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Background: Efficient and effective doctor-patient consultations have been extensively linked to many positive patient outcomes. Aims: This project addressed the following research questions: Are junior doctors using effective consultation skills with their patients in the clinical setting and what do their patients think? How confident are junior doctors in their ability to perform effective consultations? What factors influence the teaching, learning and subsequent practice of consultation skills for junior doctors and other clinicians? Research Methods: This mixed-methods project encompassed 3 interlinked studies. • Study 1 used a parallel questionnaire to investigate junior (Foundation) doctors’ and patients’ assessments of a shared consultation. In addition, two selfefficacy scales (before and after consultation) were completed by the doctors. • Study 2 explored the perspectives of junior doctors in more depth via semistructured interviews. • Study 3 used an online questionnaire to elicit the perspectives of more experienced clinicians. Results: Patients scored doctors significantly higher than doctors scored themselves on the consultation skills questionnaire, and male junior doctors scored themselves significantly higher than females. Doctors’ self-efficacy was high: male doctors scored higher than females and those in their last training rotation scored the highest. Interview data suggested that self-efficacy was affected by the junior doctors’ perception of their ‘role’ within the clinical context and their medical knowledge. Consultation skills training and practice were affected by the doctors’ inherent personality traits and aspects of the learning/clinical context to produce incremental progression of learning. Experienced clinicians reported similar factors as influencing their training, practice and self-efficacy. Conclusions: In this project, effective consultation skills were used confidently by junior doctors and experienced positively by their patients. Many variables about the clinical context, the doctors and their patients interplayed to affect the way that consultation skills were learnt and subsequently practiced by both junior and more senior clinicians. |
