Effective doctor-patient communication skills training optimizes functional organization of intrinsic brain architecture: a resting-state functional MRI study

Abstract

We studied the influence of doctor-patient communication skills training on brain functional architecture using resting-state functional MRI (rs-fMRI) with a regional homogeneity (ReHo) method. Ten medical students participated in the study. A 1-year long doctor-patient communication skills training program was conducted. Rs-fMRI data were collected at baseline, one month and one year after training. There was a significant increase in the communication skills test average scores between baseline and 1-month duration of training (P<0.001). After one month of communication skills training, medical students had decreased ReHo in the right superior temporal gyrus compared with the baseline. After one year of communication skills training, students had increased ReHo in multiple regions and decreased ReHo in several regions (P<0.05, Alphasim corrected). The change of ReHo values in the superior temporal gyrus negatively correlated with the change of communication skills scale score between one month after communication skills training and baseline (r=–0.734, P= 0.036). The training program we used can be an effective approach of improving doctor-patient communication skills, and the training resulted in functional plasticity of the brain's architecture toward optimizing locally functional organization.

Keywords

brain architecture / function / resting-state functional MRI (rs-fMRI) / doctor-patient communication

References

[1] Chen Y, Zhao  ZN, Liu LK . Important doctor-patient communication ability for chinese medical students[J]. Asian Pac J Cancer Prev, 2015, 16(9): 4143

[2] Zhang X, Sleeboom-Faulkner  M. Tensions between medical professionals and patients in mainland China[J]. Camb Q Healthc Ethics, 2011, 20(3): 458–465

[3] Chinese doctors are under threat. Lancet, 2010, 376(9742): 657

[4] Reinders ME, Blankenstein  AH, van der Horst HE, Does patient feedback improve the consultation skills of general practice trainees? A controlled trial[J]. Med Educ, 2010, 44(2): 156–164

[5] M van Es J ,  Wieringa-de Waard M ,  Visser MR, et al . Differential growth in doctor-patient communications skills[J]. Med Educ, 2013, 47(7): 691–700

[6] Hobma S, Ram  P, Muijtjens A , Effective improvement of doctor-patient communication: a randomised controlled trial[J]. Br J Gen Pract, 2006, 56(529): 580–586

[7] Wang JFY. Doctor-patient communication: China: People' s Medical Publishing House[J], 2013.

[8] Biswal BB, Mennes  M, Zuo XN , Toward discovery science of human brain function[J]. Proc Natl Acad Sci U S A, 2010, 107(10): 4734–4739

[9] Zuo XN, Ehmke  R, Mennes M , Network centrality in the human functional connectome[J]. Cereb Cortex, 2012, 22(8): 1862–1875

[10] Wei GX, Xu  T, Fan FM , Can Taichi reshape the brain? A brain morphometry study[J]. PLoS One, 2013, 8(4): e61038

[11] Wei GX, Dong  HM, Yang Z , Tai Chi Chuan optimizes the functional organization of the intrinsic human brain architecture in older adults[J]. Front Aging Neurosci, 2014, 6: 74

[12] Gebel B, Braun  Ch, Kaza E , Instrument specific brain activation in sensorimotor and auditory representation in musicians[J]. Neuroimage, 2013, 74: 37–44

[13] Raichle ME, Snyder  AZ. A default mode of brain function: a brief history of an evolving idea[J]. Neuroimage, 2007, 37(4): 1083–1090., discussion 1097–1099.

[14] Zang Y, Jiang  T, Lu Y , Regional homogeneity approach to fMRI data analysis[J]. Neuroimage, 2004, 22(1): 394–400

[15] Smith SM. Fast robust automated brain extraction[J]. Hum Brain Mapp, 2002, 17(3): 143–155

[16] J S. Skills for communicating with patients[M].London UK: Radcliffe Publishing Ltd, 2008.

[17] Rotthoff T, Baehring  T, David DM , The value of training in communication skills for continuing medical education[J]. Patient Educ Couns, 2011, 84(2): 170–175

[18] Schlaug G, Norton  A, Overy K , Effects of music training on the child's brain and cognitive development[J]. Ann N Y Acad Sci, 2005, 1060: 219–230

[19] Morris JS, Ohman  A, Dolan RJ . Conscious and unconscious emotional learning in the human amygdala[J]. Nature, 1998, 393(6684): 467–470

[20] Buchanan T. The Human Amygdala[M].New York: Guilford, 2009.

[21] Rolls ET. Limbic systems for emotion and for memory, but no single limbic system[J]. Cortex, 2015, 62: 119–157

[22] Shura RD, Hurley  RA, Taber KH . Insular cortex: structural and functional neuroanatomy[J]. J Neuropsychiatry Clin Neurosci, 2014, 26(4): 276–282

[23] Leech R, Sharp  DJ. The role of the posterior cingulate cortex in cognition and disease[J]. Brain, 2014, 137(Pt 1): 12–32

[24] Maddock RJ, Garrett  AS, Buonocore MH . Posterior cingulate cortex activation by emotional words: fMRI evidence from a valence decision task[J]. Hum Brain Mapp, 2003, 18(1): 30–41

[25] Radua J, Phillips  ML, Russell T , Neural response to specific components of fearful faces in healthy and schizophrenic adults[J]. Neuroimage, 2010, 49(1): 939–946

[26] Adolphs R. Is the human amygdala specialized for processing social information[J]? Ann N Y Acad Sci, 2003, 985: 326–340

[27] Rankin KP, Salazar  A, Gorno-Tempini ML , Detecting sarcasm from paralinguistic cues: anatomic and cognitive correlates in neurodegenerative disease[J]. Neuroimage, 2009, 47(4): 2005–2015

[28] Kleim JA, Barbay  S, Cooper NR , Motor learning-dependent synaptogenesis is localized to functionally reorganized motor cortex[J]. Neurobiol Learn Mem, 2002, 77(1): 63–77

[29] Hebbian. The Organization of Behavior[M]. New York: J Wiley, 1949.

[30] Merzenich M. Soft-Wired[M]. San Francisco: Parnassus Publishing, 2013.

RIGHTS & PERMISSIONS

2017 2017 by the Journal of Biomedical Research.