Much variety and little evidence: a description of guidelines for doctor-patient communication.

AIM: To explore the quality of the content of communication skills training programmes, we analysed and assessed guidelines for doctor-patient communication used in communication programmes for general practitioner (GP) trainees.
METHOD: Guidelines for doctor-patient communication were extracted from educational materials supplied by the 8 Dutch university centres for vocational training in general practice. Four themes guided the analysis of the guidelines: content, type of contact, format and structure and status. The quality of the guidelines was assessed with the Appraisal of Guidelines Research and Evaluation (AGREE) instrument, a validated measurement instrument for guideline quality.
RESULTS: We identified 18 guidelines. Guideline content covered 64-100% of the GP qualification requirements. General consultations and specific situations were the subject of 9 guidelines each. Format and structure differed between guidelines. Guideline use seemed not to be obligatory. AGREE scores were low.
CONCLUSIONS: Guidelines for doctor-patient communication are difficult to identify in materials of GP training courses. Guideline quality is low; guidelines are little evidence-based and little attention has been paid to applicability and involvement of users. GP qualification requirements are only partly covered. Guidelines differed substantially without clarity about the reasons behind different choices. Guideline status was low. RECOMMENDATIONS: When studying the factors that influence training effect, the quality of training content should be considered as well as teaching methods. Communication skills training programmes should be based on evidence-based guidelines that have been developed according to similar standards as for medical technical guidelines.