Online Program

Reflection about communication behaviors with patients: Evidence for reflective practice as a cornerstone for patient-centered care

Monday, November 4, 2013

Ashley P. Duggan, PhD, Communication Department, Boston College, Chestnut HIll, MA
Randi Sokol, MD, MPH, Malden Family Medicine Residency, Cambridge Health Alliance, Malden, MA
Jessica Early, MD, Department of Family Medicine, Cambridge Health Alliance, Malden, MA
Julie Wojno, Communication Department, Boston College, Chestnut Hill
Katherine Donahue, Communication Department, Boston College, Chestnut Hill, MA
Lucas Allen, Communication Department, Boston College, Chestnut Hill, MA
Iliana Swick, Communication Department, Boston College, Chestnut Hill, MA
Allen Shaughnessy, PharmD, Department of Family Medicine, Cambridge Health Alliance, Malden, MA
Although ongoing research documents the relationship between physicians' communication behavior and better health outcomes, best practices for understanding and teaching communication continue to unfold. This investigation introduces reflective practice as a way for family medicine residents to pay attention to their own and their patients' verbal and nonverbal messages in healthcare interactions. Family medicine residents (N= 24) were provided time and required to complete three reflective exercises per week for one year. The exercises were intentionally left as opportunity for reflection without more specific goals for how the reflection would be used. We termed these reflective exercises “clinical blogs” since they were entered into a web-based computer portfolio, though they were not available to the general public. This study examines reflection about communication behaviors in family medicine residents' written reflections over the course of the full year. Through grounded-theory based qualitative analysis, the authors identify and describe themes in the ways family medicine residents write about their own and their patients' communication behavior. Identified themes include 1) recognizing the ways physician behavior influences subsequent patient behavior and disclosure, 2) learning to pay attention to the subtleties of patient behavior that provides a fuller picture of their life and their coping with illness, and 3) integrating images of growth and awareness as connected to reflection about communication. Identified themes provides evidence for the ways ongoing experience with reflection can aid physicians' awareness of the ways they respond to (or miss) subtle but important cues from patients.

Learning Areas:

Communication and informatics
Social and behavioral sciences

Learning Objectives:
Explain the ways reflection about communication can contribute to quality and process of healthcare. Describe the potential for reflective practice to enhance a provider’s ability to produce patient-centered communication. Describe themes in reflective practice about communication. Identify the ways physicians’ reflective practices can be developed.

Keyword(s): Physicians, Quality of Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because my research area is health communication; I develop and integrate research methods for evaluating communication behaviors in reflective practice exercises. I am also an Associate Professor in Communication and Family Medicine.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.