Clinician-Patient Communication Programs offered by Northwest Permanente Department of Continuing Medical Education and Professional Development

Clinician-Patient Communication to Enhance Health Outcomes
This workshop is designed to help clinicians identify and enhance critical communication skills that they currently use or need. During the workshop, state-of-the-art techniques are presented with supporting research. Clinicians also are given opportunities to practice these techniques and to receive feedback.
At the conclusion of this workshop, clinicians should be able to:

• Describe the four communication tasks of the medical interview;
• Identify state-of-the-art communication skills and supporting research;
• Identify frustrations that make clinician-patient encounters difficult;
• Demonstrate and practice new communication skills;
• Develop a simple plan to apply new communication skills in practice.

Reflective Listening
This workshop defines and demonstrates the importance of "reflective listening" during the medical interview. Skills and strategies for implementation also are presented. Clinicians are given the opportunity to practice thinking reflectively, to form reflections, and to use reflective listening in a mock patient encounter.
At the conclusion of this workshop, clinicians should be able to:

• Understand and recognize reflective listening;
• Describe how reflective listening can be used in clinical practice;
• Practice thinking reflectively, forming reflections, and using reflective listening in encounters with patients.

Difficult Clinician­Patient Relationships
This workshop challenges clinicians to examine the types of interactions which cause clinicians the greatest difficulty. Learning new approaches for working with these situations is facilitated by exploring 15 videotaped case scenarios drawn from a variety of specialties. Each case presents a type of difficulty faced by most clinicians at some point during their careers.

Two conceptual models are introduced to frame both the problems and the possibilities of "difficult" relationships. The first model examines some of the factors that lead clinicians to apply the label "difficult" to a situation. The second model describes strategies a clinician can use in response to these situations.
At the conclusion of this workshop, clinicians should be able to:

• Identify characteristics that make patient encounters "difficult" and factors that cause clinicians to apply this label to patients;
  
• Demonstrate and practice effective strategies for coping with difficult patient encounters;
• Identify communication strategies that increase satisfaction for patients as well as for clinicians.

Time Wise: Skills for Wisely Using Your Time with Patients
This workshop provides clinicians with a model of the medical interview involving both biomedical and interpersonal roles. Clinicians gain an understanding of how time can be efficiently allocated in a medical interview. The medical interview model enables clinicians to view communication skills as critical techniques for wisely managing the time spent with patients.
Clinicians in this program should learn and practice three main skills:

• Negotiating an agenda with a patient (ie, how time will be used, topics to be addressed);
• Responding to emotional expressions and psychosocial concerns in a warm and timely way;
• Closing the visit on time after maintaining focus on the agreed-upon agenda.

Choices & Changes
Choices and Changes gives clinicians an opportunity to explore their own beliefs about the change process and to test these beliefs against the empirical literature that has been developed during the past two decades. The program also provides the clinician with specific strategies to use within the time constraints of a typical office visit. At the conclusion of this workshop, clinicians should be able to:

• Examine their own attitudes, beliefs, and values about promoting patient behavior change;
• Learn key aspects of three major models (Stages of Change, Motivational Interviewing, and Self-Efficacy) as applied to promoting patient behavior change;
• Practice using these models to rapidly identify key interventions that promote patient behavior change. For this purpose, examples of clinical scenarios are presented on videotape and enacted in small groups.

Communication: A Risk Management Tool
This program was developed in response to the need expressed by many malpractice insurance carriers for a brief program that would identify and inform clinicians of the communication practices that attract--or prevent--malpractice litigation. At the conclusion of this workshop, clinicians should be able to:

• Understand the expectations of patients and families regarding communication and interaction and how, if mishandled, these activities can lead to formal complaints and lawsuits;
• Recognize and analyze unsatisfactory interactions with patients and families and quickly develop remedies for these situations;
• Address other unexpected, disappointing outcomes (as well as mistakes) in a way that reduces the risk of attracting lawsuits or complaints;
• Review current practice settings and identify for future action areas of risk.