Consultation Skills Training and Practice: A Mixed-Methods Exploration of Perspectives from Junior Doctors, their Patients and other Clinicians.

Fromage, M (2013) Consultation Skills Training and Practice: A Mixed-Methods Exploration of Perspectives from Junior Doctors, their Patients and other Clinicians. Doctoral thesis, University of East Anglia.

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Abstract

Background
Efficient and effective doctor-patient consultations have been extensively linked to
many positive patient outcomes.
Aims
This project addressed the following research questions: Are junior doctors using
effective consultation skills with their patients in the clinical setting and what do their
patients think? How confident are junior doctors in their ability to perform effective
consultations? What factors influence the teaching, learning and subsequent practice
of consultation skills for junior doctors and other clinicians?
Research Methods
This mixed-methods project encompassed 3 interlinked studies.
 Study 1 used a parallel questionnaire to investigate junior (Foundation) doctors’
and patients’ assessments of a shared consultation. In addition, two selfefficacy
scales (before and after consultation) were completed by the doctors.
 Study 2 explored the perspectives of junior doctors in more depth via semistructured
interviews.
 Study 3 used an online questionnaire to elicit the perspectives of more
experienced clinicians.
Results
Patients scored doctors significantly higher than doctors scored themselves on the
consultation skills questionnaire, and male junior doctors scored themselves
significantly higher than females. Doctors’ self-efficacy was high: male doctors scored
higher than females and those in their last training rotation scored the highest.
Interview data suggested that self-efficacy was affected by the junior doctors’
perception of their ‘role’ within the clinical context and their medical knowledge.
Consultation skills training and practice were affected by the doctors’ inherent
personality traits and aspects of the learning/clinical context to produce incremental
progression of learning. Experienced clinicians reported similar factors as influencing
their training, practice and self-efficacy.
Conclusions
In this project, effective consultation skills were used confidently by junior doctors and
experienced positively by their patients. Many variables about the clinical context, the
doctors and their patients interplayed to affect the way that consultation skills were
learnt and subsequently practiced by both junior and more senior clinicians.

Item Type: Thesis (Doctoral)
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: Mia Reeves
Date Deposited: 12 Jun 2014 11:24
Last Modified: 12 Jun 2014 11:24
URI: https://ueaeprints.uea.ac.uk/id/eprint/48745
DOI:

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