Implementing and tailoring a western-developed communication skills training program for graduate medical trainees in Qatar.

Abstract

In 2009, the Accreditation Council for Graduate Medical Education launched an international branch (ACGME-I). In July 2012, Hamad Medical Corporation (HMC) in Qatar was the second international organization to receive institutional accreditation. The evolution of the ACGME into an international organization leads to the need to understand how to effectively build upon educational programs developed in western cultures while still being attentive to important cultural differences and local needs of international programs. Harden1 delineated three ways of approaching curriculum in international medical education: (1) local educators build a local curriculum; (2) a curriculum built in one country is exported to another; or (3) a transnational curriculum is developed with a strong international basis and attention to local students’ needs. All three approaches may be used by ACGME-I accredited institutions. Communication skills training (CST) programs are of particular interest since the key concept of communication crosses many of the competencies and milestones. Yet communication, perhaps more than other competencies, is subject to differences in interpretation and cultural norms.2 For example, a communication competency such as “Create and sustain a relationship that is therapeutic for patients and supportive of their families”3 may be applied differently in international graduate medical education programs where the role of the family in healthcare is central.2 Important cultural differences notwithstanding, we began this project believing that there were more cross-cultural similarities than differences in healthcare communication skills. Thus, rather than develop a new program, we chose to tailor and implement a western model of CSTin graduate medical education in Qatar.Much has been published internationally on CST for medical students, graduate medical trainees and practicing physicians.4-6 Best practices for teaching communication skills are well-established,7 focusing on facilitator-guided, experiential work.8,9 Research on these programs generally show positive evaluations of such interventions and demonstrate skills uptake as measured with Standardized Patients (SPs). However, most published work about CST has been from western countries. Implementing a CST program in Qatar was innovative as we introduced a western-based curriculum. This is significant as previous educators have questioned whether an experiential role play approach would work in non-western countries.10 The primary purpose of this paper is to report on our experience tailoring and implementing a western-developed CST program in Qatar. Components of training Setting HMC is Qatar’s not-for-profit public healthcare system, consisting of eight public hospitals and other healthcare services, with 19 residency training programs, 14 of which are ACGME-I accredited. Residents and fellows are mandated to complete the CST course during their training.