CST interventions underpinned by conversation analysis show improved interactional outcomes in neurology, psychiatry and aphasia settings¶

Claim · All claims
Evidence · 1 study (3 entries) · review r2–r3 · q2–q3
Currency · newest study 2018 · not yet checked against its sources · not reviewed by a person

Subclaims¶

q2 i? A one-day CA-based training for senior neurology trainees produced marked improvements in eliciting diagnostically useful patient narratives in real clinical encounters before and after training. → Pilnick Alison 2018 q3 i? After a CA-informed psychosis communication intervention, CA revealed more self-repairs in psychiatrist-patient encounters, interpreted as efforts to achieve shared understanding, alongside improved views of the therapeutic relationship. → Pilnick Alison 2018 (2) q3 i? Evaluations of the CA-underpinned Better Conversations with Aphasia intervention showed significant positive change in interaction for people with aphasia and their conversation partners. → Pilnick Alison 2018 (3)

Evidence¶

Pilnick Alison 2018¶

Pilnick Alison, Trusson Diane, Beeke Suzanne, O'Brien Rebecca, Goldberg Sarah, Harwood Rowan H. (2018). Using conversation analysis to inform role play and simulated interaction in communications skills training for healthcare professionals: identifying avenues for further development through a scoping review. BMC Medical Education. https://doi.org/10.1186/s12909-018-1381-1

q2 · i? · review · r2

A one-day CA-based training program taught senior neurology trainees to design opening questions; video footage of real clinical encounters before and after training showed "marked improvements in eliciting narratives". No effect size printed.

"By being encouraged to ask a neutral opening enquiry ('so how can I help you today?'), and tolerate silences, there were marked improvements in eliciting narratives from patients that revealed diagnostically useful interactional and linguistic features when measured in video footage of real clinical encounters before and after training."

Pilnick Alison 2018 (2)¶

Pilnick Alison, Trusson Diane, Beeke Suzanne, O'Brien Rebecca, Goldberg Sarah, Harwood Rowan H. (2018). Using conversation analysis to inform role play and simulated interaction in communications skills training for healthcare professionals: identifying avenues for further development through a scoping review. BMC Medical Education. https://doi.org/10.1186/s12909-018-1381-1

q3 · i? · review · r2

The review reports the TEMPO cluster randomised trial context: CA analysis of psychiatrist/patient encounter videos before and after training found more self-repairs, plus improvements in both parties' views of the therapeutic relationship. No effect size printed.

"After the training, CA revealed more instances of self-repairs in the transcripts of psychiatrist/patient encounters, which the authors argued is indicative of the efforts that psychiatrists were making to achieve shared understanding of the patient's symptoms."

Pilnick Alison 2018 (3)¶

Pilnick Alison, Trusson Diane, Beeke Suzanne, O'Brien Rebecca, Goldberg Sarah, Harwood Rowan H. (2018). Using conversation analysis to inform role play and simulated interaction in communications skills training for healthcare professionals: identifying avenues for further development through a scoping review. BMC Medical Education. https://doi.org/10.1186/s12909-018-1381-1

q3 · i? · review · r3

The review reports evaluations of the Better Conversations with Aphasia package showing "significant positive change in interaction for both PWA and their conversation partners". No effect size printed.

"Subsequent studies evaluating the outcomes of a standard intervention package underpinned by CA, Better Conversations with Aphasia [61] have shown significant positive change in interaction for both PWA and their conversation partners [62, 63]."

Discussion¶

Related Claims¶

• Studies of simulated patient-based CST report positive effects on trainee confidence and communication performance — a broader claim this one bears on
• Communication skills training programs improve clinician patient-centeredness, but training approaches are variable and long-term retention is untested — related
• Direct comparisons find simulated patients as effective as real patients for CST outcomes — related
• Training durations varied widely, most commonly 1–5 days/sessions (22%), ranging from one-off lectures to content embedded across four-year degrees — related