|Talking With Your Doctor | The P.A.C.E Framework | Patient-Doctor Communication in Childbearing Years|
A wealth of evidence shows that patients have difficulty communicating with their doctors. Change can be realized through enhancement of communication skills and support to encourage and facilitate the use of these skills.
"Talking with Your Doctor" is an interactive workshop series that aims to help citizens communicate more effectively with their doctors. This project was developed to assist seniors, mental health clients and stroke recovery patients with Informed and Shared Decision Making and the PACE framework to improve their health care. The centerpiece of the workshops are trigger videos which illustrate a common patient-doctor encounter. In the videos patients use the PACE framework to resolve a communication problem. The videos are short (about 5 minutes) and have pauses after each scene to allow for group discussion. The Patient Voices Network and Langara College School of Nursing have adopted our workshop model and, with our support and workshop materials, facilitate workshops with various community groups across Lower Mainland BC.
Patient Voices Network (PVN) Pilot Project (August 2010 - March 2011)
The Division of Health Care Communication in partnership with the Patient Voices Network, an initiative of Impact BC, trained a group of PVN members to facilitate 'Talking with Your Doctor and other Health Care Professionals' workshops. PVN facilitators delivered workshops in pairs across Vancouver and the Lower Mainland. Program evaluation showed participants had increased confidence in talking with their doctor following the workshop and the program could be broadly implement across BC by training of workshop facilitators via the Patient Voices Network.
Parntership with Langara School of Nursing
Since 2005, the Division of Health Care Communication has partnered with the Langara school of Nursing to offer 'Talking with Your Doctor' workshops to senior citizens in the community. Senior level nursing students learn workshop facilitation and program evaluation skills as part of a 3rd year Health Promotion and Community Development course. The students practice these skills by facilitating 'Talking with Your Doctor' sessions in the community.
Lead project coordinators and collaborators include: Vera Etches, Medical Student-1997; Niriksha Chand, Medical Student-1999; Amanda LaMarre, Psychology Student-2001; Holly Wiesinger, Medical Student-2001, Jennifer Manklow, Medical Student-2001; Julia Ridley, Medical Student-2002; Janel Casey, Medical Student-2003; Carolyn Saunders, Midwifery Student- 2003-04; Lucinda McQuarrie, Medical Student-2004; Asia Salo, Midwifery Student- 2004-05
Quick Links to Documents and Reports
Webinar: for PainBC Webinar Series, Chronic Pain: Improving Life While Living It, "Talking with your Doctor and other Heathcare Professionals". William Godolphin, Angela Towle
Manual: P.A.C.E Manual for Facilitators
Booklet: "Talking With Your Doctor... and other Healthcare Professionals". by Donald J. Cegala. Modified, with permisison, for a project of the Patient Voices Network and UBC Division of Health Care Communication.
Poster: "Enabling Seniors to Overcome Barriers in Health Care Communication". William Godolphin, Angela Towle, Sheila Dyer, Donald Cegala, Jennifer Manklow, Holly Wiesinger, and Lionsview Seniors Planning Society.
Poster: "Seniors' Perceptions of Doctor-patient Communications Skills. A Follow up Study to Communication Skills Workshops in the Community." Jennifer Manklow, Holly Wiesinger, Angela Towle, William Godolphin & Lionsview Seniors' Planning Society.
Poster: What do Patients do with Evidence Based Information? A randomized control trial. William Godolphin, Angela Towle, James McCormack, Robert Rangno, Rachel McKendry, and Lionsview Seniors' Planning Society.
Article: Kline, C., Saunders, C. P.A.C.E Yourself! Talking with Your Doctor. In A Nutshell 2005; Spring: 1-2, 18.
Talking With Your Doctor: Community Workshops has received support from the following sponsors: BC Medical Services Foundation (1996-2001, 2003-2004); Max Bell Foundation (1998-2001); UBC Summer Career Placement Project (1999); UBC Faculty of Medicine Summer Student Research Program (1997, 1999, 2001-2005); UBC Teaching and Learning Enhancement Fund (1996-1997, 2000-2001); Vancouver Foundation (2000-2003)
Communicating With Your Doctor:
Often communicating with a physician can be difficult. The Division has created a number of workshops for different populations including seniors, stroke survivors, adolescents and parents in the child-bearing years. These workshops aim to improve communication between patients and their doctors allowing patients to get more out of their visits. Workshops utilize the P.A.C.E framework.
The PACE framework was developed by Dr. Donald Cegala at the University of Ohio as an easy way for patients to ensure they are taking their share of the responsibility for good communication in the doctor-patient relationship. Dr. Cegala evaluated the effectiveness of the PACE Strategies and found that patients who have been trained to use the PACE communication skills get more information from their doctor and promote patient-physician partnership.
detailed information about how you are feeling. questions if desired information is not provided. your understanding of information that is given to you. any concerns about the recommended treatment.
detailed information about how you are feeling.
questions if desired information is not provided.
your understanding of information that is given to you.
any concerns about the recommended treatment.
The information the patient gives to the doctor about their symptoms, lifestyle, values and family history provide the basis from which doctors must make their diagnosis and recommend treatment options. Berfore your appointment, prepare to present detailed inormation to your doctor. Some people find it helpful to write a list of their questions or track their symptoms in a journal.
Patients typically don’t ask their doctors very many questions, even though virtually all patients claim they want as much information as possible. Patients can ask questions, not only to solicit information from their doctor but also to get their doctor to do something for them. For example, a patient may ask “ What are the side effects of this medication?” or they may ask “ Could you refer me to a specialist?”
It is important that patients verify the information their doctors give them. They can do this by asking for clarification (e.g. Did you mean I should take only half a tablet a day?), by requests for repetition of information (e.g. Please tell me the name of that test again), or by summarizing what the doctor has said.
Sometimes patients may have concerns or fears about a particular treatment. It is important that patients be honest with their doctor about any concerns they have. With any condition there are usually many different treatment options. By expressing your concerns you can works with your doctor to find the treatment that best meets your needs.
Quick Links to Publications and Presentations
- Presentation: "Talking with Your Doctor" - Talk to Your Doc. William Godolphin, Donald J Cegala, Carolyn Saunders, Catherine Kline, Angela Towle.
- Publication: "P.A.C.E. Yourself! Talking with your Doctor" - P.A.C.E. yourself! Talking with your doctor. Catherine Kline and Carolyn Saunders.
- P.A.C.E. Facilitator Manual - Talking with your doctor: A manual for facilitators.
This research project built on the Division's previous work to promote better health outcomes and self care through better patient-doctor communication. In a project similar to the Talking With Your Doctor workshops for seniors, Stroke Survivors and Mental Health clients, the "Patient-Doctor cummunication in Childbearing years" project looked at completing a needs assessment for prenatal clients in the hopes of adapting the workshop to the unique needs of prenatal clients.
The prenatal period provides a unique opportunity to improve client involvement in health care decision-making because many women and their partners actively seek out learning opportunities during this time, namely by attending prenatal classes. The outcome of the birth, and a client's perception of her decision-making power in the birth process can determine how she and her family relates to future health care practitioners.
Lead project coordinators and Collaborators include: Lindsay Van Tongren, Medical Student- 2005; Amanda Lai, Medical Student-2005
Quick Links to Publications and Presentations
Report: Enabling Prenatal Clients to Overcome Barriers in Health Care Communication - Aisia Salo, Lucinda McQuarrie, Carolyn Saunders, William Godolphin and Angela Towle
Report: Use of the Internet by Prenatal Patients for Health Information and its Consequences - Lindsay Van Tongeren, Amanda Lai, Williamm Godolphin & Angela Towle.
Poster: Use of the Internet by Prenatal Patients for Health Information and its Consequences Lindsay Van Tongeren,Amanda Lai, William Godolphin & Angela Towle.
Detailed Project Description
The prenatal period presents an excellent opportunity to enhance the ability of clients to communicate with health professionals to improve client involvement in health care decision making about childbirth.
If a woman and her partner feel empowered to take responsibility for their care and view their active role in decision-making as essential to the doctor-patient relationship then they may be more likely to bring this perspective to their future interactions with health care professionals. Prenatal classes are an opportunity to enhance client's communication skills by encouraging and facilitating the use of those skills during the prenatal and postpartum period. This project used a collaborative approach which attempted to incorporate a module on doctor-client communication into existing prenatal classes. By promoting self-care and active patient participation this project could have lasting implications for changing clients' communication behaviors.
The goals of this project were to:
- Evaluate prenatal classes for their coverage of health care communication skills.
- Identify the gaps in current prenatal classes in regards to communication skills.
- Conduct a needs assessment with prenatal clients and prenatal class instructors to identify particular communication difficulties and to respond to potential barriers.
- Investigate the experiences, views and feelings of women and their partners around communicating with their health care provider(s).
- Explore and describe the process of parental decision-making during the prenatal period and identify examples of decision-making challenges.
Project Outcomes can be seen in the reports above in the Quick Links section
Patient-Doctor Communication in the Childbearing Year has received support from the following sponsors: UBC Faculty of Medicine Summer Student Research Program (2004-2005)