Communication Skills In Medical Schools Research Articles

Covid-19: knowledge, risk perception, trust and vaccination readiness among German medical students

IntroductionThe Covid-19 pandemic has highlighted the urgency for innovative vaccine strategies since the best of vaccines cannot be useful if people do not accept vaccinations. The current situation suggests that vaccinology has been ignored in the medical curriculum and needs more representation in teaching.ObjectivesWhat, where and how vaccinology is taught during medical studies in Heidelberg and development of an interdisciplinary revised syllabus and practice-oriented teaching methods.MethodsCurricular mapping of courses on the topic of “vaccination”, defining new learning objectives for designing innovative teaching units in consultation with teachers and students, redevelopment and updating of teaching materials.ResultsIn preliminary work, an OSCE has been created by students. Initial findings on the status of teaching on vaccinations and related communication skills in medical schools of Germany with respect to student needs and the national guidelines on learning goals for future physicians are submitted in journal ‘Vaccine’. In collaboration with the elective track Digital Medicine, two tele-OSCEs, an online knowledge quiz on vaccination education and a corresponding evaluation tool will be developed in WS 2021/22. Students will learn how to create modern teaching methods and evaluate them scientifically, using a concrete and relevant topic as an example, and will gain an insight into teaching.ConclusionsThe findings will be integrated into the Heidelberg medical school curriculum (HeiCuMed) on a long-term basis by developing a comprehensive interdisciplinary module ‘Vaccination and Vaccines’, which can either be integrated into various existing courses (e.g. virology, medical Communication, global health, etc) or as a separate elective interprofessional course.DisclosureNo significant relationships.

Communication skills in medicine: where do we come from and where are we going?

The physician-patient relationship has changed throughout history, as the role of physician has been transformed. Modern physicians need to be educated on how to use highly specialized knowledge when approaching the patient as a unique and whole person living in a given psychological, social, and material context. This relationship evolved from a paternalistic model to a cooperative-deliberative one, representing a meeting between two “experts:” the physician as the medical expert and the patient as the expert on himself. According to this model, communication between patients and physicians must be based on common understanding in a caring and dynamic relationship that also involves the patient’s family. Nevertheless, this new approach is not free from difficulties, because physicians have to learn to adapt to its demands. This situation has led to a new concept known as the “empowered patient” (1). Effective physician-patient communication is a central clinical function in building a therapeutic relationship. Therefore, in recent decades great attention has been paid to the quality of communication in medicine. However, the educational background and characteristics of communication skills teaching are a less studied field. Anglo-Saxon countries are pioneers in integrating this subject into undergraduate and postgraduate medical education. Less is known about other countries, especially Spanish-speaking and Central and Eastern European countries (2-4). The only way the future physicians (today’s students) can develop effective communication with their patients is to integrate this teaching at the university level. Therefore, it was necessary to analyze how teaching of communication skills in medical schools has evolved. This essay provides a brief historical analysis of the integration of this teaching in the pioneering countries. We also focus our attention to Spain and Croatia, where our teams come from. It can be said that these reflections are the result of teamwork and collaboration between Croatia and Spain.

Teaching Communication in Medical Schools

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.

Teaching clinically experienced physicians communication skills. A review of evaluation studies.

Interest in the teaching of communication skills in medical schools has increased since the early seventies but, despite this growing interest, relatively limited curricular time is spent on the teaching of communication skills. The limited attention to the teaching of these skills applies even more to the physicians' clinical years, when attention becomes highly focused on biomedical and technical competence. Continuing training after medical school is necessary to refresh knowledge and skills, to prohibit decline of performance and to establish further improvements. This review provides an overview of evaluation studies of communication skills training programmes for clinically experienced physicians who have finished their undergraduate medical education. The review focuses on the training objectives, the applied educational methods, the evaluation methodology and instruments, and training results. CD-ROM searches were performed on MedLine and Psychlit, with a focus on effect-studies dating from 1985. Fifteen papers on 14 evaluation studies were located. There appears to be some consistency in the aims and methods of the training programmes. Course effect measurements include physician self-ratings, independent behavioural observations and patient outcomes. Most of the studies used inadequate research designs. Overall, positive training effects on the physicians' communication behaviour are found on half or less of the observed behaviours. Studies with the most adequate designs report the fewest positive training effects. Several reasons are discussed to explain the limited findings. Future research may benefit from research methods which focus on factors that inhibit and facilitate the physicians' implementation of skills into actual behaviours in daily practice.

Communication teaching and assessment in medical education: an international consensus statement

The importance of communication between doctors and patients has been well established, and there is growing acceptance of the need to teach and assess communication skills in medical schools. Faculty meeting at a consensus workshop during the International Conference on Teaching Communication in Medicine (Oxford, July 1996) generated a series of recommendations for developing and implementing teaching and assessment programmes. The points were refined in subsequent discussions with other interested groups, and endorsed in their current form by a workshop of teachers attending the Communication in Health Care Conference organized by NIVEL, the Netherlands Institute of Primary Health Care (Amsterdam, June 1998). While focused on medical schools, the eight recommendations highlighted in this consensus statement are also relevant to both graduate and continuing medical education programmes: (1) teaching and assessment should be based on a broad view of communication in medicine; (2) communication skills teaching and clinical teaching should be consistent and complementary; (3) teaching should define, and help students achieve, patient-centred communication tasks; (4) communication teaching and assessment should foster personal and professional growth; (5) there should be a planned and coherent framework for communication skills teaching; (6) students’ ability to achieve communication tasks should be assessed directly; (7) communication skills teaching and assessment programmes should be evaluated; (8) faculty development should be supported and adequately resourced.

The teaching of communication skills in United Kingdom medical schools

A survey was carried out of the teaching of communication skills in medical schools in the United Kingdom during the academic year 1989/90. Comparison with previous surveys shows a considerable development over the last 10 years. Departments of psychiatry and general practice continue to play a major part in such teaching. There was wide variation in educational objectives and in the curricular time available. Concern is expressed about the methods of assessment and the degree of integration between departments. Future plans and the perceived barriers are reported and the implications discussed.