Healthcare Education Improving patient-centered communication: Results of a randomized controlled trial Barbara Maatouk-Bu ¨ rmann a, *, Nadja Ringel a , Jochen Spang a,1 , Carmen Weiss a, *, Andreas Mo ¨ ltner a , Urs Riemann b,2 , Wolf Langewitz c , Jobst-Hendrik Schultz a , Jana Ju ¨ nger a a Department of General Internal Medicine and Psychosomatic, Heidelberg University Hospital, Heidelberg, Germany b Department of Internal Medicine I, SLK Clinic Heilbronn, Germany c Division of Psychosomatic Medicine, Department of Internal Medicine, University Hospital Basel, Basel, Switzerland 1. Introduction Communication between physicians and patients is a key element of medical care, which is essential for anamnesis, diagnosis, informing patients about interventions, treatment planning, and outcome [1–3]. The characteristics of successful communication skills include creating a sustainable relationship, exploring patients’ perspective, verbalizing emotional experiences, empathy, shared task-finding, and joint strategy development [4–7]. These characteristics can be described as being ‘‘patient centered.’’ Studies have shown that patient-centered communi- cation improves the working relationship, diagnosis, patient cooperation, and treatment outcome [8,9]. Furthermore, it is associated with increased patient satisfaction [4,10] and reduced medical expenses [11]. In contrast, poor communication can lead to limited patient adherence and can compromise trust in the physician-patient relationship [12,13]. Typically, patient-centered communication provides the conceptual basis of medical communication trainings [14,15]. Al- though these trainings are very heterogeneous [16], there is growing consensus on the structural and content features, which appear to be promising. Positive effects seem to particularly result from multi-day trainings with a high proportion of practical content (e.g., video feedback, role play with or without simulated patients) [17–19]. Among the discrete conversation techniques used in training, the WEMS technique (Waiting, Echoing, Patient Education and Counseling 99 (2016) 117–124 ARTICLE INFO Article history: Received 11 March 2015 Received in revised form 6 August 2015 Accepted 7 August 2015 Keywords: RCT Communication training Doctor–patient relationship Patient-centered communication Patient centeredness RIAS ABSTRACT Objective: Patient-centered communication is a key element for improving the quality of care in terms of therapeutic relationship, patient participation, and treatment process. Postgraduate trainings provide an essential way of promoting patient centeredness on the job where learning opportunities are often limited by time, patient volume, and economic pressure. In the present study, changes in patient centeredness during clinical routines of postgraduate physicians (internal medicine) after a three-day communication training were assessed. Methods: A randomized controlled trial was conducted in a primary care clinic. The intervention consisted of a communication training that aimed to enhance patient centeredness in postgraduate physicians. The training was based on a need assessment and the principles of deliberate practice. Workplace-based assessment of physicians’ communication behavior was obtained using the Roter Interaction Analysis System. Results: Three months after the intervention, trained physicians showed significantly increased patient centeredness (F = 5.36, p = .04; d = 0.42). Conclusion: The communication training significantly improved patient centeredness during routine clinical practice. Thus, this training provides a structured and theory-based concept to foster patient centeredness. Practice implications: The results support the implementation of communication trainings as a part of faculty development and medical specialization training. ß 2015 Elsevier Ireland Ltd. All rights reserved. * Corresponding authors at: Heidelberg University Hospital, AG Kommunikation, c/o Dr. Carmen Weiss, Alte Krehl Klinik, Vossstraße 4, Geba ¨ ude 4310, 69115 Heidel- berg, Germany. E-mail address: barbaramaatouk@gmx.de (B. Maatouk-Bu ¨ rmann). 1 Present address: Division of Psychosomatic Medicine, Robert-Bosch-Kranken- haus, Stuttgart, Germany. 2 Present address: Kardiologische Gemeinschaftspraxis, Heilbronn, Germany. Contents lists available at ScienceDirect Patient Education and Counseling journal homepage: www.elsevier.com/locate/pateducou http://dx.doi.org/10.1016/j.pec.2015.08.012 0738-3991/ß 2015 Elsevier Ireland Ltd. All rights reserved.