Addressing violence against doctors: Using ADDIE framework for designing, implementation, and evaluation of the effectiveness of a therapeutic communication skills training module

Background and Aim: Lack of formal training and assessment in communication skills in India combined with suboptimal doctor-patient ratio leave them with little time, and therefore, patients dissatisfied with doctor's therapeutic communication and often lead to violence against doctors. There is thus an urgent need for health-care providers and their trainers to be formally and systematically trained and assessed. Materials and Methods: Descriptive study (describing the process of training module development using ADDIE Framework) and an educational intervention study (using the Kirkpatrick model for measuring effectiveness of the training). Module's contents were identified through the literature search followed by content, context, and construct validation by communication and subject experts. Modular 8 hour training was implemented for 50 participants in two batches on two different days. Results: In the immediate postintervention feedback, all participants agreed that the training will be beneficial to them in real life and they expressed confidence in teaching communication skills to their students, particularly in breaking bad news and resolving doctor-patient conflicts in the real life. Effectiveness of intervention is reflected by gain in knowledge scores from 6.84 (at pretraining) to 10.76 (immediate posttraining) and sustained at 10.8 (at 3 months posttraining). The impact of the training on their communication skills is also demonstrated by the skill scores showing incremental increase from 12.4 (at pretraining) to 19.16 (immediate posttraining) and then 21.8 (at 3 months posttraining) which is statistically significant (P < 0.05). Conclusion: The training was effective, accepted well by trainees and has been institutionalised.