Dietitians’ Perceptions of Developing Best Practice in Communication Skills.
Loading...
Date
2014-07
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Background: The communication skills of health care practitioners, such as Registered
Dietitians (RDs) are increasingly recognised as fundamental to patient care and monitoring
the effectiveness of these skills is recommended [1,2]. The aim of this study was to
explore experienced RDs views on best practice in relation to the use of communication
skills for behaviour change (CSBC) and the assessment of these skills in practice.
Methods: This qualitative study recruited eight RDs from the East Midlands and Yorkshire
to participate in semi-structured interviews. The study was part of a larger mixed methods
study which developed and validated a tool for the assessment of CSBC in dietetic
consultations, DIET-COMMS. The details of sampling, recruitment, ethics and research
methods including data collection, data management and data analysis have been
reported elsewhere [3]. Participants had viewed and assessed 20 video recorded mock
dietetic consultations. This study is a preliminary report of their opinions of those
consultations, the importance of CSBC in dietetics, what best practice is and possible
methods for professional development in this area. Interviews were transcribed verbatim
and subject to inductive thematic analysis.
Results: Preliminary analysis identified three main themes. Theme 1: Concern about
consultations viewed. Although there was great variation, participants were disappointed and sometimes ‘shocked’ by the poor skill level observed in some consultations. They felt
passionately that RDs should be highly skilled in CSBC throughout patient consultations to
be effective. Theme 2: Communication skill development and assessment: ready or not?
Participants felt that post-registration training and assessment of CSBC was desirable
throughout the profession at all levels and in all specialities but they had strong
reservations about the acceptability of this and perceived it needed to be ‘handled very
sensitively’. Theme 3: Knowledge versus communication skills: one or the other or both?
This theme related to the development and use of knowledge and/or CSBC. Participants
perceived that knowledge was more highly valued and CSBC sometimes neglected. Poor
ability to implement CSBC throughout the whole patient consultation was observed and
thought to have a negative effect on patient dietitian relationships and patient outcomes.
Discussion: Despite concerns at some of the communication skills viewed participants
were still not overwhelmingly supportive of radical action such as regular, compulsory
assessment in practice. Concern for how RDs would ‘feel’ about assessment was stronger
than concern about the effectiveness and outcomes of consultations. Theme 3 suggests
that participants recognise that both knowledge and skills are important but observed a
lack of ability to use CSBC beyond ascertaining the patients’ reason for attending the
consultation. This suggests a need to support RDs to integrate these skills throughout the
consultation for optimal effectiveness and patient outcomes. Post-registration training and
development of these skills, including tailored assessment, may be beneficial, if
challenging to implement. A change in the behaviour of RDs may be necessary in order to
facilitate more behaviour change in their patients.
Conclusion: Although it may be challenging to implement in practice, the development
and assessment of CSBC in RDs post-registration is an area for improvement in dietetics.
Description
Keywords
Communication skills, behaviour change, interviews, dietitians, assessment, qualitative
Citation
Whitehead K A, Langley -Evans S C, Tischler V, Swift J A. Dietitians’ Perceptions of Developing Best Practice in Communication Skills. European Journal of Nutrition & Food Safety. 2014 Jul-Sept; 4(3): 206-207.