On-site communication skills education increases appointment-specific client satisfaction in four companion animal practices in Texas

Natasha Janke Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO

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 PhD
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Jane R. Shaw Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO

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 DVM, PhD
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Jason B. Coe Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada

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 DVM, PhD
DOI:
https://doi.org/10.2460/javma.22.06.0242
Volume/Issue:
Volume 260: Issue 13
Online Publication Date:
17 Aug 2022
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Abstract

Objective

To assess the impact of a 15-month, in-practice communication skills intervention on client visit satisfaction.

Sample

4 purposely selected veterinary clinics, 9 veterinarians, and 930 appointment-specific client satisfaction surveys.

Procedures

The study was designed as a multipractice, preintervention-postintervention study. Practice teams participated in a 15-month communication skills intervention that included interactive group workshops and one-on-one communication coaching with the entire practice. Client Satisfaction Questionnaires were completed 3 months before (mean, 55 questionnaires/veterinarian) and after (mean, 48 questionnaires/veterinarian) the intervention. The impact of the intervention and factors associated with client visit satisfaction were evaluated with mixed logistic regression.

Results

Client satisfaction scores were dichotomized owing to extreme negative skewness. In total, 57% (284/496) of clients were completely satisfied on pretest questionnaires, and 67% (290/434) were completely satisfied on postintervention questionnaires. The odds of clients being completely satisfied were significantly higher after the communication skills intervention (OR = 1.56; P = .002). When controlling for the intervention, predictors of client visit satisfaction included appointment type (odds of being completely satisfied were significantly higher for recheck appointments than for preventative care appointments [OR = 1.71; P = .02] and health problem appointments [OR = 1.99; P = .003]) and duration of the veterinarian-client relationship (probability increased by 0.52 with each 1-year increase in relationship duration; P = .008).

Clinical Relevance

Results suggested that the client-centered, skills-based communication intervention resulted in increased client visit satisfaction. Findings contribute to current evidence that client-centered communication and duration of the veterinarian-client relationship promote client satisfaction during veterinary visits.

Abstract

Objective

To assess the impact of a 15-month, in-practice communication skills intervention on client visit satisfaction.

Sample

4 purposely selected veterinary clinics, 9 veterinarians, and 930 appointment-specific client satisfaction surveys.

Procedures

The study was designed as a multipractice, preintervention-postintervention study. Practice teams participated in a 15-month communication skills intervention that included interactive group workshops and one-on-one communication coaching with the entire practice. Client Satisfaction Questionnaires were completed 3 months before (mean, 55 questionnaires/veterinarian) and after (mean, 48 questionnaires/veterinarian) the intervention. The impact of the intervention and factors associated with client visit satisfaction were evaluated with mixed logistic regression.

Results

Client satisfaction scores were dichotomized owing to extreme negative skewness. In total, 57% (284/496) of clients were completely satisfied on pretest questionnaires, and 67% (290/434) were completely satisfied on postintervention questionnaires. The odds of clients being completely satisfied were significantly higher after the communication skills intervention (OR = 1.56; P = .002). When controlling for the intervention, predictors of client visit satisfaction included appointment type (odds of being completely satisfied were significantly higher for recheck appointments than for preventative care appointments [OR = 1.71; P = .02] and health problem appointments [OR = 1.99; P = .003]) and duration of the veterinarian-client relationship (probability increased by 0.52 with each 1-year increase in relationship duration; P = .008).

Clinical Relevance

Results suggested that the client-centered, skills-based communication intervention resulted in increased client visit satisfaction. Findings contribute to current evidence that client-centered communication and duration of the veterinarian-client relationship promote client satisfaction during veterinary visits.

Contributor Notes

Corresponding author: Dr. Janke (njanke@uoguelph.ca)
Cover Journal of the American Veterinary Medical Association
Journal of the American Veterinary Medical Association
Publication Date:
01 Oct 2022
  • 1.

    Adams CL, Conlon PD, Long KC. Professional and veterinary competencies: addressing human relations and the human-animal bond in veterinary medicine. J Vet Med Educ 2004;31(1):66–71. doi:10.3138/jvme.31.1.66

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Bristol DG. Using alumni research to assess a veterinary curriculum and alumni employment and reward patterns. J Vet Med Educ 2002;29(1):20–27. doi:10.3138/jvme.29.1.20

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Brockman BK, Taylor VA, Brockman CM. The price of unconditional love: consumer decision making for high-dollar veterinary care. J Bus Res 2008;61(5):397–405. doi:10.1016/j.jbusres.2006.09.033

    • Search Google Scholar
    • Export Citation
  • 4.

    Brown JP, Silverman JD. The current and future market for veterinarians and veterinary medical services in the United States. J Am Vet Med Assoc 1999;215(2):161–183.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Lue TW, Pantenburg DP, Crawford PM. Impact of the owner-pet and client-veterinarian bond on the care that pets receive. J Am Vet Med Assoc 2008;232(4):531–540. doi:10.2460/javma.232.4.531

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Coe JB, Adams CL, Bonnett BN. A focus group study of veterinarians’ and pet owners’ perceptions of veterinarian-client communication in companion animal practice. J Am Vet Med Assoc 2008;233(7):1072–1080. doi:10.2460/javma.233.7.1072

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Stoewen DL, Coe JB, MacMartin C, Stone EAE, Dewey C. Qualitative study of the communication expectations of clients accessing oncology care at a tertiary referral center for dogs with life-limiting cancer. J Am Vet Med Assoc 2014;245(7):785–795. doi:10.2460/javma.245.7.785

    • Search Google Scholar
    • Export Citation
  • 8.

    Janke N, Coe JB, Bernardo TM, Dewey CE, Stone EA. Pet owners’ and veterinarians’ perceptions of information exchange and clinical decision-making in companion animal practice. PLoS One 2021;16(2):e0245632. doi:10.1371/journal.pone.0245632

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Stoewen DL, Coe JB, MacMartin C, Stone EA, Dewey CE. Qualitative study of the information expectations of clients accessing oncology care at a tertiary referral center for dogs with life-limiting cancer. J Am Vet Med Assoc 2014;245(7):773–783. doi:10.2460/javma.245.7.773

    • Search Google Scholar
    • Export Citation
  • 10.

    McArthur ML, Fitzgerald JR. Companion animal veterinarians’ use of clinical communication skills. Aust Vet J 2013;91(9):374–380. doi:10.1111/avj.12083

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Kanji N, Coe JB, Adams CL, Shaw JR. Effect of veterinarian-client-patient interactions on client adherence to dentistry and surgery recommendations in companion-animal practice. J Am Vet Med Assoc 2012;240(4):427–436. doi:10.2460/javma.240.4.427

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Cornell KK, Coe JB, Shaw DH, Felsted KE, Bonvicini KA. Investigation of the effects of a practice-level communication training program on veterinary health-care team members’ communication confidence, client satisfaction, and practice financial metrics. J Am Vet Med Assoc 2019;255(12):1377–1388. doi:10.2460/javma.255.12.1377

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Shaw JR, Barley GE, Broadfoot K, et al. Outcomes assessment of on-site communication skills education in a companion animal practice. 2016;249:419–32. doi:10.2460/javma.249.4.419

    • Search Google Scholar
    • Export Citation
  • 14.

    McArthur M, Fitzgerald J. Evaluation of a communication skills training program for companion-animal veterinarians: a pilot study using RIAS coding. J Vet Med Educ 2016;43(2):111–125. doi:10.3138/jvme.0215-016R2

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Coe JB, Adams CL, Eva K, Desmarais S, Bonnett BN. Development and validation of an instrument for measuring appointment-specific client satisfaction in companion-animal practice. Prev Vet Med 2010;93(2-3):201–210. doi:10.1016/j.prevetmed.2009.10.005

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Adams CL, Kurtz S. Skills for communicating in veterinary medicine. Otmoor Publishing; 2016.

  • 17.

    Kraut AS, Omron R, Caretta-Weyer H, et al. The flipped classroom: a critical appraisal. West J Emerg Med 2019;20(3):527–536. doi:10.5811/westjem.2019.2.40979

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Bolton R, Logan C, Gittell JH. Revisiting relational coordination: a systematic review. J Appl Behav Sci 2021;57(3):290–322. doi:10.1177/0021886321991597

    • Search Google Scholar
    • Export Citation
  • 19.

    Speck P, Higginson I, Addington-Hall J. Spiritual needs in health care. BMJ 2004;329(7458):123–124. doi:10.1136/bmj.329.7458.123

  • 20.

    Shaw JR, Adams CL, Bonnett BN. What can veterinarians learn from studies of physician-patient communication about veterinarian-client-patient communication? J Am Vet Med Assoc 2004;224(5):676–684. doi:10.2460/javma.2004.224.676

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Roter D. The enduring and evolving nature of the patient-physician relationship. Patient Educ Couns 2000;39(1):5–15. doi:10.1016/S0738-3991(99)00086-5

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Shaw JR, Bonnett BN, Adams CL, Roter DL. Veterinarian-client-patient communication patterns used during clinical appointments in companion animal practice. J Am Vet Med Assoc 2006;228(5):714–721. doi:10.2460/javma.228.5.714

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23.

    Cornell KK, Kopcha M. Client-veterinarian communication: skills for client centered dialogue and shared decision making. Vet Clin North Am Small Anim Pract 2007;37(1):37–47. doi:10.1016/j.cvsm.2006.10.005

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    Kurtz SM, Silverman J, Draper J. Teaching and learning communication skills in medicine. 2nd ed. Radcliffe Medical Press; 2005.

  • 25.

    Smith S, Hanson JL, Tewksbury LR, et al. Teaching patient communication skills to medical students: a review of randomized controlled trials. Eval Health Prof 2007;30(1):3–21. doi:10.1177/0163278706297333

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26.

    Lane C, Rollnick S. The use of simulated patients and role-play in communication skills training: a review of the literature to August 2005. Patient Educ Couns 2007;67(1-2):13–20. doi:10.1016/j.pec.2007.02.011

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27.

    Coe JB, Adams CL, Bonnett BN. A focus group study of veterinarians’ and pet owners’ perceptions of the monetary aspects of veterinary care. J Am Vet Med Assoc 2007;231(10):1510–1518. doi:10.2460/javma.231.10.1510

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28.

    Corah L, Mossop L, Dean R, Cobb K. Measuring satisfaction in the small animal consultation and its relationship to consult length. Vet Rec 2020;187(11):446. doi:10.1136/vr.105910

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29.

    Kedrowicz AA. Clients and veterinarians as partners in problem solving during cancer management: implications for veterinary education. J Vet Med Educ 2015;42(4):373–381. doi:10.3138/jvme.0315-048R

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30.

    Coe J. Communication During Veterinarian-Client-Patient Interactions in Companion Animal Practice. Thesis. University of Guelph; 2008.

  • 31.

    Shaw JR, Adams CL, Bonnett BN, Larson S, Roter DL. Veterinarian-client-patient communication during wellness appointments versus appointments related to a health problem in companion animal practice. J Am Vet Med Assoc 2008;233(10):1576–1586. doi:10.2460/javma.233.10.1576

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 32.

    Platonova EA, Kennedy KN, Shewchuk RM. Understanding patient satisfaction, trust, and loyalty to primary care physicians. Med Care Res Rev 2008;65(6):696–712. doi:10.1177/1077558708322863

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 33.

    Shaw JR, Adams CL, Bonnett BN, Larson S, Roter DL. Veterinarian satisfaction with companion animal visits. J Am Vet Med Assoc 2012;240(7):832–841. doi:10.2460/javma.240.7.832

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 34.

    Donahue KE, Ashkin E, Pathman DE. Length of patient-physician relationship and patients’ satisfaction and preventive service use in the rural south: a cross-sectional telephone study. BMC Fam Pract 2005;6(1):40. doi:10.1186/1471-2296-6-40

    • Search Google Scholar
    • Export Citation
  • 35.

    Suchman AL, Roter D, Green M, Lipkin M Jr. Physician satisfaction with primary care office visits. Collaborative Study Group of the American Academy on Physician and Patient. Med Care 1993;31(12):1083–1092.

    • Search Google Scholar
    • Export Citation
  • 36.

    Hessling RM, Traxel NM, Schmidt TJ. Ceiling effect. In: Lewis-Beck MS, Bryman A, Liao TF, eds. The Sage Encyclopedia of Social Science Research Methods Sage Publications; 2004:107.

    • Search Google Scholar
    • Export Citation
  • 37.

    du Toit R, Pritchard N, Heffernan S, Simpson T, Fonn D. A comparison of three different scales for rating contact lens handling. Optom Vis Sci 2002;79(5):313–320. doi:10.1097/00006324-200205000-00011

    • PubMed
    • Search Google Scholar
    • Export Citation

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