Training & Education: The CM Educator

Primary healthcare professionals’ lack of knowledge about complementary medicine is a concern to both patients and government. Educational institutions in the field outline needs and propose various models.

Meeting in the middle: Improving communication in primary health care consultations with people with an intellectual disability

The increased presence and participation in Australian society of people with an intellectual disability provides challenges for the provision of primary health care. General practitioners (GPs) identify themselves as ill equipped to provide for this heterogeneous population. A major obstacle to the provision of appropriate health care is seen as inadequate communication between the GP and the person with an intellectual disability, who may or may not be accompanied by a carer or advocate. This qualitative study in which five GPs, three people with intellectual disability, seven carers and two advocates (parent and friend) were interviewed was conducted in Brisbane, Australia. The aim was to better understand the factors that have an impact upon the success of communication in a medical consultation. Findings suggested that GPs were concerned with the aspects of communication difficulties which influenced their ability to adequately diagnose, manage and inform patients. Implications for practice management were also identified. People with intellectual disability reported frustration when they felt that they could not communicate adequately with the GP and annoyance when they were not included in the communication exchange. Carers were strong advocates for the person with intellectual disability, but indicated insufficient skill and knowledge to provide the level of assistance required in the consultation. The outcome was a model of cooperation that outlined the responsibilities of all players in the medical encounter, prior to, during and after the event.

Intergroup processes in intragroup contexts: The roles of group status, group identification and communication in diverse work teams

The present research examines employee identification and communication in organisations. In Study 1, 2229 soldiers from a military organisation completed measures of perceived status and strength of identification with their unit, employment category and their brigade. As predicted, the status of a key organisational group influenced reactions to different organisational groups: full-time soldiers evaluated their work unit and the organisation as being lower in status and identified less strongly with both of these groups than part-time soldiers. The second study extended these findings to a different research context: a large psychiatric hospital undergoing downsizing and restructuring. Surprisingly, there were no differences in survivors' and victims' levels of identification with organisational groups. Instead, and consistent with Study 1, there was evidence to suggest that employees adjusted their patterns of identification and perceptions of group status through a compensatory mechanism that maximised opportunities for selfenhancement and positive distinctiveness. In the third study, employees from a public hospital (N = 142) rated communication from double ingroup members (same work unit/same occupational group) more favourably than communication from partial group members (same work unit/different occupational group). These results are considered in terms of their practical implications for identity management in organisations.

Using a problem detection study (PDS) to identify and compare health care provider and consumer views of antihypertensive therapy

The objectives of this study were to ascertain consumer knowledge and behaviour about hypertension and treatment and to compare these with health care providers' perceptions (of 'most' consumers). The design for the study was a problem detection study (PDS): focus groups and then survey. Focus groups and survey participants were convenience samples of consumers, doctors, nurses and pharmacists. The main outcome measures were agreement on a 5-point Likert scale with statements about consumers' knowledge and behaviour about high blood pressure and medication. The survey identified areas of consensus and disagreement between consumers and health providers. While general knowledge and concordance with antihypertensive therapy among consumers was good, consequences such as eye and kidney disease, interactions with herbal medicines, and how to deal with missing a dose were less well known. Side effects were a problem for over one-quarter of participants, and cost was a problem in continuing therapy. Half the consumers had not received sufficient written information. Providers overall disagreed that most consumers have an adequate understanding of the condition. They agreed that most consumers adhere to therapy and can manage medicines; and about their own profession's role in information provision and condition management. Consumers confirmed positive provider behaviour, suggesting opportunities for greater communication between providers about actions taken with their consumers. In conclusion, the PDS methodology was useful in identifying consumer opinions. Differences between consumer and provider responses were marked, with consumers generally rating their knowledge and behaviour above providers' ratings of 'most' consumers. There are clear gaps to be targeted to improve the outcomes of hypertension therapy.

Improving supportive care for women with breast cancer in Australia: The challenge of modifying health systems

Although the benefits of many psychosocial support strategies in improving well being in women with breast cancer have been demonstrated, few women receive these programs as part of routine care. This paper provides some recommendations, based on experience in Australia, about how access to evidence-based supportive care strategies might be improved through modification of health systems. It demonstrates the paucity of research about the costs and health service implications of psychosocial support strategies, which is vital to health planning and service delivery change. It outlines the systematic approach taken in Australia to improving psychosocial support nationally by: the development of research reviews; preparation of guidelines about supportive care, implementation of programs to foster the adoption of guidelines through modification of policy, health service delivery and clinician training; and monitoring programs. Coalitions of government, health care professionals and consumers are key to effective lobbying for change. If all women with breast cancer are to receive better supportive care, there is a need for approaches which: refocus the research effort in psycho-oncology; develop more strategic approaches to generating change in health systems and health policy and foster partnerships to advocate for improved resources. Copyright (C) 2003 John Wiley Sons, Ltd.

Trust me, I'm your boss: Trust and power in supervisor-supervisee communication

This study examined employees' perceptions of trust, power and mentoring in manager-employee relationships in a variety of sectors, including health care, education, hospitality and retail. The main theoretical frameworks used were communication accommodation theory and social identity theory, in examining the manager-employee relationships from an in-group/out-group perspective. Computer-aided content analyses revealed a number of emergent communication and relationship themes that impact upon the level of 'in-groupness' and therefore trust in supervisor-supervisee relationships. While it may be illusory to believe that any organization can enjoy complete trust among its workforce, it is clear that certain communication characteristics can result in greater trust in manager-employee relationships, even within the context of organizational constraints. It is argued that the results of the study could be used to inform human resource management academics of key aspects of managerial communication that should be further researched, and also provide insights into the main communication skills that managers should focus upon to improve trust in the workplace.

Reconciliation through communication in intercultural encounters: potential or peril?

As we reflect on the events of September 11th and their aftermath, there is strong motivation in many places to improve intercultural and international relations through communication. This laudable aim implicates the long history of research into intercultural encounters, which has always bad this goal. To achieve it, researchers and trainers must go beyond conceptualizing intercultural encounters as like interpersonal ones, except that participants have different and sometimes conflicting cultural rules and values. We must develop programs to train metaskills in analyzing miscommunication and its negative consequences. This requires the recognition that, in many interethnic and intercultural contexts, participants are not. motivated to communicate well. In such cases, the larger sociopolitical situation must be addressed, or skills training may even exacerbate the conflict. It is also crucial to understand intercultural communication as simultaneously intergroup and interpersonal, to incorporate both aspects into interventions, and to advocate for such training to improve intercultural relations.