PhD defence L.J.C. (Laura) Kranenburg - van Koppen

Dissertation in short:

The main question of this thesis is: How can we support postgraduate training of communication skills for future medical specialists? Prior research showed that it is important to deliberately practice communication skills in an environment in which the value of communication skills is recognized and support is institutionalized with appropriate feedback from role models. Question arises to what extent these elements are implemented in the daily practice of postgraduate training in chronic diseases and in training of communication skills in rare diseases. 

Within the field of rheumatology patient are treated with chronic diseases. Disease activity can change over time, just like patients preferences and values. This asks for good general communication skills and skills for Shared Decision Making. How are future rheumatologists trained to develop these skills? This thesis shows that there is still room for improvement. Rheumatologists in training would like more training and practical feedback. Video-on-the-job and feedback after observation are good interventions, but are not frequently used. 

There are several challenges in training doctor-patient communication in rare diseases: due to small numbers there is limited experience with real-life patients during specialist training and evidence of treatment options is limited. This makes the use of online learning interesting. How can online learning contribute to the training of communication skills in rare diseases? This is studied in the field of disorders of sex development (DSD), which is a subspecialty of the paediatric endocrinologist. Care for individuals with DSD is characterized by many challenges, which requires adequate doctor-patient communication skills.