OCHER

The 4th international OCHER workshop takes place at its usual venue Hotel Triaden, Lørenskog, on January 14-16, 2015. Here is the program: Program 4th OCHER 2015 Aug 21 for invitation. Note that we cannot take more than 50 participants, and that we will include at a first come-first serve basis. All participants must produce an abstract by October 31. The registration form (last page of program) should be sent as soon as possible.

Pål Gulbrandsen and Arnstein Finset just released their book “Skreddersydde samtaler” (“Tailored talks”) on Gyldendal Akademisk. The book is meant for medical students and doctors, and is brief with lots of examples from different medical situations. Two chapters cover aims and concepts, three chapters the structure and skills for the consultation’s different phases, one chapter covers 21 specific challenges, and a last chapter summarizes the evidence. The brevity of the book is deliberate, as doctors are extremely busy and need short texts.

A joint call for health services research proposals from all Norwegian health enterprises, administered by the Norwegian Research Council, led OCHER to submit its most ambitious proposal till now. With collaborating partners in five hospitals we aim to observe challenging encounters involving seriously or chronically ill patients, in order to come closer to an understanding of the connection between specific behaviours and patient understanding and involvement in decisions. The proposal, named Processes of information exchange and decision making in challenging clinical encounters (PIECE): Uncovering practices that affect patient safety and quality of care, will, if it succeeds, employ several PhD students and postdoctorals in the period 2015-2020.

Two papers from OCHER members have just been published in the Patient Education and Counseling special issue on the top papers from the International Conference on Communication in Healthcare conference that took place in September 2013 in Montreal, Canada. Jennifer Gerwing (currently a postdoc at Ahus) and Anne Marie Dalby (currently a PhD student at Ahus) explores the semantic functions of physician gestures. Pål Gulbrandsen, with the same two authors and Eirik Ofstad (also a current PhD student at Ahus/Nordlandssykehuset) describes in detail two encounters which illustrate the far from optimal shared decision making in encounters even when physicians really exhibit strong efforts. The papers have been added on the publication list.

We now have keynote speakers/discussants for our research workshop in January 14-16 confirmed. We are happy to present important contributors from diverse fields, covering qualitative and quantitative approaches. Here are the names: professor Marla Clayman, American Institutes for Research and Northwestern University, Chicago, professor Anssi Peräkylä, University of Helsinki, and professor Jan C. Frich, University of Oslo. The program will be ready by the end of August.

Following a series of articles in the Norwegian major newspaper Aftenposten about a fatal case at Molde hospital , Pål Gulbrandsen explains in an essay published [in Norwegian] June 25 why such cases are handled so clumsily. Major points are 1) risks are not sufficiently communicated up front, 2) “average” doctors are shamed by superiors, 3) debriefings lack or are not performed adequately, and 4) due to the former, patients and relatives are not given timely and serious apologies.

The symposium aims to inform health care personnel in all areas who meet cancer patients and has two international key lectures by Angela Coulter, University of Oxford and Pål Gulbrandsen, University of Oslo. See program here.

Previous studies indicating that female physicians do not get sufficient credit for being patient-centered were conducted in experimental settings only. The large Ahus dataset comprising 497 physician-patient encounters in a general hospital were analysed by Judy Hall and others to see if this is also true in the real world. The analysis demonstrated a more complex picture. Read the paper here.

In a narrative published in Patient Education and Counseling, “A matter of the heart”, Pål Gulbrandsen reflects on two very different patients with chest pain he met in clinical practice. In addition to highlighting four important virtues of a physician, curiosity, compassion, clarity, and courage, the paper demonstrates how the way we practice medicine these days teaches people that more examinations always are good, and hence reinforces the burden on healthcare costs. Read the paper here.

Today we added seven new 2-day courses in the Norwegian version of the Four Habits – 4 gode vaner – to our calendar and courses. These courses build on the development of the Four Habits Approach to Effective Clinical Communication in Kaiser Permanente, California, USA since 1989. Following their important contribution and a pilot in Oslo in August 2006, we developed an adjusted Norwegian version that was tested in a randomised controlled trial in 2007-08. We found that a condensed 20-hour training over two days was effective and changed physician behavior. Also, more than three years after the course, 60% of the physicians stated that the course had changed their practice ever after. Later, the approach has been used in Sweden and Germany, and research projects are launched in Cologne and drafted in Uppsala. Akershus University Hospital and the University of Oslo currently invest in the development of a teach-the-teachers program in order to foster a higher capacity for post-graduate teaching and supervision.