Three strategies when physicians provide complex information in interactions with patients: How to recognize and measure them.

Abstract

To define and operationalize three taught strategies for providing information in interactions with patients using videos collected in a randomized controlled trial (RCT). This was a qualitative exploratory study embedded in a randomized controlled design, using microanalysis of face-to-face dialogue as an inductive video analysis method to operationalize physicians' use of three information-provision strategies. Data were 34 video-recorded simulated (but unscripted) interactions between 17 physicians and 34 multiple sclerosis patients collected before and after a brief course on information provision. We operationalized (1) mapping the patient's preferences and (2) checking the patient's understanding, and pauses indicative of (3) portioning information. Results are detailed analytical definitions, criteria, and assessable, quantifiable outcomes for each of the three strategies. Patients responded to portioning pauses as expected: whereas 91% of these pauses elicited an immediate patient response, only 23% of non-portioning pauses did so. Our methods revealed how to define and evaluate information sharing strategies physicians used within the contingencies of clinical interaction. Findings provide applicable methods to teach, analyze, and evaluate information sharing strategies and indications for further training.