Contextual barriers in effective interpersonal communication with patients: A qualitative analysis

Purpose: - Competence building in interpersonal communication between doctor and patients requires a deep understanding of the factors influencing their interaction. These factors are contextual and specific for individual clinical set-ups. The study explored these contextual factors from multi-source perspectives and analyzed the perceived barriers to interpersonal communication for formulating a training module for undergraduate doctor trainees/students. Method- Qualitative analysis using hermeneutic phenomenology was done from June 2018– February 2019 for patient’s semi-structured interviews (n=16); interns (n=15) and faculty (n=14) unstructured focus group. Three independent authors transcribed the data, derived codes and themes individually, and then collated and reflected on them to draw conclusions. Different collection methods, multisource perspectives, and multilevel analysis provided for triangulation and validation of the study results. Results- Seven inter-dependent barriers to interpersonal communication between students and patients were identified from this study’s multi-source feedback. They were time constraints, lack of trust and respect, cultural diversity, loco-regional linguistic differences, lack of empathy, illiteracy, and financial constraints. The authors felt that addressing these factors in training modules of communication skills would prepare undergraduate students towards patient-centered care and partnership. Conclusions- Within the limitations of this study, it can be concluded that every clinical microsystem has a unique set of barriers preventing interpersonal communication. Before preparing teaching modules for undergraduate students, it was necessary to explore these contextual barriers and address them towards the creation of a graduate competent in patient-centered interpersonal communication.