We realise that the leaflet may be of value in various aspects of doctor/patient communication, but should not be seen as a substitute for communicative-skills training.
The available studies also provide support for the effectiveness of communication skills training in the form of improved communicative behaviors of clinicians [ 18] and higher patient satisfaction [ 19], whereas the effects in terms of patient outcomes [ 20– 22] are mixed.
As far we know, the effect of a combination of a simple communicative intervention (without training) and a leaflet on antibiotic prescribing was not investigated before.
In line with Heni et al., we pursued an integrative didactic approach combining medical professional content with communicative and social skills training, although the focus in the training setting described here was rather on technical procedural skills as well as on general didactic abilities, which have a high relevance for skills training such as feedback techniques and role-play.
According to Realdon et al. (2006), an adequate scaffolding structure for the training of communicative competence in an e-learning environment entails fixing both contextual boundaries and degrees of freedom to let the learner have the opportunity to give sense to the perspective selected.
They also included communicative aspects in the training programme.
Other issues that were mentioned included more training in communicative competencies like listening or recognizing nonverbal signals, and training to monitor patients' perceived problems in daily functioning.
These arguments explain why training empathic and communicative skills does not only serve to improve the patient's experience of care but also increases care quality in the professional perspective [ 19].
From this neuroscience research we deduced three principles of aphasia therapy, recommending (i) massing of training, (ii) behavioural and communicative relevance of the interaction during treatment, and (iii) focusing of training on the patients' communicative needs and possibilities.
Principles derived from neuroscience research emphasise massing of practice, behavioural relevance of the training, and focusing of communicative actions on the patients' needs and possibilities.
RC infants, but not ST infants, experienced species-typical communicative interactions with caregivers who were trained to interact in chimpanzee-appropriate ways (RC: 20 hrs/week; ST: absent).
