Miscommunication in patient interviews|Homework help
Posted: February 20th, 2023
techniques for effective patient interviews. What happens though if the interviewer or person being interviewed does not communicate well? write a 750 over miscommunication or a lack of communication and how it effects the patient.
RESEARCH ARTICLE
Can patient-physician interview skills be implemented with peer simulated patients? Funda İfakat Tengiz a, Hale Sezerb, Aysel Başerc and Hatice Şahind
aSchool of Medicine, Medical Education Department, Izmir Katip Çelebi Üniversitesi Tıp Fakültesi Tıp Eğitimi Anabilim Dalı; Izmir Katip Celebi University, Izmir, Turkey; bFaculty of Health Sciences, Nursing Department, Izmir Bakırçay Üniversitesi Sağlık Bilimleri Fakültesi Hemşirelik Bölümü; Izmir Bakırçay University, Izmir, Turkey; cSchool of Medicine, Medical Education Department, Izmir Demokrasi Üniversitesi Tıp Fakültesi Tıp Eğitimi Anabilim Dalı; Izmir Demokrasi University, Izmir, Turkey; dMedical Education Department, Ege Üniversitesi Tıp Fakültesi Tıp Eğitimi Anabilim Dalı, Ege University School of Medicine, Izmir, Turkey
ABSTRACT Introduction: Patient-physician interviewing skills are crucial in health service delivery. It is necessary for effective care and treatment that the physician initiates the interview with the patient, takes anamnesis, collects the required information, and ends the consultation. Different methods are used to improve patient-physician interview skills before encountering actual patients. In the absence of simulated patients, peer simulation is an alternative method for carrying out the training. This study aims to show whether patient-physician interview skills training can be implemented using peer simulation in the absence of the simulated patient. Methods: This is a descriptive quantitative study. This research was conducted in six stages: identification of the research problem and determination of the research question, develop- ment of data collection tools, planning, acting, evaluation, and monitoring. The data were collected via the patient-physician interview videos of the students. The research team performed descriptive analysis on quantitative data and thematic analysis on qualitative data. Results: Fifty students participated in the study. When performing peer-assisted simulation applications in the absence of simulated patients, the success rate in patient-physician inter- views and peer-simulated patient roles was over 88%. Although the students were less satisfied with playing the peer-simulated patient role, the satisfaction towards the application was between 77.33% and 98%. Discussion and Conclusion: In patient-physician interviews, the peer-simulated patient method is an effective learning approach. There may be difficulties finding suitable simulated patients, training them, budgeting to cover the costs, planning, organizing the interviews, and solving potential issues during interviews. Our study offers an affordable solution for students to earn patient-physician interview skills in faculties facing difficulties with providing simulated patients for training.
ARTICLE HISTORY Received 6 July 2021 Revised 18 January 2022 Accepted 18 February 2022
KEYWORDS Patient-physician interview skills; peer-assisted learning; simulation; peer simulated patient; peer simulation
Introduction
Medical students need to practice patient-physician interviews to develop essential clinical communica- tion and clinical reasoning skills and find the neces- sary space to apply their basic professional skills [1]. Patient-physician interviewing skills have an impor- tant place in health service delivery. A good interview is crucial for effective diagnosis and treatment. Medical educators agree that medical students should be humane and have the necessary communication skills for patient-physician interview skills. However, for years, there has been uncertainty about the ways to achieve this learning goal [2]. Having students experience a mock patient-physician interview is con- sidered the easiest method to accomplish this goal [2]. Methods based on small group activities, such as problem-based learning, role-playing, and
simulated/standardized patient simulation, are used to improve patient-physician interview skills [2,3]. Today, it is a common and accepted method to con- duct patient-physician interviews with simulated/ standardized patients [1,4–6]. Simulated patients can be theatre actors, professional actors, trained volun- teers (retirees, students, employees, etc.). There is no evidence that the simulated patient has to be a professional actor for the interview to be efficient [4,7]. There are certain advantages and disadvantages to interviewing simulated patients. Simulated patients offer a student-centered educational opportunity that is the closest to reality without time constraints. They can impersonate different patient profiles and condi- tions, allowing students to experience patients and cases that are difficult to encounter in real life [4,5].
CONTACT Funda İfakat Tengiz fundatengiz@gmail.com School of Medicine, Medical Education Department, Zmir Katip Çelebi Üniversitesi, Tıp Fakültesi Tıp Eğitimi Anabilim Dalı, İzmir 35620, Turkey
MEDICAL EDUCATION ONLINE 2022, VOL. 27, 2045670 https://doi.org/10.1080/10872981.2022.2045670
© 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Research Article Breaching the Bridge: An Investigation into Doctor-Patient Miscommunication as a Significant Factor in the Violence against Healthcare Workers in Palestine
Munther Saeedi ,1 Nihad Al-Othman ,2 and Maha Rabayaa 2
1Language Centre/Faculty of Human Science, An-Najah National University, Nablus, State of Palestine 2Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, State of Palestine
Correspondence should be addressed to Nihad Al-Othman; n.othman@najah.edu
Received 18 March 2021; Revised 25 June 2021; Accepted 13 July 2021; Published 23 July 2021
Academic Editor: Arundhati Char
Copyright © 2021Munther Saeedi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background. Workplace violence is a common issue worldwide that strikes all professions, and healthcare is one of the most susceptible ones. Verbal and nonverbal miscommunications between healthcare workers and patients are major inducers for violent attacks. Aim. To study the potential impact of verbal and nonverbal miscommunications between the patients and healthcare workers upon workplace violence from the patients’ perspectives. Methods. A descriptive cross-sectional study was performed from November to December 2020. Patients and previously hospitalized patients were asked to complete a self- reported questionnaire that involved items of verbal and nonverbal miscommunication. With the use of a suitable available sample composed of 550 participants, 505 had completed the questionnaire and were included in the study. The data were analyzed by using SPSS version 22 software. Results. 7.2% of the study population reported participating in nonverbal violence and 19.6% participated in verbal violence against healthcare workers. The nonverbal and verbal violence was characteristically displayed by the patients who are male, younger than 30 years old, and bachelor’s degree holders. The results of the study demonstrated that the verbal and nonverbal miscommunications between the patients and healthcare workers were the major factors in provoking violent responses from patients. Factors, such as age, gender, and level of education, were significant indicators of the type of patients who were more likely to respond with violence. Conclusion. Workplace violence, either verbal or nonverbal, in the health sector is a public health concern in Palestine. The verbal and nonverbal communication skills of healthcare workers should be developed well enough to overcome the effect of miscommunication provoking violent acts from patients and their relatives as well.
1. Introduction
The National Institute for Occupational Safety and Health (NIOSH) defines workplace violence as “ any physical assault, threatening behavior, or verbal abuse occurring in the work setting” [1]. Globally, workplace violence has gained a greater concern in the recent century. Assaults and acts of violence were observed against all professionals irre- spective of the nature of their profession, and the healthcare professional is not an exception. However, it has been reported that retailing and service sector encounter more than 80% of workplace violence in the United State. And the health sector workers encounter workplace violence six-
teen times more than workers in any other service sector [2]. Violent attacks against healthcare workers abound in clinics, health care centers, and hospitals; every day, the media shows something related to violence against health- care workers around the world. Several factors, including individual, organizational, and environmental factors, are the likely origins of the various forms of violence in the healthcare sector [3]. Unfortunately, the precise incidence of workplace violence globally is not documented, especially in developing countries. However, workplace violence is neg- atively affecting work performance since it is associated with decreased productivity, decreased morale, increased stress and depression, and lower service efficiency among
Hindawi BioMed Research International Volume 2021, Article ID 9994872, 8 pages https://doi.org/10.1155/2021/9994872
employees [4]. Healthcare workers, irrespective of where they work, are very likely to be abused verbally and physically, which may result in disappointment, despair, and in certain circumstances, frustration among them [5]. Healthcare workers, in general, and doctors, in specific, are always tar- geted by patients or patients’ relatives; doctors serving in Accident and Emergency Departments are more likely to be victims of violent attacks by patients and relatives more than any other healthcare workers [6].
Patient-healthcare worker communication is a central clinical requirement, and it is taken for granted that the suc- cess of healthcare workers is no longer attributed to their capacity to provide health care and medical services; neither is it related to how much information they have. It depends, to a large extent, on their ability to communicate with their clients and their family members [7]. A healthcare worker is expected to be a good communicator; otherwise, s/he is likely to be assaulted and attacked by patients or their rela- tives due to dissatisfaction with the health service provided [8, 9]. Recently, health care workers have been victims of cli- ents’ assaults and violence, whether it is verbal or nonverbal [10, 11]. Acts of violence against healthcare workers can be attributed to several factors including, but not limited to, long waiting periods, dissatisfaction with prescriptions and treat- ment methods, disagreement with doctors, verbal offenses or negative comments, and the negative impact of certain medications, such as recreational drugs [12]. A large bulk of these incidents may be attributed to a lack of good com- munication skills that is required of healthcare workers in order to put their patients at ease before commencing their medical and physical examination [7, 13].
Most of the previous studies have focused on the inci- dence of workplace violence from the workers’ perspective. This study is a leading one in Palestine as it shows the inci- dence of workplace violence from the patients’ perspectives. This study also aims to identify the crucial communication skills, verbal or nonverbal, that should be incorporated in the communications curriculum to explore how communica- tion lapses may lead to the occurrence of violent attacks against doctors.
2. Materials and Methods
2.1. Ethical Consideration. This study received official ethical approval from the Institutional Review Board at An-Najah National University located in Nablus/Palestine. The study abided by “the Declaration of Helsinki (DOH).” All ethical considerations for medical research concerning human sub- jects were enforced. The human subject confidentiality and rights were preserved throughout the study. Written informed consent was provided and handed to each patient (Appendix). The form described the study procedure, dura- tion, benefit, and lack of any harmful intentions. Moreover, the form indicated that all data collected would be used for research purposes only, while any information related to the patient would be kept confidential from all parties except the research investigators. The patients were fully informed that participation in the study was voluntary and that no pen- alty would be enforced in case of nonparticipation.
2.2. Study Sample. A cross-sectional study was carried out from November to December of the academic year 2020/2021 on patients attending hospitals seeking medical service, e.g., clinics and laboratories, surgery operations, and emergency rooms to investigate the doctor-patient mis- communication as a significant factor in violence against healthcare workers in Palestine before discharge and during follow-up visits. A convenient nonprobability available sam- ple took part in this study. The sample size was estimated using the Jekel equation. The assumption of the probability of violence against healthcare workers was 0.5 with a confi- dence level of 95%; the estimated minimum sample size was 384. Nevertheless, the researchers decided to increase the sample size to 550, to decrease the standard error of the mean and to account for the nonresponse rate. In the end, 505 participants, who were previously hospitalized in seven hospitals with different specialties in Palestine, completed the questionnaire and were included in the study.
2.3. Inclusion and Exclusion Criteria. The inclusion criteria included patients or previously hospitalized patients within six months of questionnaire administration and agreed to participate in this study. The patients were from different age groups, residential areas (city, camp, or village), and levels of education. The exclusion criteria included patients who refused to participate in the study and the doctors who work in the medical field.
2.4. Study Instrument. A self-administered questionnaire in Arabic was used for data collection and was distributed to the study population. The questionnaire was made up of four sections: sociodemographic factors including age, level of education, gender, and place of residence, verbal miscommu- nication section which comprised 14 items, the nonverbal miscommunication section which was composed of 6 items, and two questions whether a patient had ever participated in verbal or nonverbal violence. To ensure the validity of the study instrument, the tool was given to five experts in the field of public health. There was an agreement among them regarding the content of the questionnaire.
2.5. Pilot Study. A pilot study was performed on 30 individ- uals from different age groups to determine questionnaire wording, formatting, completeness of responses, clarity of choices, the relevance of the statements, and the time needed to fill the form. The questionnaire was modified accordingly. The internal consistency of the questionnaire was measured based on Cronbach Alpha values (0.81) before data collection.
2.6. Statistical Analysis. All statistical analyses were con- ducted using Statistical Package for the Social Sciences ver- sion 22 (SPSS 22). Descriptive analyses were used for sociodemographic characteristics. An initial univariate anal- ysis was used to compare sociodemographic variables and variables related to exposure to violence. Chi-Square Test was used to determine the relationship between sociodemo- graphic variables and verbal and nonverbal miscommunica- tions. A p value of <0.05 was considered statistically significant.
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3. Results
3.1. Demographic Characteristics of the Study Population. The data were analyzed and tested for normality and found to be normally distributed. Of the 505 patients who took part in the study, 272 (53.9%) were males, and 233 (46.1%) were females. The age group ≤29 years was the highest 241 (47.7%), while the age group 50-59 interval 45 (8.9%) was the lowest. According
SOLUTION
Effective communication is essential for successful patient-physician interviews. However, miscommunication or a lack of communication between the interviewer and the person being interviewed can have significant negative impacts on the patient. Miscommunication can lead to misunderstandings, decreased patient satisfaction, and even harm the patient’s health outcomes.
Miscommunication can occur when either the interviewer or the person being interviewed does not communicate well. For instance, the interviewer may use medical jargon, fail to establish rapport, or not listen attentively, leading to misunderstandings. On the other hand, the person being interviewed may have difficulty understanding the interviewer’s questions or expressing themselves clearly, leading to a lack of information or incorrect information being conveyed.
Miscommunication or a lack of communication can have several negative effects on the patient. For example, the patient may feel anxious or confused, leading to decreased trust and satisfaction with the healthcare provider. This can result in patients not following medical advice, resulting in poor health outcomes. Additionally, miscommunication can lead to missed diagnoses or incorrect treatments, resulting in harm to the patient.
To address miscommunication, it is crucial to establish effective communication techniques during patient-physician interviews. One approach is to use simulated patients during medical training. In a study conducted by Funda İ
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