Abstract
BackgroundPoor communication skills can potentially compromise patient care. However, as communication skills training (CST) programs are not seen as a priority to many clinical departments, there is a discernible absence of a standardised, recommended framework for these programs to be built upon. This systematic scoping review (SSR) aims to gather prevailing data on existing CSTs to identify key factors in teaching and assessing communication skills in the postgraduate medical setting.MethodsIndependent searches across seven bibliographic databases (PubMed, PsycINFO, EMBASE, ERIC, CINAHL, Scopus and Google Scholar) were carried out. Krishna’s Systematic Evidence-Based Approach (SEBA) was used to guide concurrent thematic and content analysis of the data. The themes and categories identified were compared and combined where possible in keeping with this approach and then compared with the tabulated summaries of the included articles.ResultsTwenty-five thousand eight hundred ninety-four abstracts were identified, and 151 articles were included and analysed. The Split Approach revealed similar categories and themes: curriculum design, teaching methods, curriculum content, assessment methods, integration into curriculum, and facilitators and barriers to CST.Amidst a wide variety of curricula designs, efforts to develop the requisite knowledge, skills and attitudes set out by the ACGME current teaching and assessment methods in CST maybe categorised into didactic and interactive methods and assessed along Kirkpatrick’s Four Levels of Learning Evaluation.ConclusionsA major flaw in existing CSTs is a lack of curriculum structure, focus and standardisation. Based upon the findings and current design principles identified in this SSR in SEBA, we forward a stepwise approach to designing CST programs. These involve 1) defining goals and learning objectives, 2) identifying target population and ideal characteristics, 3) determining curriculum structure, 4) ensuring adequate resources and mitigating barriers, 5) determining curriculum content, and 6) assessing learners and adopting quality improvement processes.
Highlights
Effective doctor-patient communication boosts patient safety and the patient experience [1, 2]
Amidst suggestions that communications skills degrade over time, a longitudinal communication skills training (CST) program that melds training, clinical experience, assessments, and reflective practice supported by role modelling, coaching and mentoring is critical [18, 19]
Rationale for this review Acknowledging growing evidence of the impact of CST in medical schools and the influence of different healthcare and education systems, practice settings and practical considerations [22] on the structure and content of CST programs, we focus on better understanding current approaches to CST in the postgraduate setting
Summary
Effective doctor-patient communication boosts patient safety and the patient experience [1, 2]. Amidst suggestions that communications skills degrade over time, a longitudinal CST program that melds training, clinical experience, assessments, and reflective practice supported by role modelling, coaching and mentoring is critical [18, 19]. Such a longitudinal approach would be consistent with Hoffman et al [20]‘s recommendation aimed at developing adaptive clinical communication skills that are responsive to the needs of different patients in different circumstances. This systematic scoping review (SSR) aims to gather prevailing data on existing CSTs to identify key factors in teaching and assessing communication skills in the postgraduate medical setting
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