***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Involvement of family in bedside rounds is one strategy to implement family-centered care to help families get clear information about their child , and be actively involved in decision-making about care . However in developing countries such as Pakistan , daily bedside rounds include the physician , residents , medical students and a nurse/technician . Parents are not currently a part of these rounds . OBJECTIVE To assess whether family-centered rounds improve  parents ' and health care professionals ' satisfaction  , decrease patient length of stay , and improve time utilization when compared to traditional practice rounds in a population with a low literacy rate , socioeconomic status , and different cultural values and beliefs . DESIGN A non-r and omized before-after study design . SETTING A private hospital in Karachi , Pakistan . PARTICIPANTS A convenience sample of 82 parents , whose children were hospitalized for a minimum of 48h , and 25 health care professionals able to attend two consecutive rounds . METHODS During the before phase , traditional bedside rounds were practice d ; and during after phase , family-centered rounds were practice d.  Parents and health care professionals completed a question naire on the second day of rounds . An observational form facilitated data collection on length of stay and time utilization during . RESULTS Parents ' ratings during the family-centered rounds were significantly higher for some parental satisfaction items : evidence of team work ( p=0.007 ) , use of simple language during the rounds ( p=0.002 ) , feeling of inclusion in discussion at rounds ( p=0.03 ) , decision making ( p=0.01 ) , and preference for family-centered rounds ( p=<0.001 ) . No significant differences were found in health care professionals ' satisfaction between rounds . Patient length of stay was significantly reduced in the family-centered rounds group , while no significant difference was found in the duration of rounds .  Family-centered rounds served as an opportunity for parents to correct/add to patient history or documentation . CONCLUSION Parents were satisfied with both forms of rounds ; however , they appeared to have a greater preference for family-centered rounds than health care professionals . Family-centered rounds were a re source for Pakistani parents , enabling direct communication with the medical team without impacting on the time required to complete rounds . Family-centered rounds may improve quality of care such as decreasing length of stay or preventing critical incidents OBJECTIVE It was hypothesized that parents exposed to a communication skills intervention would participate ( e.g. , ask questions , express concerns ) in a pre-surgical consultation more than parents in the control group . METHODS Sixty-five parents of prospect i ve pediatric surgery patients were r and omly assigned to either a communication skills intervention ( booklet mailed prior to the consultation ) or control group . Only initial consultation parents were included , no follow-ups . Audio-recordings of the medical consultations were obtained and the transcripts analyzed utilizing a content-coding system to determine patient participation . Also , parents were given a  health literacy test ( s-TOFHLA ) and a post-interview question naire to gather demographic data . RESULTS Intervention parents participated overall significantly more than control parents . Follow-up analyses revealed that intervention parents asked significantly more questions , and engaged in significantly more information verifying and expressing of concerns . There were no significant differences for parents ' assertive statements or information provision . Other significant predictors of parents ' participation were consultation length and parents ' income . CONCLUSION The intervention tested in this study promoted parents ' participation in a pre-surgical consultation . As such , it has the potential to improve information exchange between parents and physicians with positive implication s for informed consent . PRACTICE IMPLICATION S Providing parents with communication guidelines prior to a surgical consultation may improve physician-patient communication OBJECTIVE Problems with clinician-patient communication negatively impact newborn screening , genetics , and all of healthcare . Training programs teach communication , but educational methods are not feasible for entire population s of clinicians . To address this healthcare quality gap , we developed a Communication Quality Assurance intervention . METHODS Child health providers volunteered for a r and omized controlled trial of assessment and a report card . Participants provided telephone counseling to a st and ardized parent regarding a newborn screening result showing heterozygous status for cystic fibrosis or sickle cell disease . Our rapid-throughput timeline allows individualized feedback within a week . Two encounters were recorded ( baseline and after a r and om sample received the report card ) and abstract ed for four groups of communication quality indicators . RESULTS 92 participants finished both counseling encounters within our rapid-throughput time limits . Participants r and omized to receive the report card improved communication behaviors more than controls , including request for teach-back ( p<0.01 ) , opening behaviors ( p=0.01 ) , anticipate/vali date emotion ( p<0.001 ) and the ratio of explained to unexplained jargon words ( p<0.03 ) . CONCLUSION The rapid-throughput report card is effective at improving specific communication behaviors . PRACTICE IMPLICATION S Communication can be taught , but this project shows how healthcare organizations can assure communication quality everywhere . Further implementation could improve newborn screening , genetics , and healthcare in general OBJECTIVE . We evaluated the effectiveness of a continuing medical education program , Physician Asthma Care Education , in improving pediatricians ’ asthma therapeutic and communication skills and patients ’ health care utilization for asthma . METHODS . We conducted a r and omized trial in 10 regions in the United States . Primary care providers were recruited and r and omly assigned by site to receive the program provided by local faculty . The program included 2 interactive seminar sessions ( 2.5 hours each ) that review ed national asthma guidelines , communication skills , and key educational messages . Format included short lectures , case discussion s , and a video modeling communication techniques . We collected information on parent perceptions of physicians ’ communication , the child ’s asthma symptoms , and patients ’ asthma health care utilization . We used multivariate regression models to determine differences between control and intervention groups . RESULTS . A total of 101 primary care providers and a r and om sample of 870 of their asthma patients participated . After 1 year , we completed follow-up telephone interviews with the parents of 731 of the 870 patients . Compared to control subjects , parents reported that physicians in the intervention group were more likely to inquire about patients ’ concerns about asthma , encourage patients to be physically active , and set goals for successful treatment . Patients of physicians that attended the program had a greater decrease in days limited by asthma symptoms ( 8.5 vs 15.6 days ) , as well as decreased emergency department asthma visits ( 0.30 vs 0.55 visits per year ) . CONCLUSIONS . The Physician Asthma Care Education program was used in a range of locations and was effective in improving parent-reported provider communication skills , the number of days affected by asthma symptoms , and asthma health care use . Patients with more frequent asthma symptoms and higher health care utilization at baseline were more likely to benefit from their physician ’s participation in the program OBJECTIVE To determine whether augmenting st and ard feedback on resident performance with a multi source feedback intervention improved pediatric resident communication skills and professionalism . DESIGN R and omized controlled trial . SETTING Children 's Hospital Medical Center , Cincinnati , Ohio , from June 21 , 2004 , to July 7 , 2005 . PARTICIPANTS Thirty-six first-year pediatric residents . INTERVENTIONS Residents assigned to the multi source feedback group ( n = 18 ) completed a self- assessment , received a feedback report about baseline parent and nurse evaluations , and participated in a tailored coaching session in addition to receiving st and ard feedback . Residents in the control group ( n = 18 ) received st and ard feedback only . The control group and their residency directors were blinded to parent and nurse evaluations until the end of the study . MAIN OUTCOME MEASURES Residents ' specific communication skills and professional behaviors were rated by parents and nurses of pediatric patients . Both groups were evaluated at baseline and after 5 months . Scores were calculated on each item as percentage in the highest response category . RESULTS Both groups had comparable baseline characteristics and ratings . Parent ratings increased for both groups . While parent ratings increased more for the multi source feedback group , differences between groups were not statistically significant . In contrast , nurse ratings increased for the multi source feedback group and decreased for the control group . The difference in change between groups was statistically significant for communicating effectively with the patient and family ( 35 % ; 95 % confidence interval , 11.0%-58.0 % ) , timeliness of completing tasks ( 30 % ; 95 % confidence interval , 7.9%-53.0 % ) , and demonstrating responsibility and accountability ( 26 % ; 95 % confidence interval , 2.9%-49.0 % ) . CONCLUSION A multi source feedback intervention positively affected communication skills and professional behavior among pediatric residents Background To assess the student perspective on acceptability , realism , and perceived effect of communication training with peer role play ( RP ) and st and ardised patients ( SP ) . Methods 69 prefinal year students from a large German medical faculty were r and omly assigned to one of two groups receiving communication training with RP ( N = 34 ) or SP ( N = 35 ) in the course of their paediatric rotation . In both groups , training addressed major medical and communication problems encountered in the exploration and counselling of parents of sick children .  Acceptability and realism of the training as well as perceived effects and applicability for future parent-physician encounters were assessed using six-point Likert scales . Results Both forms of training were highly accepted ( RP 5.32 ± .41 , SP 5.51 ± .44 , n.s . ; 6 = very good , 1 = very poor ) and perceived to be highly realistic ( RP 5.60 ± .38 , SP 5.53 ± .36 , n.s . ; 6 = highly realistic , 1 = unrealistic ) . Regarding perceived effects , participation was seen to be significantly more worthwhile in the SP group ( RP 5.17 ± .37 , SP 5.50 ± .43 ; p < .003 ; 6 = totally agree , 1 = do n't agree at all ) . Both training methods were perceived as useful for training communication skills ( RP 5.01 ± .68 , SP 5.34 ± .47 ; 6 = totally agree ; 1 = do n't agree at all ) and were considered to be moderately applicable for future parent-physician encounters ( RP 4.29 ± 1.08 , SP 5.00 ± .89 ; 6 = well prepared , 1 = unprepared ) , with usefulness and applicability both being rated higher in the SP group ( p < .032 and p < .009 ) . Conclusions RP and SP represent comparably valuable tools for the training of specific communication skills from the student perspective . Both provide highly realistic training scenarios and warrant inclusion in medical curricula . Given the expense of SP , deciding which method to employ should be carefully weighed up . From the perspective of the students in our study , SP were seen as a more useful and more applicable tool than RP . We discuss the potential of RP to foster a greater empathic appreciation of the patient perspective To determine whether st and ardized instructions enhance communication of discharge information , we provided 197 parents of children in whom otitis media was diagnosed with one of three types of instruction at the time of discharge from a pediatric emergency department : ( 1 ) instruction by individual housestaff and medical students after consultation with an attending physician ( control group ) ; ( 2 ) st and ardized verbal instructions given by housestaff and students trained in their use ( verbal group ) ; or ( 3 ) the same instructions given to the verbal group , together with a type-written copy of the information to take home ( verbal + written group ) . Prior to leaving the emergency department and , again , by phone , 1 and 3 days later , parents were question ed concerning the prescribed medication 's name , dose , frequency , and duration of administration ( medication data ) , three signs of improvement , and eight signs indicating the need for medical advice ( worrisome signs ) . The mean percentage of correct responses per parent in each group was computed for each information category . Both at exit interview and at follow-up , parents receiving either form of st and ardized instructions showed significantly greater knowledge of information related to their child 's illness than did controls . Information regarding medication data was more likely to be communicated to parents in all groups than were signs of improvement or worrisome signs . The addition of written instructions to st and ardized verbal instructions did not improve parental recall of discharge information The Physician Asthma Care Education ( PACE ) program significantly improved asthma prescribing and communication behaviours of primary care paediatricians in the USA . We tested the feasibility and acceptability of a modified PACE program with Australian general practitioners ( GP ) and measured its impact on self-reported consulting behaviours in a pilot study . Recruitment took place through a local GP division . Twenty-five GP completed two PACE Australia workshops , which incorporated paediatric asthma management consistent with Australian asthma guidelines and focussed on effective communication strategies .  Program feasibility , usefulness and perceived benefit were measured by question naires before the workshop and 1 month later , and an evaluation question naire after each workshop . GP were universally enthusiastic and supportive of the workshops . The most useful elements they reported were communication skills , case studies , device demonstrations and the toolkit provided . GP self reports of the perceived helpfulness of the key communication strategies and their confidence in their application and reported frequency of use increased significantly after the workshops . The PACE program shows promise in improving the way in which Australian GP manage asthma consultations , particularly with regard to doctor-patient communication . The impact ofthe modified PACE Australia program on the processes and outcomes ofGP care ofchildren with asthma is now being measured in a r and omised controlled trial INTRODUCTION Following the recent amendment to the Medical Education Act in Germany ( Approbationsordnung 2002 ) and the abolition of the prelim 
    Output:
    
Most interventions improved providers ' interpersonal , patient-centered interviewing skills .
Interventions that targeted parents involved booklets and role-playing to encourage questions .
They improved parents ' satisfaction and communication .
An intervention that targeted youth used a video portraying how children can communicate better with physicians .
Once the children aged 5 - 15 years watched the video , they wrote questions for their physicians prior to the medical visit .
The experimental group of children had better rapport with physicians and could recall recommendations about medications more often than the control group .