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Objective: To explore the similarities and differences in the needs of young adults with T1D during life transitions.Methods: Data obtained for this paper was based on three qualitative studies carried out in Denmark and Australia. In total, 33 Individual interviews and two focus groups (n = 46) were conducted. Data was analysed using thematic analysis.Results: The most pertinent themes related to the importance of support from peers with diabetes and healthcare professionals to help young adults adjust to independent living. The main difference experienced by Australian and Danish young adults related to the willingness and barriers in clinical attendance during this transitional period.Conclusions: Clinical care for young adults with diabetes can be better adapted to support this population as they transition through significant milestones by engagement on the young adults' terms and encouraging young adults to seek out peer support. It is vital that clinical care is tailored to support them in order to ensure the best transition into adulthood with diabetes.Practice Implications: Clinicians need to adopt a person-centred approach when engaging with young adults with diabetes. Considerations need to be made around external factors related to life events in young adulthood that may influence diabetes care. [ABSTRACT FROM AUTHOR]

Objective: Vaccine hesitancy is a persistent barrier to vaccination uptake, and health professionals report interactions with such parents to be difficult. Using discourse analytic techniques, we examine the foundation of a therapeutic relationship: the display of empathy and attempts to build rapport, in consultations between immunisation specialists and vaccine reluctant parents.Methods: Consultations between consenting clinicians and parents in two Specialist Immunisation Clinics in Australia were recorded. Twelve conversations between the clinicians and parents were analysed using interactional sociolinguistic (IS) discourse analytic methods.Results: This paper takes a case study approach by citing two interactions that exemplify the interactional work of the consultants as they strive to engender mutual understanding and goodwill, noting examples of discursive choices that demonstrate empathy and the building of rapport.Conclusion: Awareness of discourse strategies that interweave relational and clinical goals enable a more nuanced understanding of communication skills that support a guiding partnership in vaccine related decisions with parents.Practical Implications: Through highlighting the strategic interactional work that displays empathy and builds rapport, we can inform educational approaches and build a repertoire of communication choices that strengthen the communication skills of health professionals. [ABSTRACT FROM AUTHOR]

The demand for medical students to be trained to communicate effectively has seen the emergence of interpersonal communication skills as core graduate competencies in medical training. We conducted a systematic review of interventions for medical students aiming to improve interpersonal communication in medical consultations. We searched five electronic databases in September 2020 and screened reference lists of relevant articles. We included randomised controlled trials, cluster-RCTs, and non-randomised controlled trials evaluating the effectiveness of interventions delivered to students in pre-service medical programmes. Standard Cochrane methodological procedures were used. We found 91 publications relating to 76 separate studies (involving 10,124 students). We performed meta-analysis according to comparison and outcome. Outcomes reporting on overall communication skills, empathy, rapport or relationship building, patient perceptions/satisfaction, information gathering, and explanation and planning were reported separately. The quality of evidence ranged from moderate to very low, and there was high, unexplained heterogeneity. Overall, interventions had positive effects on most outcomes, but generally small effect sizes and low quality limit the conclusions that can be drawn. for discussion include: programmes that include personalised feedback probably improve medical students' overall communication skills more than programmes that involve general or no feedback; and online or self-directed programmes may make little to no difference in improving skills in empathy or rapport compared with face-to-face teaching. Since publication of the papers in the review, the tertiary education sector has been rocked by the global Covid-19 pandemic. Taken together, the results of our review and the subsequent pandemic-related experiences lend weight to the notion that 'when taught, students will learn'. Combining the lessons of the review with those of the pandemic, we are in a position to offer well-informed guidance to educators and accreditors about the most practical and evidence-based approaches to teaching communication skills. [ABSTRACT FROM AUTHOR]

Objective To determine physician perspectives about direct notification of normal and abnormal test results. Methods We conducted a cross-sectional survey at five clinical sites in the US and Australia. The US-based study was conducted via web-based survey of primary care physicians and specialists between July and October 2012. An identical paper-based survey was self-administered between June and September 2012 with specialists in Australia. Results Of 1417 physicians invited, 315 (22.2%) completed the survey. Two-thirds (65.3%) believed that patients should be directly notified of normal results, but only 21.3% were comfortable with direct notification of clinically significant abnormal results. Physicians were more likely to endorse direct notification of abnormal results if they believed it would reduce the number of patients lost to follow-up (OR = 4.98, 95%CI = 2.21–1.21) or if they had personally missed an abnormal test result (OR = 2.95, 95%CI = 1.44–6.02). Conversely, physicians were less likely to endorse if they believed that direct notification interfered with the practice of medicine (OR = 0.39, 95%CI = 0.20–0.74). Conclusion Physicians we surveyed generally favor direct notification of normal results but appear to have substantial concerns about direct notification of abnormal results. Practice implications Widespread use of direct notification should be accompanied by strategies to help patients manage test result abnormalities they receive. [ABSTRACT FROM AUTHOR]