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How to learn skilled communication in primary care MUS consultations: a focus group study.

Houwen, J., Lucassen, P.L.B.J., Stappers, H.W., Spaendonck, K. van, Duinhoven, A. van, Olde Hartman, T.C., Dulmen, S. van. How to learn skilled communication in primary care MUS consultations: a focus group study. Scandinavian Journal of Primary Health Care: 2021, 39(1), p. 101-110
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Background
Many general practitioners (GPs) experience communication problems inmedically unexplained symptoms (MUS) consultations as they are insufficiently equipped with adequate communication skills or do not apply these in MUS consultations.

Objective
To define the most important learnable communication elements during MUS consultations according to MUS patients, GPs, MUS experts and teachers and to explore how these elements should be taught to GPs and GP trainees.

Methods
Five focus groups were conducted with homogeneous groups of MUS patients, GPs, MUS experts and teachers. MUS patients and GPs formulated a list of important communication elements. MUS experts identified from this list the most important communication elements. Teachers explored how these elements could be trained to GPs and GP trainees. Two researchers independently analysed the data applying the principles of constant comparative analysis.

Results
MUS patients and GPs identified a list of important communication elements. From this list, MUS experts selected five important communication elements: (1) thorough somatic and psychosocial exploration, (2) communication with empathy, (3) creating a shared understanding of the problem, (4) providing a tangible explanation and (5) taking control. Teachers described three teaching methods for these communication elements: (1) awareness and reflection of GPs about their feelings towards MUS patients, (2) assessment of GPs’ individual needs and (3) training and supervision in daily practice.

Conclusion
Teachers consider a focus on personal attitudes and needs, which should be guided by opportunities to practice and receive supervision, as the best method to teach GPs about communication in MUS consultations.