students. Int J Psychiatry Medicine. 1999;29: 347-356. 5. Engle GL. The Clinical Application of the Biopsychosocial Model.Amer J Psychiat. 1980;137:535-544. 6. Krupat E, Yeager CM, Putnam S. Patient Role Orientations, Doctor – Patient fit, and visit Satisfaction. Psychology and health. 2000;15:707-719. 7. Krupat E, Bell RA, KravitzRL,Thom D. When physicians and patients think alike: patient-centered beliefs and their impact on satisfaction and trust. Journal of Family Practice. 2001;50:1057-1062. 8. Little P, Everitt H, Williamson I, Observational study of effect of patient centredness and positive approach on outcomes of general practice consultations. BMJ. 2001;323:908-911. 9. Hirsh D, Gaufberg E, Ogur, Cohen P, Krupat E, Cox M, Pelletier S, Bor D, When physicians and patients think alike: patient-centered beliefs and their impact on satisfaction and trust, Academic Medicine. 2012; 87: 643-650. 10. Haidet P, Kelly A, Chau C, Characterizing the Patient-Centeredness of Hidden Curricula in Medical Schools: Development and Validation of a NewMeasure. Academic Medicine, Vol. 80, No. 1 / January 2005. 11. Hojat M, Joseph S. G., Thomas J.N., Salvatore M, Michael V., Mechael M., Physician Empathy: Definition, Components, Measurement, and Relationship to Gender and Specialty, Am J Psychiatry 2002; 159:1563–1569. 12. Hojat M. Empathy in Patient care. Antecedents, Development, Measurement, and outcomes.2007 Springer Science. 13. Tsimitiou Z, Kerasidou O, Efstathiou N, Papaharitou S, Hatzimouratidis K, &Hatzichristou D. Medical students’ attitudes toward patient-centred care: a longitudinal survey. MEDICAL EDUCATION.2007; 41: 146-53. 14. Krupat E, Pelletier S, Alexander EK, Hirsh D, Ogur B, Schwartzstein R. Can Changes in the Principal Clinical Year Prevent the Erosion of Students’ Patient-Centered Beliefs? . Academic Medicine. 2009; 85: 582-586.Abstract
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