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Gepubliceerd in: Huisarts en wetenschap 4/2015

01-04-2015 | Onderzoek

De communicatietoets en de context van het consult

Auteur: dr. Geurt Essers

Gepubliceerd in: Huisarts en wetenschap | Uitgave 4/2015

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Samenvatting

De communicatietoets en de context van het consult. Huisarts Wet 2015;58(4):186-90.

Achtergrond

Communicatie is voor artsen een belangrijke competentie en de toetsing van communicatievaardigheden is een integraal onderdeel van de huisartsenopleiding. Die toetsing is echter vatbaar voor verbetering. In de huisartsgeneeskunde hecht men er veel waarde aan dat de arts klachten interpreteert binnen de context. De toetsing van arts-patiëntcommunicatie houdt echter geen rekening met de context waarin zij plaatsvindt. Wij gingen na hoe die context in de toetsing verdisconteerd kan worden.

Methode

Met een mixed-method design onderzochten we hoe de scores van huisartsen en aios op de MAAS-Globaal communicatietoets zouden veranderen wanneer men bij de scoring rekening zou houden met een aantal vooraf gedefinieerde contextfactoren. We bepaalden de scores van de deelnemers tweemaal: één keer de score op de standaardtoets en één keer de score op de toets waarin ook contextfactoren waren opgenomen.

Resultaten

In de consulten vonden we alle vooraf geïdentificeerde contextfactoren terug. Zowel voor de huisartsen als voor de aios steeg de gemiddelde score, al was het verschil bij de aios over het algemeen kleiner. De huisartsen scoorden op de contextgevoelige toets gemiddeld boven het vastgestelde niveau voor ‘adequaat communicerend’.

Conclusie

Bij het toetsen van de arts-patiëntcommunicatie in de huisartsenopleiding moeten contextfactoren eerder als signaal dan als ruis worden opgevat. Het expliciet betrekken van contextfactoren in de toets maakt deze transparanter. Contextspecifieke toepassing van communicatievaardigheden verdient in de vervolgopleiding meer nadruk, zowel bij het onderwijs als bij de toetsing.
Literatuur
1.
go back to reference Den Boer C, Düsman H, Faddegon H, Jobse P, Kramer AMW, Van Peet PG, et al. Landelijk Toetsplan 2011. Utrecht: Werkgroep Toetsing Huisartsopleiding Nederland, 2011. Den Boer C, Düsman H, Faddegon H, Jobse P, Kramer AMW, Van Peet PG, et al. Landelijk Toetsplan 2011. Utrecht: Werkgroep Toetsing Huisartsopleiding Nederland, 2011.
2.
go back to reference Ram P, Grol R, Rethans JJ, Schouten B, Van der Vleuten C, Kester A. Assessment of general practitioners by video observation of communicative and medical performance in daily practice: issues of validity, reliability and feasibility. Med Educ 1999;33:447–54.CrossRefPubMed Ram P, Grol R, Rethans JJ, Schouten B, Van der Vleuten C, Kester A. Assessment of general practitioners by video observation of communicative and medical performance in daily practice: issues of validity, reliability and feasibility. Med Educ 1999;33:447–54.CrossRefPubMed
3.
go back to reference Hobma S, Ram P, Muijtjens A, Van der Vleuten C, Grol R. Effective improvement of doctor-patient communication: A randomised controlled trial. Br J Gen Pract 2006;56:580–6.PubMedCentralPubMed Hobma S, Ram P, Muijtjens A, Van der Vleuten C, Grol R. Effective improvement of doctor-patient communication: A randomised controlled trial. Br J Gen Pract 2006;56:580–6.PubMedCentralPubMed
4.
go back to reference Cals JWL, Scheppers NAM, Hopstaken RM, Hood K, Dinant GJ, Goettsch H, et al. Evidence based management of acute bronchitis; sustained competence of enhanced communication skills acquisition in general practice. Patient Educ Couns 2007;68:270–8.CrossRefPubMed Cals JWL, Scheppers NAM, Hopstaken RM, Hood K, Dinant GJ, Goettsch H, et al. Evidence based management of acute bronchitis; sustained competence of enhanced communication skills acquisition in general practice. Patient Educ Couns 2007;68:270–8.CrossRefPubMed
5.
go back to reference Zolnierek KBH, DiMatteo MR. Physician communication and patient adherence to treatment: A meta-analysis. Med Care 2009;47:826–34.CrossRefPubMed Zolnierek KBH, DiMatteo MR. Physician communication and patient adherence to treatment: A meta-analysis. Med Care 2009;47:826–34.CrossRefPubMed
6.
go back to reference Beck RS, Daughtridge R, Sloane PD: Physician-patient communication in the primary care office: a systematic review. J Am Board Fam Pract 2002;15:25–38.PubMed Beck RS, Daughtridge R, Sloane PD: Physician-patient communication in the primary care office: a systematic review. J Am Board Fam Pract 2002;15:25–38.PubMed
7.
go back to reference Uitterhoeve RJ, Bensing JM, Grol RP, Demulder PHM, Van Achterberg T. The effect of communication skills training on patient outcomes in cancer care: A systematic review of the literature. Eur J Cancer Care 2010;19:442–57.CrossRef Uitterhoeve RJ, Bensing JM, Grol RP, Demulder PHM, Van Achterberg T. The effect of communication skills training on patient outcomes in cancer care: A systematic review of the literature. Eur J Cancer Care 2010;19:442–57.CrossRef
8.
go back to reference Brock DM, Mauksch LB, Witteborn S, Hummel J, Nagasawa P, Robins LS. Effectiveness of intensive physician training in upfront agenda setting. J Gen Intern Med 2011;26:1317–23.CrossRefPubMedCentralPubMed Brock DM, Mauksch LB, Witteborn S, Hummel J, Nagasawa P, Robins LS. Effectiveness of intensive physician training in upfront agenda setting. J Gen Intern Med 2011;26:1317–23.CrossRefPubMedCentralPubMed
9.
go back to reference Kramer AWM, Dusman H, Tan LHC, Jansen JJM, Grol R, Van der Vleuten CPM. Acquisition of communication skills in postgraduate training for general practice. Med Educ 2004;38:158–67.CrossRefPubMed Kramer AWM, Dusman H, Tan LHC, Jansen JJM, Grol R, Van der Vleuten CPM. Acquisition of communication skills in postgraduate training for general practice. Med Educ 2004;38:158–67.CrossRefPubMed
10.
go back to reference Reinders ME, Blankenstein AH, Van der Horst HE, Knol DL, Schoonheim PL, Van Marwijk HWJ. Does patient feedback improve the consultation skills of general practice trainees? A controlled trial. Med Educ 2010;44:156–64.CrossRefPubMed Reinders ME, Blankenstein AH, Van der Horst HE, Knol DL, Schoonheim PL, Van Marwijk HWJ. Does patient feedback improve the consultation skills of general practice trainees? A controlled trial. Med Educ 2010;44:156–64.CrossRefPubMed
11.
go back to reference Van Es J, De Waard-Wieringa M, Visser M. Differential growth in doctor-patient communication skills in GP trainees. Med Educ 2013;47:691–700.CrossRef Van Es J, De Waard-Wieringa M, Visser M. Differential growth in doctor-patient communication skills in GP trainees. Med Educ 2013;47:691–700.CrossRef
12.
go back to reference Hulsman RL. Shifting goals in medical communication: Determinants of goal detection and response formation. Patient Educ Couns 2009;74:302–8.CrossRefPubMed Hulsman RL. Shifting goals in medical communication: Determinants of goal detection and response formation. Patient Educ Couns 2009;74:302–8.CrossRefPubMed
13.
go back to reference Schirmer JM, Mauksch L, Lang F, Marvel MK, Zoppi K, Epstein RM, et al. Assessing communication competence: a review of current tools. Fam Med 2005;37:184–92.PubMed Schirmer JM, Mauksch L, Lang F, Marvel MK, Zoppi K, Epstein RM, et al. Assessing communication competence: a review of current tools. Fam Med 2005;37:184–92.PubMed
14.
go back to reference Zoppi K, Epstein RM. Is communication a skill? Communication behaviors and being in relation. Fam Med 2002;34:319–24.PubMed Zoppi K, Epstein RM. Is communication a skill? Communication behaviors and being in relation. Fam Med 2002;34:319–24.PubMed
15.
16.
go back to reference Cegala DJ, Lenzmeier Broz S. Physician communication skills training: a review of theoretical backgrounds, objectives and skills. Med Educ 2002;36:1004–16.CrossRefPubMed Cegala DJ, Lenzmeier Broz S. Physician communication skills training: a review of theoretical backgrounds, objectives and skills. Med Educ 2002;36:1004–16.CrossRefPubMed
17.
go back to reference Salmon P, Young B. Creativity in clinical communication: from communication skills to skilled communication. Med Educ 2011;45:217–26.CrossRefPubMed Salmon P, Young B. Creativity in clinical communication: from communication skills to skilled communication. Med Educ 2011;45:217–26.CrossRefPubMed
19.
go back to reference Durning SJ, Artino AR, Pangaro LN, Van der Vleuten C, Schuwirth L. Perspective: redefining context in the clinical encounter: Implications for research and training in medical education. Acad Med 2010;85:894–901.CrossRefPubMed Durning SJ, Artino AR, Pangaro LN, Van der Vleuten C, Schuwirth L. Perspective: redefining context in the clinical encounter: Implications for research and training in medical education. Acad Med 2010;85:894–901.CrossRefPubMed
20.
go back to reference Feldman-Stewart D, Brundage MD, Tishelman C. A conceptual framework for patient-professional communication: an application to the cancer context. Psychooncology 2005;14:801–9.CrossRefPubMed Feldman-Stewart D, Brundage MD, Tishelman C. A conceptual framework for patient-professional communication: an application to the cancer context. Psychooncology 2005;14:801–9.CrossRefPubMed
21.
go back to reference Essers G, Van Dulmen S, Van Weel C, Van der Vleuten C, Kramer A. Identifying context factors explaining physician's low performance in communication assessment: an explorative study in general practice. BMC Fam Pract 2011;12:13–8.CrossRef Essers G, Van Dulmen S, Van Weel C, Van der Vleuten C, Kramer A. Identifying context factors explaining physician's low performance in communication assessment: an explorative study in general practice. BMC Fam Pract 2011;12:13–8.CrossRef
22.
go back to reference Noordman J, Verhaak P, Van Beljouw I, Van Dulmen S. Consulting room computers and their effect on general practitioner-patient communication. Fam Pract 2010;27:644–51.CrossRefPubMed Noordman J, Verhaak P, Van Beljouw I, Van Dulmen S. Consulting room computers and their effect on general practitioner-patient communication. Fam Pract 2010;27:644–51.CrossRefPubMed
23.
go back to reference Van Thiel J, Ram P, Van Dalen J. MAAS-Global 2000. Maastricht: Maastricht University; 2003. Van Thiel J, Ram P, Van Dalen J. MAAS-Global 2000. Maastricht: Maastricht University; 2003.
24.
go back to reference Hobma SO, Ram PM, Muijtjens AM, Grol RP, Van der Vleuten CP. Setting a standard for performance assessment of doctor-patient communication in general practice. Med Educ 2004;38:1244–52.CrossRefPubMed Hobma SO, Ram PM, Muijtjens AM, Grol RP, Van der Vleuten CP. Setting a standard for performance assessment of doctor-patient communication in general practice. Med Educ 2004;38:1244–52.CrossRefPubMed
25.
go back to reference De Jong J, Visser MR, Mohrs J, Wieringa-de Waard M. Opening the black box: the patient mix of GP trainees. Br J Gen Pract 2011;61:e650–7.CrossRefPubMed De Jong J, Visser MR, Mohrs J, Wieringa-de Waard M. Opening the black box: the patient mix of GP trainees. Br J Gen Pract 2011;61:e650–7.CrossRefPubMed
26.
go back to reference Bonney A, Phillipson L, Reis S, Jones SC, Iverson D. Patients' attitudes to general practice registrars: a review of the literature. Educ Prim Care 2009;20:371–8.PubMed Bonney A, Phillipson L, Reis S, Jones SC, Iverson D. Patients' attitudes to general practice registrars: a review of the literature. Educ Prim Care 2009;20:371–8.PubMed
27.
go back to reference Young B, Ward J, Forsey M, Gravenhorst K, Salmon P. Examining the validity of the unitary theory of clinical relationships: comparison of observed and experienced parent-doctor interaction. Patient Educ Couns 2011;85:60–7.CrossRefPubMed Young B, Ward J, Forsey M, Gravenhorst K, Salmon P. Examining the validity of the unitary theory of clinical relationships: comparison of observed and experienced parent-doctor interaction. Patient Educ Couns 2011;85:60–7.CrossRefPubMed
28.
go back to reference Salmon P, Mendick N, Young B. Integrative qualitative communication analysis of consultation and patient and practitioner perspectives: towards a theory of authentic caring in clinical relationships. Patient Educ Couns 2011;82:448–54.CrossRefPubMed Salmon P, Mendick N, Young B. Integrative qualitative communication analysis of consultation and patient and practitioner perspectives: towards a theory of authentic caring in clinical relationships. Patient Educ Couns 2011;82:448–54.CrossRefPubMed
Metagegevens
Titel
De communicatietoets en de context van het consult
Auteur
dr. Geurt Essers
Publicatiedatum
01-04-2015
Uitgeverij
Bohn Stafleu van Loghum
Gepubliceerd in
Huisarts en wetenschap / Uitgave 4/2015
Print ISSN: 0018-7070
Elektronisch ISSN: 1876-5912
DOI
https://doi.org/10.1007/s12445-015-0105-6

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