Teaching Communication in Clinical Clerkships: Models from the Macy Initiative in Health Communications (original) (raw)
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(2018): Teaching future doctors to communicate: a communication intervention for medical students in their clinical year, Journal of Communication in Healthcare, ABSTRACT Background: Effective patient-provider communication enables shared decision-making and leads to improved patient satisfaction, treatment adherence, and health outcomes. The ideal time for developing effective patient-provider communication skills is during a student's clinical training, yet few medical schools have a formal communication curriculum during the clinical year. Methods: We developed a communication curriculum for third-year medical students during clinical training, involving videotaped mock patient interactions and direct instruction by a communication professor. The final mock interviews of the intervention group (n = 10) and the control group (n = 9) were assessed by three blinded communication professors using a communication assessment tool. Results: Students who received the communication intervention scored higher than controls overall and in each of four subcategories (identification convergence, information seeking, information giving, nonverbal behaviors), a pattern statistically significant using a one-tailed sign test (P = 0.031). The intervention group's subscore for information giving was also significantly higher (Wilcoxon Rank Sum test, P = 0.047). Discussion: The communication intervention was successful in improving the students' communication skills, especially information giving, which is critical to enabling patients to make informed decisions in shared decision-making. A curriculum emphasizing the practical application of communication skills in the clinical year can produce measurable improvements in medical students' communication.
Teaching communication skills to medical students, a challenge in the curriculum
Patient Education and Counseling, 2005
Introduction: As communication skills become more and more important in medical practice, the new medical curriculum at Ghent University (1999) implemented a communication curriculum. Method: Communication training or experiences in 'real life' settings are provided every year of the medical curriculum. The training starts with simple basic skills but gradually slips into medical communication or consultation training and results in communication in different contextual situations or with special groups of patients. Rehearsal is important and seen as inevitable. Poorly performing students get extra training.
Patient Education and Counseling, 2013
To describe a program with integrated learning of communication and consultation skills developed with the intention of preventing deterioration of communication skills, and to present student evaluation data. Description and evaluation of the program through: (1) monthly student evaluations; (2) questionnaire on student perceptions about the integrated curriculum; (3) a questionnaire about the value of one specific integrated training preceding the pediatric clerkship. Key components of training throughout years 3-6 are reinforcement throughout the clinical years, adapting communication training to the clinical context of clerkships using a sandwich model with cycles of preparation, clerkship, and reflection. response rates were 69%, 93% and 93%, respectively. Students value practicing integration of communication and medical content with SPs who represent the population of their next clerkships. They appreciate the multisource feedback during the training, feedback by clerkship specific specialists and SPs is valued most. This description shows an example of an integrated curriculum that helps students to feel well prepared for their communication tasks in subsequent clerkships. Designing and implementing communication curricula to address the issue of integration is feasible. The effects of such integrated programs should be subject to future studies.
Teaching Communication Skills on the Surgery Clerkship
Medical Education Online, 2005
Background: Physician communication skills, linked to important patient outcomes, are rarely formally addressed after the pre-clinical years of medical school. We implemented a new communication skills curriculum during the third year Surgery Clerkship which was part of a larger curriculum revision found in a controlled trial to significantly improve students' overall communication competence. Description: In three 2 hour workshops students, learned to address common communication challenges in surgery: patient education, shared decision-making, and delivering bad news. Each 2 hour, surgeon facilitated session was comprised of a 30 minute introductory lecture, a 15 minute checklist driven video critique, a 15 minute group discussion, a 45 minute standardized patient (SP) exercise with feedback from the SP, peers, and faculty member, and a 15 minute closing summary. To date, over 25 surgery faculty have been trained to conduct these sessions. In an endof-clerkship survey, students reported on skill changes and assessed the curriculum's educational effectiveness. Evaluation: A survey was completed by 120 of the 160 (76%) third year students who participated in the curriculum. Fifty-five percent of students reported improvement in their communication skills and ability to address specific communication challenges. Students were satisfied with the amount and quality of teaching.
Teaching Communication in Medical Schools
Rambam Maimonides Medical Journal, 2011
In spite of the enormous progress of Western medicine during the past century there has not be a concomitant rise in the public's satisfaction with the medical profession. Much of the discontent relates to problems in physician-patient communication. The multiple advantages of good communication have been clearly demonstrated by numerous careful studies. While the past few decades have witnessed much more attention given to teaching communication skills in medical schools, there are a number of factors that create new problems in physician-patient communication and counteract the positive teaching efforts. The "hidden curriculum", the increased emphasis on technology, the greater time pressures, and the introduction of the computer in the interface between physician and patient present new challenges for the teaching of physician-patient communication.
Curriculum factors influencing knowledge of communication skills among medical students
BMC Medical Education, 2007
Background: Communication training builds on the assumption that understanding of the concepts related to professional communication facilitates the training. We know little about whether students' knowledge of clinical communication skills is affected by their attendance of communication training courses, or to what degree other elements of the clinical training or curriculum design also play a role. The aim of this study was to determine which elements of the curriculum influence acquisition of knowledge regarding clinical communication skills by medical students.
Teaching Inpatient Communication Skills to Medical Students: An Innovative Strategy
Academic Medicine, 2005
At the University of Washington, a group of medical educators defined a set of communication skills, or "benchmarks," that are expected of second-year medical students conducting history and physical examinations on hospitalized patients. In order to teach the skills listed in the communication benchmarks, an educational strategy was devised that included training sessions for 30 medical teachers and the development of an innovative videotape tool used to train the teachers and their students. The benchmarks were designed in 2003 for the developmental level of the students and were based on key communication concepts and essential elements of medical communication. A set of five short videotaped scenarios was developed that illustrated various segments of a student history and physical examination. Each scenario consisted of an "OK" version of communication and a "better" version of the same scenario. The video scenarios were used in teaching sessions to help students identify effective communication techniques and to stimulate discussion about the communication benchmarks. After the training sessions, teachers and students were surveyed to assess the effectiveness of the educational methods. The majority of students felt that the educational design stimulated discussion and improved their understanding of communication skills. Faculty found the educational design useful and 95% felt that the curriculum and videotape contributed to their own education. The development of communication benchmarks illustrated with short videotaped scenarios contrasting "OK" with "better" communication skills is a useful technique that is transferable to other institutions.
Communication Skills Training in the Medical Curriculum
Journal of Education and Learning (EduLearn), 2013
Communication is an essential skill in the armory of any worker in the health field. It is an integral part of the skills required, not only in medical doctors, but in all health workers. Communication is more than history taking; it includes all methods of interaction with patients, patient's relatives, members of the health care team, and the public. Many studies stressed that the main complaints of patients are related to communication problems and not to clinical competency. This has contributed to an increase in the number of law suits, non-adherence to medical regimens, and the tendency of patients to keep changing physicians and hospitals. Also, it has been shown that health outcome is positively affected by proper communication. This includes patient's satisfaction and cooperation, decrease in treatment duration, decrease in painkillers requirements, and decrease in hospital stay. Also, it has been shown that communication skills can be taught and important changes in physician's behavior and in their communication skills have been demonstrated after courses of communication skills. Thus, many medical colleges in the world are including communication skills courses in their undergraduate and graduate curricula.