Deepening the teaching and learning of clinical communication (original) (raw)
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Journal of Health Communication, 2015
Patients share straightforward statements with physicians such as describing their fears about their diagnosis. Physicians need to also understanding implicit, indirect, subtle communication cues that give broader context to patients' illness experiences. This project examines physicians' written reflections that offer insight into their interpretation of both the stated and the tacit aspects of their observations about communication, their resulting responses, and their intended actions. Tufts University Family Medicine residents (N = 33) of the Tufts Family Medicine Cambridge Health Alliance completed three reflective exercises each week over the course of 1 year (756 reflective entries). An interdisciplinary research team identified communication-related concepts within the reflections. Identified themes include (a) physicians recognizing and discovering mutual interplay of their communication with and patient disclosure, (b) physicians paying attention to subtleties of patient behavior as indicative of a fuller picture of patients' lives and their coping with illness, and (c) physician images of growth and awareness about communication indicative of their potential for growth and improvement. The project extends the literature in communication and medical education by examining explicit and tacit points of reflection about communication. The project (a) allows for unpacking the multifaceted aspects of reflection and (b) bridges reflective theory and medical education with communication foundations.
(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.
Learning Clinical Communication
Procedia - Social and Behavioral Sciences, 2014
Problem statement: Clinician-patient communication is a basic skill that medical students should learn as part of their training process. Communication skills curriculums aim to develop effective communication with patients, carers, and colleagues by working on both verbal and non-verbal skills. These include being able to take a history and share information, and particularly explaining procedures and discussing treatment options and their effects. Students taking the Communication, interview and clinical history module are asked to follow a simulated-patient clinical interview, which is recorded and then self and tutorassessed using standardized questionnaires. Purpose of study: The aim of this study is to conduct a pilot test to compare questionnaire results for self and tutor-assessed video-recorded clinical interviews. Methods: The results of students' self-assessment questionnaires within the Communication, interview and clinical history module (second year of the medical degree) were compared with those of their tutors. The questionnaire used was a shortened version of the 17-itemCICCA-D (Conectar-Identificar-Comprender-Acordar-Ayudar-Connect-Identify-Understand-Agree-Help) instrument (score of 2, 1 or 0 for each item), based on patient-centred interviews. The assessments were carried out independently from one another, with no previous training, after watching the clinical interview video recording. Results: A total of 47 student and tutor assessments were carried out. Differences in the global average scores were statistically significant (p-value < 0.05). The students' mean self-assessment score was 13 (SD = 5), while the tutors' was 15 (SD = 5). A weak direct and statistically significant correlation was observed in the global questionnaire score between both self and tutor assessment (n = 47): with an ICC of 0.41 (confidence interval [CI] 95%, (0.09-0.66). Conclusions: Pilot test results show that tutors consider students having better communication skills than students themselves. Lack of previous training in the use of the questionnaire could be relevant. Further research is needed to confirm these preliminary results.
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, 2009
Our objective was to dynamically engage with parents and carers of children treated in a large children's hospital as experts by experience, to find out what they thought medical students should be learning about communicating with children and families in order to inform our communication teaching. We used focus groups to facilitate parents and carers in articulating the communication issues they felt were important for medical students to learn. These data were analysed, using qualitative and quantitative methods, to produce a survey for a Delphi consultation. The results of this stage were mapped onto the Calgary-Cambridge framework for the medical interview. There was considerable overlap of the data on the Calgary-Cambridge framework. There was, however, an emphasis by respondents on perceptual skills, self-awareness and partnership. Within the main tasks of the Calgary-Cambridge framework, new objectives emerged, including giving information in the right place, and the imp...
The art of communication in medicine
Effective communication is an essential skill in general practice consultations. The art of communication is the development of effective skills and finding a style of communication that suits the clinician and produces benefits for both patient and doctor.
Electronic physician, 2015
Introduction: Medical students have a serious need to acquire communication skills with others. In many medical schools, special curriculums are developed to improve such skills. Effective training of communication skills requires expert curriculum design. The aim of this study was to explore the experiences and views of experts and stakeholders in order to design a suitable training program in communication skills for medical students. Methods: The content analysis approach was used in this qualitative study. Forty-three participants were selected from the faculty, nurses, physicians, residents, and medical students at Mashhad University of Medical Sciences using purposive sampling. The data were collected through focus group discussions and semi-structured interviews. To ensure the accuracy of the data, the criteria of credibility, transferability, dependability, and conformability were met. The data were analyzed by MAXQDA software using the Graneheim & Lundman model. Results: The findings of this study consisted of two main themes, i.e., "The vast nature of the present communication skills training" and "administrative requirements of the training program regarding communication skills." The first theme included the educational needs of students, the problems associated with training people to have good communication skills, the importance of good communication skills in performing professional duties, communication skills and job requirements, the learning environment of communication skills, and the status of existing training programs for communication skills. Strategies and suitable methods for teaching communication skills and methods of evaluating the students in this regard also were obtained. Conclusion: The findings of this study were the elements required to design a proper and local model to teach communication skills to medical students through analyzing the concepts of effective communication. The results of this study can be useful for medical faculties in designing a proper program for teaching medical students how to communicate effectively with patients and colleagues.