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01.12.2014 | PhD Report | Ausgabe 6/2014 Open Access

Perspectives on Medical Education 6/2014

Improving communication skills in the Southeast Asian health care context

Perspectives on Medical Education > Ausgabe 6/2014
Mora Claramita, Astrid Pratidina Susilo
Wichtige Hinweise
Mora Claramita defended her thesis ‘Doctor-patient communication in a culturally hierarchical context of Southeast Asia: a partnership approach’ at Maastricht University on 30 March 2012. Her PhD supervisors were Jan van Dalen, Hardyanto Soebono and Cees van der Vleuten.
Astrid Pratidina Susilo defended her thesis ‘Learning to be the patient advocate: the development of a communication skills course to enhance nurses’ contribution in the informed consent process’ at Maastricht University on 24 October 2013. Her PhD supervisors were Albert Scherpbier and Jan van Dalen.
The authors worked together during their PhD programmes and in writing the draft of this PhD report.


The aim of these two PhD thesis are to develop a guideline on doctor-patient communication skills based on cultural characteristics of Southeast Asian context and to develop communication skills training for nurses to enhance their contribution to the informed consent and shared decision making process, in the same context. These studies started with qualitative methods; including grounded theory methodology, by exploring doctors’, patients’, medical students’ and nurses’ perceptions on the current and desired communication skills in which influenced by culture. Based on the results, we design communication skills training and evaluate the training with quantitative methods, using pre and post test studies. Southeast Asian desired ideal partnership style in communicating with their doctors. More emphasize on basic skills such as listening to subtle non-verbal cues are needed for doctors and nurses. A guideline on doctor-patient communication tailored to local culture was developed as well as training for nurses using 4CID design to enhance their contribution to the shared decision making process. To promote two-way interaction between doctors and patients and between health professionals require mastering basic skills in communicating with people, such as explorations on the unspoken concern. In a culturally hierarchical context of Indonesia, this two-way interaction is quite a challenge. To generalize our studies to other culture, more studies with rigorous methods should follow. To promote the use of basic skills in communicating with patients to approach the desired partnership communication style in Southeast Asian context, we need to use local evidences.
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