The specific aim of this research is to test the effects of communication skills training that instructs patients in how to seek, provide and verify understanding of information during a primary care medical consultation. The long-range goal of this program of research is to develop and disseminate printed and videotaped educational materials that may be used by patients to improve communication in information exchange during medical consultations. Previous research into patient communication skills training suggests that such training enhances patients' perception of control and preference for participation in medical decision making and improves recall of, and adherence to, treatment plans. Most research has obtained these outcomes with no significant increase in the length of consultations. While the outcomes of patient communication skills training are encouraging, little research has extended training beyond information seeking skills. The proposed study will examine the effects of training patients in information provision and verification skills, in information seeking. The design of the study includes three groups of patients: a trained group (which receives an instruction booklet), an attention control group (which receives only a brief summary of key points contained in the instruction booklet), and an untrained group (which does not receive any instructional material). A total of 28 physicians at approximately 16 family practice locations will each see six patients, two patients in each of the three treatment groups (N = 168). Subsequent to each medical consultation, patients and doctors will complete a communication competence measure that assesses perceptions of self and other effectiveness in information exchange, and a measure of the reason(s) and expectations for the patient's visit. Additionally, patients will complete a measure of recall of diagnostic and treatment information. Two weeks following the consultation, patients will complete a measure of adherence to treatment recommendations. The expectation is that patient communication skills training will increase patients': information-seeking questions; summaries and repetitions of information; completeness of information provision; recall of diagnostic and treatment information; adherence to treatment.
