Contact information
Type
Scientific
Primary contact
Prof Pål Gulbrandsen
ORCID ID
Contact details
Helse Øst Health Services Research Centre
Mail drawer 95
Akershus University Hospital
Lørenskog
1478
Norway
+47 (0)67 929461
pal.gulbrandsen@ahus.no
Additional identifiers
EudraCT number
ClinicalTrials.gov number
Protocol/serial number
Helse Øst RHF (Regional Authorities for Hospital Care, Eastern Norway) 2007 - 015
Study information
Scientific title
Acronym
4HN
Study hypothesis
The Four Habits Model describes the four patterns of behaviour used by clinicians during medical interviews (Frankel and Stein, 2001). Hypothesis: A 20-hour intensive course in effective clinical communication according to the "Four Habits" approach will significantly alter the communication skills of participating physicians.
Frankel and Stein, Getting the most out of the clinical encounter: the four habits model, J Med Pract Manage, 2001 Jan-Feb;16(4):184-91
Ethics approval
The Regional Ethics Committee for Medical Research of East Norway gave approval on the 13th April 2007 (ref: 1.2007.356)
Study design
Randomised controlled trial.
Primary study design
Interventional
Secondary study design
Randomised controlled trial
Trial setting
Hospitals
Trial type
Diagnostic
Patient information sheet
Condition
Clinical communication
Intervention
Participating physicians are given a 20-hour intensive course in clinical communication using the "Four habits" approach. 40 physicians will attend the training course in June 2007, and the other 40 physicians will attend the course in January 2008. For all physicians, two consultations/meetings will be recorded before the June course, four consultations/meetings will be recorded between the June and the January courses, and two consultations/meetings will be recorded after the January course for evaluation.
Intervention type
Other
Phase
Not Applicable
Drug names
Primary outcome measure
The videotaped consultations/meetings were assessed using the Four Habits Coding Scheme (Krupat et al, 2006).
Krupat E, Frankel R, Stein T, Irish J. The Four Habits Coding Scheme: validation of an instrument to assess clinicians communication behavior. Pat Educ Couns 2006; 62: 38-45.
Secondary outcome measures
1. Change in Habit 1 through 4 behaviours according to which habit the physicians particularly commit themselves to improve (physicians may want to implement all habits, but are prompted to give priority to one of them)
2. Changes in Habits in 20% of physicians with the lowest scores
3. Changes in Habits across age groups, gender, specialties, seniors/juniors
4. Change in physician communication specific self-efficacy
5. Change in patient satisfaction
Overall trial start date
13/04/2007
Overall trial end date
31/03/2010
Reason abandoned (if study stopped)
Eligibility
Participant inclusion criteria
Physicians under 60 years doing full or part-time clinical work in somatic departments of Akershus University Hospital. Altogether 8 real consultations or meetings with patients/relatives of patients per physician are recruited consecutively.
Participant type
Patient
Age group
Adult
Gender
Both
Target number of participants
64 physicians (512 consultations)
Participant exclusion criteria
None for physicians.
For consultations:
1. Anticipated consultation duration less than 5 minutes
2. Consultations or meetings with patients or relatives where they are in a particularly vulnerable situation and where videotaping would be inappropriate (e.g. when conveying serious messages)
Recruitment start date
13/04/2007
Recruitment end date
31/03/2010
Locations
Countries of recruitment
Norway
Trial participating centre
Helse Øst Health Services Research Centre
Lørenskog
1478
Norway
Sponsor information
Organisation
Regional Authorities for Hospital Care, Eastern Norway (Helse Øst RHF)
Sponsor details
PO Box 404
Hamar
2301
Norway
+47 (0)62 585500
postmottak@helse-ost.no
Sponsor type
Government
Website
Funders
Funder type
Government
Funder name
Regional Authorities for Hospital Care, Eastern Norway (Helse Øst RHF) (ref: 2007 - 015)
Alternative name(s)
Funding Body Type
Funding Body Subtype
Location
Results and Publications
Publication and dissemination plan
Not provided at time of registration
Intention to publish date
Participant level data
Not provided at time of registration
Basic results (scientific)
Publication list
1. 2009 results of substudy on self-efficacy among doctors in hospitals after a course in clinical communication in http://www.ncbi.nlm.nih.gov/pubmed/19935933 [in Norwegian]
2. 2010 results on confirmation of informed consent by SMS in http://www.ncbi.nlm.nih.gov/pubmed/20133410
3. 2011 results in http://www.ncbi.nlm.nih.gov/pubmed/21050695
Publication citations
-
Results on confirmation of informed consent by SMS
Gulbrandsen P, Jensen BF, Post-recruitment confirmation of informed consent by SMS., J Med Ethics, 2010, 36, 2, 126-128, doi: 10.1136/jme.2009.033456.
-
Results
Fossli Jensen B, Gulbrandsen P, Dahl FA, Krupat E, Frankel RM, Finset A, Effectiveness of a short course in clinical communication skills for hospital doctors: results of a crossover randomized controlled trial (ISRCTN22153332)., Patient Educ Couns, 2011, 84, 2, 163-169, doi: 10.1016/j.pec.2010.08.028.
-
Gulbrandsen P, Jensen BF, Finset A, [Self-efficacy among doctors in hospitals after a course in clinical communication]., Tidsskr. Nor. Laegeforen., 2009, 129, 22, 2343-2346, doi: 10.4045/tidsskr.09.0261.