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Table 2 Communication skills training of included studies (n = 19, ordered by study time)

From: The impact of training healthcare professionals’ communication skills on the clinical care of diabetes and hypertension: a systematic review and meta-analysis

Study

Conceptual frameworks or theory for interventions

Training content

Training types

Number of sessions

Training evaluation reported before trials

Kinmonth 1998

Action research

Training aimed patient centred care. The first half day was to review the evidence for patient centred consulting and a further full day was to practice skills with a facilitator, including active listening and negotiation of behavioural change.

Lectures, group discussions

1.5 days

Yes

Brug 2007

NA

Training aimed motivational interviewing (MI). The first day was to introduce MI theory and principles and the second day was to practice MI skills. Another one-day follow-up workshop for discussing experiences with experts and refresh knowledge. Training was developed and conducted by authors.

Workshop

3 days

No

Rubak 2009

NA

Training aimed motivational interviewing. A book was used to guide specific skills e.g. empowerment, ambivalence, the decisional balance schedule, the visual analogue scale, stage of change, and reflective listening. The courses consisted of a 1½-day training sessions with a half-day follow-up twice. Training was conducted by only one trained teacher.

NA

2.5 days

No

Sequist 2010

NA

Training aimed cultural competency. Training goals included understanding attitudes of trust and bias, increasing knowledge about health disparities and skills. The curriculum reviewed potential racial and cultural biases in health care, appropriate methods of collecting clinically relevant cultural data, and ways to incorporate such information into effective clinical care plans for diabetes.

Lectures, group discussions, community engagement activities

2 days

No

Heinrich 2010

NA

Training aimed motivational interviewing. Trainees received a project folder with information about the study, training material (e.g. cases for role-playing), background information about MI. Trainees received instruction charts specifying counselling techniques. Trainees were visited three times after being trained.

Role play, discussions, audio-taped consultations feedback

21.5 h

No

Rubak 2011

NA

Training aimed motivational interviewing. Training was conducted by a trained teacher. Training included specific skills, e.g. empowerment, ambivalence, the decisional balance schedule, the visual analogue scale, stage of change, and reflective listening.

NA

2.5 days

No

Robling 2012

Medical Research Council (MRC) framework

Training aimed constructive consultations (Talking Diabetes).Training emphasized shared setting of agendas and a guiding communication style, strategies and skills drawn from motivational interviewing practice.

Role play, web based modules, work shop, case studies

2 days

Yes

Farmer 2012

Theory of Planned Behaviour

Training aimed theory of planned behaviour. These included perceived benefits and harms of taking medicines. Positive beliefs were reinforced verbally and non-verbally through provision of tailored information and problem solving was facilitated around negative beliefs.

Audio-taped consultations feedback

1 day

Yes

Welschen 2012

Leventhal’s self-regulation theory,Theory of Planned Behavior

Training aimed cardiovascular disease risk communication. This included communication of the absolute risk, visual communication, message framing, communication with the patient for a reaction.

NA

1 day

No

Jansink 2013

NA

Training aimed motivational interviewing and agenda setting. This included building motivation for change, asking open questions, listening reflectively, affirming, summarizing, eliciting change, expressing empathy, developing discretion, rolling with resistance and supporting self-efficacy. Training were spread equally over 6 months.

Video recording feedback

2 days

Yes

Tinsel 2013

NA

Training aimed shared decision making (SDM) and motivational interviewing. This included risk communication, the process steps of SDM, introduction of a decision table with options.

Role play

NA

Yes

Juul 2014

Self-determination theory

Training aimed self-determination theory. This included patient-health care provider relationships, communication skills, patient worksheets, implementation of the course content in daily practice.

NA

2 days

Yes

Ma 2014

Social cognitive theory

Training aimed motivational interviewing and social cognitive theory. Training was presented by a certified trainer. Training included building rapport with the patients, evaluating the patients’ confidence and motivation for behaviour changes, helping change patients behaviours and so on.

Lectures, role play, discussions

3 days

Yes

Manze 2015

NA

Training aimed patient-centered counseling and cultural competency training. Training was led by experts in medicine and patient-centered counseling. Training includes implementing 5 A's: ask the patient about their BP management, assess their medication adherence, advise the patient about pharmacologic treatment, assist them in overcoming barriers to treatment adherence and arrange for follow-up. The cultural competency training included understanding patients, their social and financial risks for non-adherence, their fears and concerns.

Role play, work shop

2 sessions

No

Kressin 2016

NA

Training aimed patient-centered counseling. Training was led by an experienced trainer. Training includes implementing 4 A's: ask about patients’ hypertension beliefs, assess patients’ prior experiences in changing behaviors, assist patients in making needed changes, and address relapse.

Role play, discussions

2 h

Yes

Okada 2017

NA

Training aimed modified motivational interviewing. Training was based on empowerment or coaching-style communication, including: using an open question, setting each goal with patients, and closing with encouragement.

NA

4 h

No

Akturan 2017

NA

Training aimed BATHE interview (Background, Affect, Troubling, Handling, and Empathy). Training was evaluated by researchers. Trainees were asked to use the BATHE technique on their patients 3 times, with 3-month intervals.

Role play

3 h

No

Belin 2017

NA

Training aimed patient-centered counseling. Training was led by a doctor specialist. Trainees were used open-ended questions to identify the needs, barriers, patient beliefs, and ideas consistent with the patient centered counseling approach. Trainees identified that poor patient–provider communication and improved communication skills. Training was conducted using a training package and a self-assessment checklist.

Focus-group discussion, workshop

5 sessions

No

Ismail 2018

NA

Training aimed six psychological skills. The six skills were drawn from MI and CBT, including: active listening; managing resistance; directing change; supporting self-efficacy; addressing health beliefs and shaping behaviours.

NA

NA

Yes

Kinmonth 1998

Action research

Training aimed patient centred care. The first half day was to review the evidence for patient centred consulting and a further full day was to practice skills with a facilitator, including active listening and negotiation of behavioural change.

Lectures, group discussions

1.5 days

Yes

Brug 2007

NA

Training aimed motivational interviewing (MI). The first day was to introduce MI theory and principles and the second day was to practice MI skills. Another one-day follow-up workshop for discussing experiences with experts and refresh knowledge. Training was developed and conducted by authors.

Workshop

3 days

No

Rubak 2009]

NA

Training aimed motivational interviewing. A book was used to guide specific skills e.g., empowerment, ambivalence, the decisional balance schedule, the visual analogue scale, stage of change, and reflective listening. The courses consisted of a 1.5 day training sessions with a half-day follow-up twice. Training was conducted by only one trained teacher.

NA

2.5 days

No

Sequist 2010

NA

Training aimed cultural competency. Training goals included understanding attitudes of trust and bias, increasing knowledge about health disparities and skills. The curriculum reviewed potential racial and cultural biases in health care, appropriate methods of collecting clinically relevant cultural data, and ways to incorporate such information into effective clinical care plans for diabetes.

Lectures, group discussions, community engagement activities

2 days

No

Heinrich 2010

NA

Training aimed motivational interviewing. Trainees received a project folder with information about the study, training material (e.g., cases for role-playing), background information about MI. Trainees received instruction charts specifying counselling techniques. Trainees were visited three times after being trained.

Role play, discussions, audio-taped consultations feedback

21.5 h

No

Rubak 2011

NA

Training aimed motivational interviewing. Training was conducted by a trained teacher. Training included specific skills, e.g., empowerment, ambivalence, the decisional balance schedule, the visual analogue scale, stage of change, and reflective listening.

NA

2.5 days

No

Robling 2012

Medical Research Council (MRC) framework

Training aimed constructive consultations (Talking Diabetes). Training emphasized shared setting of agendas and a guiding communication style, strategies and skills drawn from motivational interviewing practice.

Role play, web-based modules, workshop, case studies

2 days

Yes

Farmer 2012

Theory of Planned Behaviour

Training aimed theory of planned behaviour. These included perceived benefits and harms of taking medicines. Positive beliefs were reinforced verbally and non-verbally through provision of tailored information and problem solving was facilitated around negative beliefs.

Audio-taped consultations feedback

1 day

Yes

Welschen 2012

Leventhal’s self-regulation theory, theory of planned behavior

Training aimed cardiovascular disease risk communication. This included communication of the absolute risk, visual communication, message framing, communication with the patient for a reaction.

NA

1 day

No

Jansink 2013

NA

Training aimed motivational interviewing and agenda setting. This included building motivation for change, asking open questions, listening reflectively, affirming, summarizing, eliciting change, expressing empathy, developing discretion, rolling with resistance, and supporting self-efficacy. Training was spread equally over 6 months.

Video recording feedback

2 days

Yes

Tinsel 2013]

NA

Training aimed shared decision making (SDM) and motivational interviewing. This included risk communication, the process steps of SDM, introduction of a decision table with options.

Role play

NA

Yes

Juul 2014

Self-determination theory

Training aimed self-determination theory. This included patient-health care provider relationships, communication skills, patient worksheets, implementation of the course content in daily practice.

NA

2 days

Yes

Ma 2014

Social cognitive theory

Training aimed motivational interviewing and social cognitive theory. Training was presented by a certified trainer. Training included building rapport with the patients, evaluating the patients’ confidence and motivation for behaviour changes, helping change patients behaviours and so on.

Lectures, role play, discussions

3 days

Yes

Manze 2015

NA

Training aimed patient-centered counseling and cultural competency training. Training was led by experts in medicine and patient-centered counseling. Training includes implementing 5 A's: ask the patient about their BP management, assess their medication adherence, advise the patient about pharmacologic treatment, assist them in overcoming barriers to treatment adherence and arrange for follow-up. The cultural competency training included understanding patients, their social and financial risks for non-adherence, their fears and concerns.

Role play, workshop

2 sessions

No

Kressin 2016

NA

Training aimed patient-centered counseling. Training was led by an experienced trainer. Training includes implementing 4 A's: ask about patients’ hypertension

beliefs, assess patients’ prior experiences in changing behaviors, assist patients in making needed changes, address relapse.

Role play, discussions

2 h

Yes

Okada 2017

NA

Training aimed modified motivational interviewing. Training was based on empowerment or coaching-style communication, including using an open question, setting each goal with patients, and closing with encouragement.

NA

4 h

No

Akturan 2017

NA

Training aimed BATHE interview (Background, Affect, Troubling, Handling, and Empathy). Training was evaluated by researchers. Trainees were asked to use the BATHE technique on their patients 3 times, with 3-month intervals.

Role play

3 h

No

Belin 2017

NA

Training aimed patient-centered counseling. Training was led by a doctor specialist. Trainees were used open-ended questions to identify the needs, barriers, patient beliefs, and ideas consistent with the patient centered counseling approach. Trainees identified that poor patient–provider communication and improved communication skills. Training was conducted using a training package and a self-assessment checklist.

Focus-group discussion, workshop

5 sessions

No

Ismail 2018

NA

Training aimed six psychological skills. The six skills were drawn from MI and CBT, including: active listening; managing resistance; directing change; supporting self-efficacy; addressing health beliefs and shaping behaviours.

NA

NA

Yes

  1. NA: not available