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Analyzing communication skills of Pediatric Postgraduate Residents in Clinical Encounter by using video recordings
Attia Bari1, Rehan Ahmed Khan2, Uzma Jabeen3
1Dr. Attia Bari, MBBS, DCH, MCPS, FCPS. MHPE. Associate Professor of Pediatric Medicine, Department of Pediatric Medicine, The Children's Hospital and The Institute of Child Health, Lahore, Pakistan.
Objective:
To analyze communication skills of pediatric postgraduate residents in clinical encounter by using video recordings.
Methods:
This qualitative exploratory research was conducted through video recording at The Children's Hospital Lahore, Pakistan. Residents who had attended the mandatory communication skills workshop offered by CPSP were included. The video recording of clinical encounter was done by a trained audiovisual person while the resident was interacting with the patient in the clinical encounter. Data was analyzed by thematic analysis.
Results:
Initially on open coding 36 codes emerged and then through axial and selective coding these were condensed to 17 subthemes. Out of these four main themes emerged: (1) Courteous and polite attitude, (2) Marginal nonverbal communication skills, (3) Power game/Ignoring child participation and (4) Patient as medical object/Instrumental behaviour. All residents treated the patient as a medical object to reach a right diagnosis and ignored them as a human being. There was dominant role of doctors and marginal nonverbal communication skills were displayed by the residents in the form of lack of social touch, and appropriate eye contact due to documenting notes. A brief non-medical interaction for rapport building at the beginning of interaction was missing and there was lack of child involvement.
Conclusion:
Paediatric postgraduate residents were polite while communicating with parents and child but lacking in good nonverbal communication skills. Communication pattern in our study was mostly one-way showing doctor's instrumental behaviour and ignoring the child participation.
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