Skip to main content

Effect of a Coaching Intervention to Improve Cardiologist Communication: A Randomized Clinical Trial.

Publication ,  Journal Article
Pollak, KI; Olsen, MK; Yang, H; Prose, N; Jackson, LR; Pinheiro, SO; Dunbar, TK; Johnson, KS
Published in: JAMA Intern Med
June 1, 2023

IMPORTANCE: Communication between cardiologists and patients can significantly affect patient comprehension, adherence, and satisfaction. To our knowledge, a coaching intervention to improve cardiologist communication has not been tested. OBJECTIVE: To evaluate the effect of a communication coaching intervention to teach evidence-based communication skills to cardiologists. DESIGN, SETTING, AND PARTICIPANTS: This 2-arm randomized clinical trial was performed at outpatient cardiology clinics at an academic medical center and affiliated community clinics, and from February 2019 through March 2020 recruited 40 cardiologists and audio recorded 161 patients in the preintervention phase and 240 in the postintervention phase. Data analysis was performed from March 2022 to January 2023. INTERVENTIONS: Half of the cardiologists were randomized to receive a coaching intervention that involved three 1:1 sessions, 2 of which included feedback on their audio-recorded encounters. Communication coaches taught 5 skills derived from motivational interviewing: (1) sitting down and making eye contact with all in the room, (2) open-ended questions, (3) reflective statements, (4) empathic statements, and (5) "What questions do you have?" MAIN OUTCOMES AND MEASURES: Coders unaware of study arm coded these behaviors in the preintervention and postintervention audio-recorded encounters (objective communication). Patients completed a survey after the visit to report perceptions of communication quality (subjective communication). RESULTS: Analysis included 40 cardiologists (mean [SD] age, 47 [9] years; 7 female and 33 male) and 240 patients in the postintervention phase (mean [SD] age, 58 [15] years; 122 female, 118 male). When controlling for preintervention behaviors, cardiologists in the intervention vs control arm were more likely to make empathic statements (intervention: 52 of 117 [44%] vs control: 31 of 113 [27%]; P = .05); to ask, "What questions do you have?" (26 of 117 [22%] vs 6 of 113 [5%]; P = .002); and to respond with empathy when patients expressed negative emotions (mean ratio of empathic responses to empathic opportunities, 0.50 vs 0.20; P = .004). These effects did not vary based on patient or cardiologist race or sex. We found no arm differences for open-ended questions or reflective statements and were unable to assess differences in patient ratings due to ceiling effects. CONCLUSIONS AND RELEVANCE: In this randomized clinical trial, a communication coaching intervention improved 2 key communication behaviors: expressing empathy and eliciting questions. Empathic communication is a harder-level skill that may improve the patient experience and information comprehension. Future work should explore how best to assess the effect of communication coaching on patient perceptions of care and clinical outcomes and determine its effectiveness in larger, more diverse samples of cardiologists. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03464110.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

JAMA Intern Med

DOI

EISSN

2168-6114

Publication Date

June 1, 2023

Volume

183

Issue

6

Start / End Page

544 / 553

Location

United States

Related Subject Headings

  • Patients
  • Middle Aged
  • Mentoring
  • Male
  • Humans
  • Female
  • Empathy
  • Communication
  • Cardiologists
  • 4203 Health services and systems
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Pollak, K. I., Olsen, M. K., Yang, H., Prose, N., Jackson, L. R., Pinheiro, S. O., … Johnson, K. S. (2023). Effect of a Coaching Intervention to Improve Cardiologist Communication: A Randomized Clinical Trial. JAMA Intern Med, 183(6), 544–553. https://doi.org/10.1001/jamainternmed.2023.0629
Pollak, Kathryn I., Maren K. Olsen, Hongqiu Yang, Neil Prose, Larry R. Jackson, Sandro O. Pinheiro, T Kayla Dunbar, and Kimberly S. Johnson. “Effect of a Coaching Intervention to Improve Cardiologist Communication: A Randomized Clinical Trial.JAMA Intern Med 183, no. 6 (June 1, 2023): 544–53. https://doi.org/10.1001/jamainternmed.2023.0629.
Pollak KI, Olsen MK, Yang H, Prose N, Jackson LR, Pinheiro SO, et al. Effect of a Coaching Intervention to Improve Cardiologist Communication: A Randomized Clinical Trial. JAMA Intern Med. 2023 Jun 1;183(6):544–53.
Pollak, Kathryn I., et al. “Effect of a Coaching Intervention to Improve Cardiologist Communication: A Randomized Clinical Trial.JAMA Intern Med, vol. 183, no. 6, June 2023, pp. 544–53. Pubmed, doi:10.1001/jamainternmed.2023.0629.
Pollak KI, Olsen MK, Yang H, Prose N, Jackson LR, Pinheiro SO, Dunbar TK, Johnson KS. Effect of a Coaching Intervention to Improve Cardiologist Communication: A Randomized Clinical Trial. JAMA Intern Med. 2023 Jun 1;183(6):544–553.

Published In

JAMA Intern Med

DOI

EISSN

2168-6114

Publication Date

June 1, 2023

Volume

183

Issue

6

Start / End Page

544 / 553

Location

United States

Related Subject Headings

  • Patients
  • Middle Aged
  • Mentoring
  • Male
  • Humans
  • Female
  • Empathy
  • Communication
  • Cardiologists
  • 4203 Health services and systems