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Medical students’ medication communication skills regarding drug prescription—a qualitative analysis of simulated physician-patient consultations

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Abstract

Purpose

Poor medication communication of physicians to patients is detrimental, e.g. for medication adherence. Reasons for physicians’ deficits in medication communication may be unfavourable conditions in daily practice or already insufficient training during their (undergraduate) medical studies. We explored medical students’ communication on new medications in simulated physician-patient conversations to identify actual deficits indicating apparent educational needs.

Methods

Fifth year medical students attending a mandatory course at the University of Cologne had simulated physician-patient consultations aiming at drug prescription. In 2015, 21 consultations were recorded, transcribed and subjected to qualitative content analysis based on the method of inductive coding.

Results

Even essential information on drug therapy was often lacking (e.g. adverse effects, drug administration). Some aspects were addressed more frequently than others. This seemed to differ depending on the diagnosis underlying the particular treatment (acute event vs. chronic disease). The extent of information on drug treatments given in simulated physician-patient consultations varied significantly between students.

Conclusions

Fifth year medical students showed appreciable deficits in communicating drug prescriptions to patients though there were remarkable inter-individual differences. Our findings suggest that communication on drug therapy to patients is no self-evolving skill. Thus, there is obviously a need for emphasizing medication communication in the training of medical students. Communication aids specifically aiming at medication communication might facilitate learning of adequate medication communication skills.

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Notes

  1. Chronic obstructive pulmonary disease

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Acknowledgements

We thank Jessica Köth and Wiebke Seemann for technical help with recording simulated conversations. The help of Monika Endres with transcription is appreciated. Thanks to Jana Bauer for helpful discussions. This work was in part supported by the rectorate of the University of Cologne [Inno-2013-3-3].

Authors’ contribution

KH and JM designed the study, analysed the data and wrote the manuscript.

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Corresponding author

Correspondence to Jan Matthes.

Ethics declarations

Every student whose role play was to be filmed and analysed gave his or her written consent. After transcription of the conversations, only anonymised transcripts were used for further analysis. A formal approval by our local ethics committee was thus considered not necessary.

Conflicts of interest

The authors declare that they have no conflict of interest.

Electronic supplementary material

Table S1

Detailed description of identified codes and underlying contents. The column in the middle gives the definitions of each code. The column on the right gives issues derived from the conversation transcripts that are underlying the respective code. (DOCX 19 kb)

Figure S1

Manual for physician-patient communication on medication as used in medical education in Cologne. Based upon the essential steps of shared decision-making as compiled by Loh et al. [40] we propose certain steps to be addressed by a (simulated) physician when talking to a (simulated) patient about a new medication. (GIF 318 kb)

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Hauser, K., Matthes, J. Medical students’ medication communication skills regarding drug prescription—a qualitative analysis of simulated physician-patient consultations. Eur J Clin Pharmacol 73, 429–435 (2017). https://doi.org/10.1007/s00228-016-2192-0

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