Better clinical communication in hospital - a study of the effect of a Norwegian version of the "Four habits Approach to Effective Clinical Communication" in Akershus University Hospital

ISRCTN	ISRCTN22153332
DOI	https://doi.org/10.1186/ISRCTN22153332
Protocol serial number	Helse Øst RHF (Regional Authorities for Hospital Care, Eastern Norway) 2007 - 015
Sponsor	Regional Authorities for Hospital Care, Eastern Norway (Helse Øst RHF)
Funder	Regional Authorities for Hospital Care, Eastern Norway (Helse Øst RHF) (ref: 2007 - 015)

Submission date: 23/04/2007
Registration date: 12/06/2007
Last edited: 21/12/2011

Recruitment status: No longer recruiting
Overall study status: Completed
Condition category: Other

Prospectively registered

Protocol

Statistical analysis plan

Results

Individual participant data

Plain English summary of protocol

Not provided at time of registration

Contact information

Prof Pål Gulbrandsen
Scientific

Helse Øst Health Services Research Centre
Mail drawer 95
Akershus University Hospital
Lørenskog
1478
Norway

Phone	+47 (0)67 929461
Email	pal.gulbrandsen@ahus.no

Study information

Primary study design	Interventional
Study design	Randomised controlled trial.
Secondary study design	Randomised controlled trial
Scientific title
Study acronym	4HN
Study objectives	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(s)	The Regional Ethics Committee for Medical Research of East Norway gave approval on the 13th April 2007 (ref: 1.2007.356)
Health condition(s) or problem(s) studied	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
Primary outcome measure(s)	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.
Key secondary outcome measure(s)	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
Completion date	31/03/2010

Eligibility

Participant type(s)	Patient
Age group	Adult
Sex	All
Target sample size at registration	64
Key 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.
Key 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)
Date of first enrolment	13/04/2007
Date of final enrolment	31/03/2010

Locations

Countries of recruitment

Norway

Study participating centre

Helse Øst Health Services Research Centre

Lørenskog
1478
Norway

Results and Publications

Individual participant data (IPD) Intention to share	No
IPD sharing plan summary	Not provided at time of registration
IPD sharing plan

Study outputs

Output type	Details	Date created	Peer reviewed?	Patient-facing?
Results article	results of substudy on self-efficacy among doctors in hospitals after a course in clinical communication	19/11/2009	Yes	No
Results article	results on confirmation of informed consent by SMS	01/02/2010	Yes	No
Results article	results	01/08/2011	Yes	No