Conversations concerning treatment limitations: A qualitative research into the differences in doctors’ communication skills during the decision-making process prior and after training.

Abstract

Doctors’ adequacy and use of communication skills are important in conversations regarding treatment limitations. This observational study investigated doctors’ communication skills in conversations about treatment decisions and the ways in which doctors’ communication skills in these conversations before and after a communication skills training (CST). The qualitative study is based on a within-subject design, in which 48 video recordings of five doctors before and after the CST, were analyzed. A structured observation scheme was developed to investigate doctors’ adequacy and use of communication skills, namely information provision, shared-decision making (SDM), engagement and listening. The current study found that before training, in general doctors had a high adequacy level of engagement and listening skills, which may explain why these skills were not further improved by the CST. Besides this, the current study indicates that doctors were unable to transfer information provision skills from one context to another. Furthermore, the current study suggested that after training, doctors’ use of some of the SDM steps improved by the CST. The current study indicates that doctors’ communication skills can be improved by CST when the learning objectives CST are aligned with the level of the doctors’ communication skills.