Effectiveness of training parents of beta thalassemia patients in improving medical student-patient communication: a developing country-perspective

Background: Patients and parents with long standing medical problems attending health care facilities over long periods on a regular basis come across medical students repeatedly. A conversation with untrained medical students is perceived as a strain by some patients mainly because they do not understand reasons for some parts of the conversation. Therefore understanding about the process of communication by patients/parents of children has considerable potential benefit to patients themselves. Once the process of the history taking is understood, patient will develop the capacity to provide more meaningful feedback to students.

Objectives: To assess parents’ satisfaction of medical students’ history taking behaviour and medical students’ perception of outcomes following training of parents/patients with thalassaemia major in communication skills based on Calgary-Cambridge communication model.

Method: Twenty six final year medical students were assessed quantitatively and qualitatively regarding their history taking experience with twenty six patients having thalassaemia major and their parents at pre-intervention stage. The parents of these children consented for enrolment in a communication skills training programme based on Calgary-Cambridge Communication Model. Each student was permitted to engage with the same patient over the next fortnight subsequent to the intervention. Quantitative evaluation was repeated after a fortnight. Wilcoxon signed rank test was utilised for identifying statistical significance.

Results: Concerning skills perception (self-reporting) in selected communication components, medical students scored the following before and after intervention: ability to engage with patients (69%, 97.5%, p<0.001), talking with patients (60%, 93%, p<0.001), discussing psychological issues (67%, 95.5%, p<0.001), discussing socio-economic issues (63%, 95.5%, p<0.001), physical examination (75%, 76%, p>0.05), giving information (80.5%, 82%, p>0.05), giving advice (73%, 73%, p>0.05), learning from patients (83%, 97.5%, p<0.05), and obtaining feedback from parents (70.6%, 89%, p<0.05).

Conclusions: Training of parents significantly improved medical students’ commitment to engaging and talking with thalassaemia patients, and discussing psychological and socioeconomic issues. It was associated with increased commitment to learning and obtaining feedback from parents.

Sri Lanka Journal of Child Health, 2020; 49(4): 369-374