Table 1 The percentage of agreement among Family Physicians on Key Competencies and the competencies represented by each group of Key Competencies
Clinical Communication Skills (Key Competencies) | Group of Competencies (Fragments) (CCS)* | |||||||||||
1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | |
Communicate effectively according to given roles | 44% | 3% | 2% | 1% | 7% | 7% | 5% | 3% | 2% | 0% | 0% | 0% |
Establish a therapeutic and professional relationship | 4% | 1% | 42% | 0% | 2% | 0% | 1% | 0% | 0% | 5% | 0% | 0% |
Build a suitable relationship | 3% | 49% | 29% | 6% | 7% | 6% | 1% | 2% | 0% | 0% | 0% | 0% |
Involve the bio-psycho-social context | 1% | 0% | 0% | 7% | 2% | 8% | 0% | 2% | 0% | 0% | 2% | 84% |
Understand the perspective of the patient and his or her family | 2% | 1% | 3% | 63% | 6% | 2% | 5% | 2% | 6% | 0% | 2% | 11% |
Adapt communication according to the patient and his or her family | 18% | 5% | 3% | 3% | 1% | 71% | 8% | 2% | 2% | 0% | 3% | 0% |
Engage patients and families to share in decision-making | 3% | 27% | 9% | 10% | 11% | 0% | 10% | 0% | 0% | 5% | 63% | 0% |
Support decision-making based on the needs and interests of the patient | 1% | 8% | 8% | 7% | 13% | 3% | 15% | 4% | 0% | 79% | 12% | 5% |
Structure and organize communication/clinical interviews | 6% | 2% | 0% | 1% | 37% | 1% | 6% | 85% | 2% | 5% | 1% | 0% |
Inform patients and family adequately | 9% | 0% | 2% | 0% | 2% | 2% | 40% | 0% | 0% | 0% | 14% | 0% |
Communicate bad news appropriately | 5% | 0% | 0% | 2% | 0% | 2% | 4% | 0% | 87% | 0% | 0% | 0% |
None of the Key Competencies | 4% | 3% | 2% | 1% | 11% | 0% | 3% | 2% | 0% | 5% | 0% | 0% |
Group of Competencies (Fragments) (CCS)* | Competency (Fragments) | |||||||||||
1 | Communicate effectively with patients, families and the public | |||||||||||
Communicate effectively in wider roles including health advocacy, teaching, assessing and appraising. Communicate effectively about ethical issues with patients and family | ||||||||||||
Communicate effectively in various roles, for example, as patient advocate, teacher, manager or improvement leader | ||||||||||||
Uses effective and efficient communication and management strategies | ||||||||||||
Demonstrate by listening, sharing and responding, the ability to communicate clearly, sensitively and effectively with patients and their family/careers | ||||||||||||
Communicate clearly, sensitively and effectively with patients, their relatives or other carers, and colleagues from the medical and other professions, by listening, sharing and responding | ||||||||||||
Demonstrate by listening, sharing and responding, the ability to communicate clearly, sensitively and effectively with patients and their family/careers | ||||||||||||
2 | Building relationship (Using appropriate non-verbal behaviour, Developing rapport and Involving the patient) | |||||||||||
Shaping of relationship: involves the patient in the interaction using a patient-centered approach | ||||||||||||
Recognizes the patient as a partner in shaping a relationship | ||||||||||||
3 | Involves the patient in the interaction to establish a therapeutic relationship using a patient-centered approach. | |||||||||||
Relates to the patient respectfully including ensuring confidentiality, privacy and autonomy... | ||||||||||||
Establish professional therapeutic relationships with patients and their families | ||||||||||||
Create and sustain a therapeutic, ethical relationships with patients | ||||||||||||
4 | Gathering information (Exploration of patient’s problems and Additional skills for understanding the patient’s perspective) | |||||||||||
Encourage the patient to express own ideas, concerns, expectations and feelings and accepts legitimacy of patients views and feeling | ||||||||||||
Understand the Patient’s Perspective | ||||||||||||
5 | Gather information | |||||||||||
Information: effectively collects the relevant information for the reasoning and decision-making process | ||||||||||||
Effectively collects relevant information for reasoning and decision making | ||||||||||||
Initiating the session (Establishing initial rapport and Identifying the reason(s) for the consultation) | ||||||||||||
Open the Discussion | ||||||||||||
6 | Communication in the doctor–patient relationship: orients her communication behaviour along the actual concerns and the personality of the patient | |||||||||||
Social behaviour and communication: adapts her social behaviour and communication to different social contexts and communication partners. | ||||||||||||
Adapts own communication to the level of understanding and language of the patient, uses techniques aproppriates for this | ||||||||||||
7 | Explanation and planning (Providing the correct amount and type of information, Aiding accurate recall and understanding...) | |||||||||||
Information: effectively communicates the relevant information for the reasoning and decision-making process | ||||||||||||
Effectively communicates relevant information for reasoning and decision making. Gives information to the patient in a timely, comprehensive and meaningful manner | ||||||||||||
Elicit and synthesize accurate and relevant information, incorporating the perspectives of patients and their families | ||||||||||||
8 | Shapes a conversation from beginning to end with regard to structure (e.g. introduction, initiating the conversation, gathering and giving information, planning, closing interview, setting up next meeting; time management) | |||||||||||
Providing structure (Making organization overt And Attending to flow) | ||||||||||||
9 | Communicate appropriately with difficult or violent patients; people with mental illness and vulnerable patients//Communicate appropriately in difficult circumstances, such as when breaking bad news, and when discussing sensitive issues, such as alcohol consumption, smoking or obesity | |||||||||||
Recognizes difficult situations and communication challenges and deals with them sensitively and constructively | ||||||||||||
10 | ;...developing plans that reflect the patient’s health care needs and goals | |||||||||||
11 | Involve patients in decision-making and planning their treatment, including communicating risk and benefits of management options. | |||||||||||
Engage patients and their families... | ||||||||||||
Share information | ||||||||||||
Explanation and planning (Achieving a shared understanding: incorporating the patient’s perspective and Planning: shared decision making) | ||||||||||||
Share health care information and plans with patients and their families | ||||||||||||
12 | Elicits and explores the content of the patient’s bio-psycho-social history. | |||||||||||
Interpersonal Communication (Key Competencies) | Number (IC) | |||||||||||
1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | |||
Work effectively in multidisciplinary team, adapting to the particularities of each team and given roles | 72% | 30% | 87% | 55% | 25% | 9% | 12% | 0% | 0% | 0% | ||
Perform consulting, helping colleagues, other professionals, and the healthcare system | 11% | 26% | 0% | 0% | 39% | 82% | 6% | 5% | 0% | 0% | ||
Communicate effectively to promote understanding and resolve conflicts, aiming to ensure the success of teamwork | 11% | 19% | 13% | 30% | 6% | 0% | 65% | 11% | 82% | 18% | ||
Perform teamwork, aiming to ensure patient safety | 6% | 7% | 0% | 10% | 9% | 0% | 6% | 79% | 0% | 5% | ||
Communicate about ethical issues with other health professionals | 0% | 4% | 0% | 0% | 0% | 0% | 0% | 0% | 18% | 77% | ||
None of the Key Competencies | 0% | 15% | 0% | 5% | 19% | 9% | 11% | 5% | 0% | 0% | ||
Number (IC) | Competency (Fragments) | |||||||||||
1 | Work effectively with physicians and other colleagues in the health care professions | |||||||||||
2 | Communicate effectively with physicians, other health professionals and health-related agencies | |||||||||||
3 | Team building and working in a team: adapts her behaviour to different phases of team building and efficiently shapes her working style to contribute to a successful team | |||||||||||
4 | Shows ability to communicate effectively in multi-professional teams | |||||||||||
5 | Contribute to the improvement of health care delivery in teams, organizations, and systems | |||||||||||
6 | Act in a consultative role to other physicians, health-related agencies and policy-makers | |||||||||||
7 | Work with physicians and other colleagues in the healthcare professions to promote understanding, manage differences, and resolve conflicts | |||||||||||
8 | Demonstrate by listening, sharing and responding, the ability to communicate clearly, sensitively and effectively with doctors and other health professionals. | |||||||||||
9 | Hand over the care of a patient to another health care professional to facilitate continuity of safe patient care | |||||||||||
10 | Communicate effectively about ethical issues with health care professionals. | |||||||||||
Leadership (Key Competencies) | Number (Leadership) | |||||||||||
1 | 2 | 3 | 4 | 5 | 6 | 7 | ||||||
Demonstrate basic leadership skills | 94% | 82% | 80% | 73% | 100% | 24% | 14% | |||||
Engage in the management of human and health care resources | 0% | 9% | 5% | 20% | 0% | 76% | 81% | |||||
None of the Key Competencies | 6% | 9% | 15% | 7% | 0% | 0% | 5% | |||||
Number (Leadership) | Competency (Fragments) | |||||||||||
1 | Demonstrate leadership in professional practice | |||||||||||
2 | Work with other care providers as a team leader or member | |||||||||||
3 | Describe the principles and practice of leadership in health care. | |||||||||||
4 | Leadership: shows basic competencies in leadership skills and supports the development and maintenance of the teamwork with her behavior | |||||||||||
5 | Shows basic competencies in leadership skills | |||||||||||
6 | Engage in the stewardship of health care resources. | |||||||||||
7 | Manage career planning, finances, and health human resources in a practice | |||||||||||