Communication Skills (CS) training of physicians in China and its role in actual challenges of patient-physician relationship: a cross-sectional survey
Abstract Background The Chinese healthcare system is affected by frequent disputes between physicians and patients. Although recent reforms have contributed towards improving the patient-physician relationship, distrust in physicians is still high. Communication skills (CS) training of physicians ho...
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| Format: | Article |
| Language: | English |
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BMC
2022-11-01
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| Series: | BMC Medical Education |
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| Online Access: | https://doi.org/10.1186/s12909-022-03830-9 |
| _version_ | 1828098537349447680 |
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| author | Junfeng Du Gwendolyn Mayer Elisabetta Posenato Svenja Hummel Ali Zafar Till Bärnighausen Jobst-Hendrik Schultz |
| author_facet | Junfeng Du Gwendolyn Mayer Elisabetta Posenato Svenja Hummel Ali Zafar Till Bärnighausen Jobst-Hendrik Schultz |
| author_sort | Junfeng Du |
| collection | DOAJ |
| description | Abstract Background The Chinese healthcare system is affected by frequent disputes between physicians and patients. Although recent reforms have contributed towards improving the patient-physician relationship, distrust in physicians is still high. Communication skills (CS) training of physicians holds the key to improving patient confidence and diffusing stressful situations. This survey reports on the status of CS training in medical education in China, and the experiences and attitudes of physicians towards CS training. Methods A cross-sectional survey was conducted at medical institutions across China. A questionnaire developed for this study included the status of CS training, current aspects of patient-physician relationships, perceived own CS and patient-centeredness with Likert-scaled items from 1 (most negative) to 6 (most positive). Physicians’ attitude towards CS training was measured with the Communication Skills Attitude Scale (CSAS) and its subscales PAS (Positive Attitude Scale) and NAS (Negative Attitude Scale). Data were analyzed descriptively and for group differences between the hospital level and operating vs. non-operating physicians. Binary logistic regression analysis was done to find associations explaining the occurrence of verbal and physical attacks and the role of CS attitudes. Results Out of 1080 questionnaires, 772 physicians met inclusion criteria. A total of 466/772 participants (60.4%) had received at least one CS training during their career. The participants rated the current situation related to patient-physician relationship in China as highly stressful (mean = 4.52, SD = 1.26, 95% CI: 4.43–4.60), experiencing verbal attacks in the past three years once a year in 372/772 cases (48.2%) and physical attacks 111/772 times (14.4%). The mean PAS was 62.96 (SD = 7.63, 95% CI: 62.41–63.47). Being female was associated with increased risk of verbal attacks (OR = 1.51, 95% CI: 1.01–2.25) while working in a tertiary hospital and showing high levels of PAS decreased this risk (OR = 0.62, 95% CI: 0.43–0.89, and OR = 0.95, 95% CI: 0.93–0.98). Having received a previous CS training decreased the odds of physical attacks (OR = 0.54, 95% CI: 0.35–0.83). Conclusions A majority of Chinese physicians showed a high positive attitude towards CS training, were trained in CS and would value further training. Our results highlight that CS training is likely to promote patient-centered communication and reduce attacks against physicians. Both of these effects are to improve the patient-physician-relationship in the long run. More CS training should be offered to Chinese physicians, especially at secondary- and primary-care hospitals, where such practices remain infrequent. |
| first_indexed | 2024-04-11T08:03:06Z |
| format | Article |
| id | doaj.art-d9b5cf49ab4941d285c33f6629d94fa0 |
| institution | Directory Open Access Journal |
| issn | 1472-6920 |
| language | English |
| last_indexed | 2024-04-11T08:03:06Z |
| publishDate | 2022-11-01 |
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| series | BMC Medical Education |
| spelling | doaj.art-d9b5cf49ab4941d285c33f6629d94fa02022-12-22T04:35:39ZengBMCBMC Medical Education1472-69202022-11-0122111110.1186/s12909-022-03830-9Communication Skills (CS) training of physicians in China and its role in actual challenges of patient-physician relationship: a cross-sectional surveyJunfeng Du0Gwendolyn Mayer1Elisabetta Posenato2Svenja Hummel3Ali Zafar4Till Bärnighausen5Jobst-Hendrik Schultz6Department of Plastic Surgery, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of General Internal Medicine and Psychosomatics, Heidelberg University HospitalDepartment of General Internal Medicine and Psychosomatics, Heidelberg University HospitalDepartment of General Internal Medicine and Psychosomatics, Heidelberg University HospitalDepartment of General Internal Medicine and Psychosomatics, Heidelberg University HospitalHeidelberg Institute of Global Health, Heidelberg University HospitalDepartment of General Internal Medicine and Psychosomatics, Heidelberg University HospitalAbstract Background The Chinese healthcare system is affected by frequent disputes between physicians and patients. Although recent reforms have contributed towards improving the patient-physician relationship, distrust in physicians is still high. Communication skills (CS) training of physicians holds the key to improving patient confidence and diffusing stressful situations. This survey reports on the status of CS training in medical education in China, and the experiences and attitudes of physicians towards CS training. Methods A cross-sectional survey was conducted at medical institutions across China. A questionnaire developed for this study included the status of CS training, current aspects of patient-physician relationships, perceived own CS and patient-centeredness with Likert-scaled items from 1 (most negative) to 6 (most positive). Physicians’ attitude towards CS training was measured with the Communication Skills Attitude Scale (CSAS) and its subscales PAS (Positive Attitude Scale) and NAS (Negative Attitude Scale). Data were analyzed descriptively and for group differences between the hospital level and operating vs. non-operating physicians. Binary logistic regression analysis was done to find associations explaining the occurrence of verbal and physical attacks and the role of CS attitudes. Results Out of 1080 questionnaires, 772 physicians met inclusion criteria. A total of 466/772 participants (60.4%) had received at least one CS training during their career. The participants rated the current situation related to patient-physician relationship in China as highly stressful (mean = 4.52, SD = 1.26, 95% CI: 4.43–4.60), experiencing verbal attacks in the past three years once a year in 372/772 cases (48.2%) and physical attacks 111/772 times (14.4%). The mean PAS was 62.96 (SD = 7.63, 95% CI: 62.41–63.47). Being female was associated with increased risk of verbal attacks (OR = 1.51, 95% CI: 1.01–2.25) while working in a tertiary hospital and showing high levels of PAS decreased this risk (OR = 0.62, 95% CI: 0.43–0.89, and OR = 0.95, 95% CI: 0.93–0.98). Having received a previous CS training decreased the odds of physical attacks (OR = 0.54, 95% CI: 0.35–0.83). Conclusions A majority of Chinese physicians showed a high positive attitude towards CS training, were trained in CS and would value further training. Our results highlight that CS training is likely to promote patient-centered communication and reduce attacks against physicians. Both of these effects are to improve the patient-physician-relationship in the long run. More CS training should be offered to Chinese physicians, especially at secondary- and primary-care hospitals, where such practices remain infrequent.https://doi.org/10.1186/s12909-022-03830-9Medical educationCommunication skillsDoctor-patient-relationshipChinaPatient-centered communication |
| spellingShingle | Junfeng Du Gwendolyn Mayer Elisabetta Posenato Svenja Hummel Ali Zafar Till Bärnighausen Jobst-Hendrik Schultz Communication Skills (CS) training of physicians in China and its role in actual challenges of patient-physician relationship: a cross-sectional survey BMC Medical Education Medical education Communication skills Doctor-patient-relationship China Patient-centered communication |
| title | Communication Skills (CS) training of physicians in China and its role in actual challenges of patient-physician relationship: a cross-sectional survey |
| title_full | Communication Skills (CS) training of physicians in China and its role in actual challenges of patient-physician relationship: a cross-sectional survey |
| title_fullStr | Communication Skills (CS) training of physicians in China and its role in actual challenges of patient-physician relationship: a cross-sectional survey |
| title_full_unstemmed | Communication Skills (CS) training of physicians in China and its role in actual challenges of patient-physician relationship: a cross-sectional survey |
| title_short | Communication Skills (CS) training of physicians in China and its role in actual challenges of patient-physician relationship: a cross-sectional survey |
| title_sort | communication skills cs training of physicians in china and its role in actual challenges of patient physician relationship a cross sectional survey |
| topic | Medical education Communication skills Doctor-patient-relationship China Patient-centered communication |
| url | https://doi.org/10.1186/s12909-022-03830-9 |
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