S48 Workshops /Symposia / Patient Education and Counseling 34 (1998) S43 –S55

where. The quality of life score is significant correlated introduction of the VRS on the evaluation of the qualitywith the positive coping with the disease (.54), and the and communication with the helpline.positive coping is significant correlated with the satisfac- Conclusions. For patients and relatives / friends the com-tion (.28), as shown in regression analysis. municational aspects of the helpline were very important.Conclusions. A survey among ex-patients seems to be a Conclusions with respect to the impact of the VRS on thereliable and valid method to study the satisfaction of evaluation of the quality and communication of thecancer patients in hospitals as well as their quality of life helpline will be presented.and coping with the cancer. Improvement of the satisfac-tion by organizational development of patient-centered 6 symposiumcare may influence patients’ quality of life and their FACILITATING PATIENT OUTCOMESpositive attitudes towards their illness and its conse- THROUGH IMPROVING PATIENT-DOCTORquence for their lives.

COMMUNICATION

Communicating with cancer patients and significantThe symposium will address the findings of research

others: evaluating the dutch cancer information hel-conducted by the Royal Australian College of GeneralplinePractitioners’ (RACGP) Training Program and Client-Focused Evaluations Program, Inc. The research focusesL. Lechner, H. De Vries. Department of Health Educa-on the teaching of interpersonal skills within a generaltion & Promotion, University of Maastricht, P.O. Boxpractice training program and the evaluation of this616, 6200 MD Maastricht, The Netherlands.training using patient-based assessments, as well asresearch on patient evaluations of interpersonal skillsIntroduction. Since 1982, the Dutch Cancer Societywithin the wider medical profession and across threeoffers cancer patients and relatives / friends the possibilitydifferent countries.to contact an information telephone helpline with ques-The speakers will describe a number of educationaltions and problems that people experience concerningstrategies developed by the RACGP Training Programcancer. Via this helpline people can obtain informationfor teaching interpersonal / communication skills, in-about cancer or psychosocial support from trained oncol-cluding the use of Triads and Distance Education Learn-ogy educators. Recently, a computer-assisted Voice Re-ing Modules. Patient outcomes will be highlighted,sponse System (VRS) was implemented in the helpline.including the cultural and methodological difficulties ofThis VRS shifts out general informational questions soimplementing patient-based assessments in the evaluationthat cancer patients and significant others can be helpedof interpersonal skills. The symposium will also outlinemore intensely with less waiting time. This study wasthe findings of assessments of the quality of the patient-performed to evaluate the experience and impact of thedoctor relationship for Australian, Irish and New Zealandhelpline and the influence of the introduction of the VRSGPs.on the evaluation of the helpline.

Methods. To compare the evaluation of the helplinebefore and after the implementation of the VRS, during 2 Triads as a tool for teaching active listening skillssimilar periods (in the fall of 1993 en 1997) all callerswere asked to fill in a structured postal questionnaire Dr John Buckley(response 1993 5 73%). Different characteristics of thehelpline were evaluated: the overall quality of the Introduction. Effective listening is a vital part of theinformation given, the communication skills of the medical consultation. It is important to the outcomes foreducators and the telephone as a channel for getting both doctor and patient. Are good listening skills innateinformation concerning cancer. Also, several outcomes or can they be taught? The authors have devised awere measured: the overall satisfaction with the helpline, teaching module on listening skills for General Practicethe impact on anxiety and the impact on meeting (GP) Registrars in the RACGP Training Program. Theexpectations that subjects had. module contextualises and demonstrates good listeningResults. The 1993 measurement showed that relatives / skills as applied to General Practice. The key element offriends and patients seemed much in need of communica- the teaching is the use of ‘‘triads’’ (groups of threetional feedback from the educators. For patients, not the Registrars and one facilitator) to practice and experienceinformation itself was the most important determinant of ‘‘active listening’’ skills.satisfaction with the helpline, but their evaluation of the Methods. In their first three months of General Practicecommunicational skills of the educators (like respect, experience GP Registrars were taught for five hours oversincerity, supportiveness and reassurance). To this date a five-week period, including two ‘‘triad’’ sessions of onewe only have the data of the 1993 measurement. At the hour each. Focus groups of Registrars provided input intoconference data from both 1993 and 1997 will be the design of the teaching module.presented. Results will be presented of the impact of the Results. Further focus groups were used to evaluate the

Workshops /Symposia / Patient Education and Counseling 34 (1998) S43 –S55 S49

teaching. These groups showed that GP Registrars per- module was piloted with 23 GP Supervisors and theirceived changes in both their attitudes and their be- Registrars from 2 Australian states [Queensland andhaviour. The other two key findings were that the Tasmania]. Its effectiveness was evaluated through self‘‘triads’’ were considered the most valuable part of the reflection, questionnaire and focus groups of the particip-teaching and that the GP Registrars requested rein- ants, and by observation of subsequent skill levels byforcement of this teaching throughout the rest of their Educators.training. Results. Registrars, Supervisors and Educators found theConclusion. Listening skills can be effectively taught in module a useful tool. It provided new insights intoGeneral Practice training, improving communication and, patient’s perspectives and priorities, and encouragedtherefore, equity in the patient-doctor relationship. interpersonal dialogue between teacher and learner.

Coverage of basic skills allowed more efficient develop-Patient assessment of a communication skills course ment of advanced com-unication skills during subsequentfor GP registrars educational workshops.

Conclusion. The use of a practice-based distance educa-Mr Michael Greco tional module can assist Registrars develop interpersonal

skills and so improve communication and equity in theIntroduction. 885 patient completed questionnaires were GP consultation.used to evaluate the effectiveness of an interpersonalskills module designed for a vocational training program Assessment of Communication Skills in a Qualityfor general practitioners. It was anticipated that patient- Assurance Program for General Practitionersbased assessments would detect a significant improve-ment in the interpersonal skills of GP Registrars who Ms Julie McGovernundertook the module.Methods. A quasi-experimental design using an interven- Introduction. The maintenance of professional standardstion and control group (comprising of 68 GP Registrars) for general practitioners within Australia is administeredwas used to monitor the outcomes of the interpersonal by the RACGP Quality Assurance and Continuing Edu-skills module. cation Program. Over 15000 GPs participate in profes-Results.Patient ratings of interpersonal skills were sig- sional development activities in order to maintain theirnificantly higher for those GP Registrars who participated Vocational Registration.in the interpersonal skills module. Methods. A significant component of this Program is theConclusion. Patient-based assessments are a useful option for GPs to receive systematic patient feedback onevaluation method for assessing the quality of the their interpersonal skills within the consultation. Thepatient-doctor relationship. Client-Focused Evaluations Program (CFEP) administers

the Doctors’ Interpersonal Skills Questionnaire (DISQ)An educational module for improving interpersonal as a means of eliciting patient feedback for GPs. Theskills in the medical consultation results are presented to individual GPs who are required

to provide a report based on their critical reflections ofDr David Field the results.

Results. Over 1400 GPs have undertaken systematicIntroduction. Interpersonal and communication skills are patient feedback using DISQ. There are consistent find-essential components of our educational program for ings which highlight both strengths and weaknesses ofBasic GP Term Registrars. As part of our commitment to GPs’ interpersonal skills. Implications for training issuesimproving this training we developed, trialed and evalu- have also emerged.ated an interpersonal skills training module. The module Conclusion. Systematic patient feedback on the inter-was designed to contextualise theory into the general personal skills of GPs is an acceptable and highlypractice setting, to normalise discussion of interpersonal informative tool for assisting GPs in the maintenance ofissues, to lay a foundation for subsequent skills training professional standards.and to provide a practical distance education resource.Methods. A training module was developed after evalua- Impact of the Doctors’ Interpersonal Skills Ques-tion of our pre-existing communication skills course. The tionnaire (DISQ) in Australia, Ireland and Newmodule included a workbook and video requiring both Zealandpersonal reading and reflection, and discussion betweenSupervisor and Registrar. The module explored the Professor Arthur Brownleadoctor’s interpersonal skills as they relate to such diverseissues as the surgery set up, practice staff, clinical Introduction. There is increasing realisation amongsthistory, examination and problem management. The service providers that client feedback has real value in