AB1389 How do we learn to communicate to our patients? an inventory study amongst rheumatologists in training in the netherlands how they train communication skills
Authors: L. Kranenburg – Van Koppen, M. Hazes, W.V.D. Broek, M. Dankbaar
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Effective doctor-patient communication, more specific 'Shared Decision Making (SDM)', is essential in high-quality health care. Physicians value the principles of SDM, but the practice is disappointing. Difficult subjects are avoided, options are not equally explained or patients' values remain unclear. As a rheumatologist, communication is an essential and powerful competency. Guidelines endorse SDM for the management of various rhematic diseases. What we do not know is how we acquire the right communication skills for the task. As rheumatologists we learn a lot about pathophysiology, diagnostic approach and treatment options, but not how to explain these aspects in comprehensible language to our patients. <h3>Objectives</h3> Objective of this study is to investigate how rheumatologists in training acquire communication skills, more specific skills in SDM. How do they rate their communication competency and what can be done to improve. <h3>Methods</h3> An online survey was developed with questions dedicated to evaluate the posed questions. The survey was distributed amongst aspirant members of the Dutch Society for Rheumatology by email with a link to the survey. The survey consists of questions asking for self-reflection and rating on various communication skills regarding different aspects of communication. <h3>Results</h3> These are preliminary results based at the first 23 responses, which is 33% of the total number of rheumatologists in training. From the received responses eleven fellows were in their fourth year, four in their fifth year and seven were in their final year of education. Fellows believe communication is the most important CanMEDS competency after 'Medical Expert'. Self-assessment of communication competency shows an average score of 3.7 on a five-point scale (5=most experienced). When a new diagnosis is explained, fellows rate their skills at levels to be expected for their years of education, except for the diagnose SLE, Systemic Sclerosis and M. Sjögren. Items that are always discussed are the diagnosis and the treatment, but other aspects such as implications for pregnancy, work, social life and sexual intercourse are only discussed on request. Regarding the explanation of treatment options the right words to explain different biological DMARDs seem to run short. When presenting details about treatment fellows always communicate possible treatment effect and side effects, but do not always mention frequency of side-effects. Furthermore, alternatives and preferences of the patient are not always discussed but only on request by 68% of the respondents. Fellows indicate that they think communication and SDM are very important and are interested to acquire further skills. They prefer videos with examples of how to explain certain diagnoses, treatment options and how to deal with various patient types. A specific request was made for a training in Somatic Unexplained Complaints. <h3>Conclusions</h3> Rheumatologists in training highly value good doctor-patient communication. In daily practice the explanation of certain diseases and treatment options seems difficult. Diagnoses and drugs with possible (side) effects are always explained, but social implications and patients' preferences are only discussed on request. Therefore, additional training of SDM seems important. <h3>Disclosure of Interest</h3> None declared