Residents' Communication Skills and Patient-Centered Care: An Eight- year Observational Study from Lebanon

Communication skills (CS) are essential in residency training. Several accreditation bodies consider CS a core competency. Direct observational studies evaluating patient centered communication is lacking in the Middle East. This study aims to explore the performance of residents in the Family Medicine Department (FMD) at the American University of Beirut Medical Center (AUBMC) in communication skills, with a focus on adopting a patient-centered approach.

We reviewed a total of 390 evaluations of FM residents based on real time observation via closed-circuit television (CCTV). Monitoring via CCTV occurred from a room adjacent to the consultation rooms used by residents. The evaluations were conducted using a validated CS assessment form. Descriptive and comparative analyses were performed.

Fifty-nine Family Medicine (FM) residents were evaluated by 20 faculty members. The checklist demonstrated good internal reliability, with a Cronbach's alpha of 0.784. Residents performed best in opening interviews with a mean score of 97.4% and a standard deviation (SD) of 11.8. A high score was also noted in explaining diagnoses and management plans with a mean score of 90.5 and SD of 16.5. Scores below 50% were observed in areas related to patient-centered approaches and addressing patients' emotions. No decline in empathy-related communication behaviors was observed across residency levels. A gender difference was identified among third-year female residents interviewing female patients.

There is a need to enhance teaching activities that focus on patient-centered approaches and addressing emotions, while also considering gender-related cultural dynamics.