Learning person-centred consultation skills in clinical medicine : a randomised controlled case study

Abstract

BACKGROUND : Training institutions need to ensure that healthcare students learn the skills to conduct person-centred consultations. We studied changes in person-centred practice over time following a quality improvement (QI) intervention among Bachelor of Clinical Medical Practice undergraduate students. METHODS : Students were randomised to intervention and control groups. The intervention group received training and did a QI cycle on their own consultation skills. Consultations with simulated patients were recorded during structured clinical examinations in June (baseline) and November (post-intervention) 2015. RESULTS : Matched consultations for 64 students were analysed. The total SEGUE (Set the stage, Elicit information, Give information, Understand the patient’s perspective and End the encounter scores) were significantly higher in the final assessment compared to baseline for both the whole group and the intervention group (p = 0.005 and 0.015, respectively). The improvement did not differ significantly between intervention and control groups ( p = 0.778). Third-year students improved significantly more than second years (p = 0.007). CONCLUSION : The person-centred practice (including collaboration) of clinical associate students did improve over the period studied. The results show that students’ learning of personcentred practice also happened in ways other than through the QI intervention. There is a need to develop students’ collaborative skills during the medical consultation.