Effectiveness of a short course in clinical communication skills for hospital doctors: Results of a crossover randomized controlled trial (ISRCTN22153332)

ObjectiveTo test the hypothesis that a 20-h communication skills course based on the Four Habits model can improve doctor–patient communication among hospital employed doctors across specialties.MethodsCrossover randomized controlled trial in a 500-bed hospital with interventions at different time points in the two arms. Assessments were video-based and blinded. Intervention consisted of 20 h of communication training, containing alternating plenary with theory/debriefs and practical group sessions with role-plays tailored to each doctor.ResultsOf 103 doctors asked to participate, 72 were included, 62 received the intervention, 51 were included in the main analysis, and another six were included in the intention-to-treat analysis. We found an increase in the Four Habits Coding Scheme of 7.5 points (p = 0.01, 95% confidence interval 1.6–13.3), fairly evenly distributed on subgroups. Baseline score (SD) was 60.3 (9.9). Global patient satisfaction did not change, neither did average encounter duration.ConclusionUtilizing an outpatient-clinic training model developed in the US, we demonstrated that a 20-h course could be generalized across medical and national cultures, indicating improvement of communication skills among hospital doctors.Practice implicationsThe Four Habits model is suitable for communication-training courses in hospital settings. Doctors across specialties can attend the same course.