PhD defense of Alexandre Bellier from team TIMC BCM, on May the 31th, at 9am:
« Interpersonal skills in medical consultation:
assessment and improvement for the quality of care »
Place: Salle des thèses du Bâtiment Boucherle, 23 avenue des Maquis du Grésivaudan, 38700 La Tronche
- José LABARERE, Professeur des Universités - Praticien Hospitalier, Université Grenoble Alpes, Supervisor
- Philippe CHAFFANJON, Professeur des Universités - Praticien Hospitalier, Université Grenoble Alpes, Co-Supervisor
- Marc BRAUN, Professeur des Universités - Praticien Hospitalier, Université de Lorraine, Reporter
- Laurent BOYER, Professeur des Universités - Praticien Hospitalier, Université Aix-Marseille, Reporter
- Marie-Claude AUDETAT, Professeure Associée, Université de Genève, Examiner
- Carole SCHWEBEL, Professeure des Universités - Praticienne Hospitalière, Université Grenoble Alpes, Examiner
Medical education, Interpersonal skills, Evaluation
Physician-patient interpersonal skills, which include communication, empathy and patient-centered interview structuring, are among the core skills of a physician. They are a key component of an effective medical consultation and have a strong impact on the quality of care.
The first objective was the evaluation of these non-technical skills, which are often considered subjective. We identified the Four Habits Coding Scheme (4-HCS), a standardized instrument designed for independent evaluation of physicians' interpersonal skills, based on video-recorded consultations. We carried out a cross-cultural adaptation of this scale in French, and then evaluated its psychometric attributes. The internal consistency was satisfactory but the scale required the use of two independent raters to achieve satisfactory reliability.
The second objective was to elucidate the determinants of interpersonal skills in order to develop dedicated medical education program. As part of an observational study, medical students with higher levels of interpersonal skills in simulation were more likely to be female, to have completed an international clinical placement (as part of ERASMUS exchange program) or to have worked in a research laboratory. The length of the consultation was also associated with interpersonal skills.
Finally, many organizations have implemented structured training programs to improve physicians' interpersonal skills, with limited level of evidence on their effectiveness. To address the latter objective, we therefore evaluated the effectiveness of a standardized, multifaceted interpersonal skills development program for hospital-based physicians, as well as existing programs for medical students. We showed the value of dedicated training, especially when repeated and even if short in duration. Our randomized controlled trial suggested an impact on patient outcomes including therapeutic alliance, but also on the physician outcomes including personal achievement.