PATIENT- PRACTITIONER: SAVAGE & ARMSTRONG

Question 1

Describe the different styles during consultations in the study

Answer 1

Sharing style: actively involves the patient in the consultation. Asks questions such as what they think is wrong with them and how they would like the doctor to help them.
Directed style: Doctor makes the diagnosis after hearing their symptoms and tells them what treatment they need. The doctor is seen as an authority figure who is in control of the patients wellbeing.

Question 2

State the aim

Answer 2

• To investigate whether patient satisfaction is increased with a sharing style of consultation compared to a directed style

Question 3

Describe the sample

Answer 3

• 200 randomly sampled patients
• ages 16-75 years
• a random number generator was used to select 4 patients from each surgery the doctor held over a 4month period
• a patient presenting any form of symptom was eligible for the study
• 159 participants left as they did not complete both assessments

Question 4

Describe the methodology

Answer 4

• Used a field experiment. Which took place in an inner London general practice

Question 5

Describe the IV of the study

Answer 5

• patients were randomly allocated into one of 2 conditions;
• Directed style of consultation
• Sharing style of consultation.
• A set of cards were placed on the doctors desk, face down. The card allocating the patient to either condition was only turned once the patient had been identified as being suitable for the study

Question 6

Give examples of prompts used by the doctor in sharing style

Answer 6

• “Why do you think this happened”
• “What do these symptoms mean to you”
• “When would you like to come and see me again?”

Question 7

Give examples of prompts used by the doctor in directed style

Answer 7

• “This is a serious problem/not a serious problem”
• “You are suffering from…”
• “You should be better in…days”

Question 8

Describe the DV of the study

Answer 8

• At the end of the consultation, patients were given a questionnaire to complete.
• Some examples of questions were:
  > I felt much better
  > I felt greatly helped
  > I received an excellent explanation
• A second questionnaire with a stamped address was given to the patient. They were asked to complete it and post it back, questions asked were the same as the first.

Question 9

State 3 results of the study

Answer 9

• No significant differences in the length of consultation between the sharing and directing style of consultation
• In the initial questionnaire, it showed more patients who received the directed style agreed with the ‘I received an excellent explanation’ statement compared to the sharing style (45% versus 24%)
• Patients in the directed style group who rarely attended surgery, showed a significantly better perception of the doctors explanation

Question 10

State 2 conclusions

Answer 10

• Directed style consultations lead to greater patient satisfaction
• Patients with simple phsyical illnesses benefit more from a directed style of consultation

Question 11

State 3 methodological strengths

Answer 11

• Took place in a real-life setting. i.e it used real patients coming for actual consultations with their doctor. So high ecological validity
• It used random sampling to select participants. Smaple was representative of the patients in the doctors surgery. Ha the doctor used opportunity, they may have selected patients they knew well.
• They had the right to withdraw and could chose not to complete either of the questionnaire. The researcher also excluded any participants with life threatening conditions or whom they perceived might be upset.

Question 12

State 2 weaknesses

Answer 12

• The prompts were not part of the doctors normal interpersonal style. This could have affected how the patients responded to him as he could have acted less-relaxed, thus lowering the validity
• A significant number of patients failed to complete both questionnaires. This lowers the generalisability as those that completed it may have a certain personality type which could have impacted the data.

Question 13

Application to everyday life:

Answer 13

• By understanding which consultation style works best for different individual patients, doctors can adapt their style to that individual.
• This can help with information disclosure and more accurate diagnoses.

Question 14

Determinism versus Free will

Answer 14

• It is suggested that our thoughts and behaviour are determined by genetics and environmental factors
• However techniques such as counselling can help patients change how they cope with a serious diagnosis therefore people can use free will to change how they feel (Boulton et al.)

Question 15

Individual versus Situational

Answer 15

• The study supports the situational side
• However it ignores individual differences. For instance, some patients may already know their medical condition and have a good understanding of it thus, prefer a more sharing style.
• Doctors should therefore take into account these factors and be flexible in terms of matching the style of communication (situational) to the knowledge, culture and personality of the patient (individual)