Communication Skills In Medicine Research Articles

Creation of a model for training the communication skills of medical specialists

BACKGROUND: Effective interaction between medical workers and patients is not only a service function but also influences compliance with the implementation of recommendations for the prevention and treatment of diseases. The communicative competence of healthcare professionals affects treatment effectiveness and the success of health-preserving measures.
 AIM: To examine the problems associated with the formation of communicative competence and determine the fundamental principles of the model of communicative skills of a medical worker.
 MATERIALS AND METHODS: A literature review of 32 domestic and 54 foreign publications on teaching communication in medicine was performed. The work of an expert focus group within the framework of a strategic session on communication skills “A coordinated approach to teaching communication skills in medicine” was analyzed.
 RESULTS: During the work of the focus group, experts reviewed and specified the main shortcomings in the work of medical personnel in ensuring communication with the patient. In the second part of the focus group work, based on communication defects, four blocks of skills were developed to avoid communication errors. Because of a review of literature data and a generalization of the results of the work of experts, a prototype model of the communication skills of a medical worker was proposed.
 CONCLUSIONS: Existing models of medical communication must adapt to national characteristics based on research and joint discussions. The authors propose using fundamental principles of the model of communication skills of a medical worker in educational programs of higher and additional professional education, as outlined in this article.

Experience of Holding the All-Russian Olympiad on Communication Skills in Medicine Using “Simulated Patient” Technology

The article presents the experience of the Volga Research Medical University in organizing and holding the All-Russian Olympiad in the psychology of communication “Communicative competence from the perspective of modern medicine.” Students of medical and non-medical specialties, as well as young doctors, were invited to participate. Participants solved cases, situational problems, and analyzed videos filmed using a “simulation” patient. This mixed format made it possible to identify the main gaps in the knowledge of medical students; the experience of “non-medical” students revealed possible communication problems on the part of the patient.

The Influence of Teaching Methods on Self-Assessment of Academic Achievements of Students in Teaching Communication Skills in Medicine

Differences in the self-assessment of academic achievements of students depending on the use of interactive teaching methods are revealed. To prepare for primary accreditation, the Standardized Patient methodology is effective. For the formation of competencies necessary in real professional activity, the use of role-playing games and group discussions is significant. Simulation training has a positive effect on the formation of a predictive self-assessment of academic achievements, an increase in the educational and professional motivation of students, and the development of their reflective and productive thinking.

Student-Patient Communication. A View from the Practitioner

The main goal of communication skills in medicine was considered to be the acquisition of the necessary knowledge for the diagnosis and implementation of effective treatment. This goal is still a priority. But taking into account the development of review sites, increasing the availability of awareness, a new item appeared that interested medical and educational institutions. This is the rating of the institution. The rating is built on two main points: 1) technical equipment, personnel and new technologies and 2) public opinion about the institution. Institutional opinion is based on the opinion of patients or students.

Leveraging Technology to Overcome the "Scalability Problem" in Communication Skills Training Courses.

Although multiple consensus statements have called for large-scale efforts to improve clinicians’ communication skills regarding a variety of difficult conversations in medicine, this goal will be difficult to attain because there are no readily scalable, validated communication skills training programs for clinicians. However, novel applications of existing technologies and approaches grounded in learning science can overcome the scalability barriers. Moreover, future advances in virtual reality and artificial intelligence are likely to greatly enhance the possibilities for communication skills training programs. The purpose of this paper is to propose a scalable, theoretically grounded method to train clinicians in advanced communication skills in medicine. First, we summarize four key principles of adult learning relevant to communication skills training in medicine. Second, we discuss recommended practices to design effective technology-enhanced educational interventions, with an emphasis on achieving high amounts of user engagement. Third, we synthesize these principles into a framework for a web- and videoconference-based platform for teaching advanced communication skills in medicine. Once developed, this low-cost, scalable training platform has the potential to allow thousands of clinicians to acquire the advanced communication skills needed for difficult conversations in medicine.

Promoting cultural awareness, professionalism, and communication skills in medicine through anatomy: The Deaf culture session.

The anatomy curriculum is a place where professionalism can be learned and practiced, including training in cultural competence and communication skills for working with diverse populations. One population that has received little attention in terms of medical education are d/Deaf and hard of hearing (d/DHH) patients, although there is much evidence to support health care disparities in this population. Several major contributing factors include differing views of deafness between medical professionals and those who are culturally Deaf, a lack of understanding of Deaf culture and American Sign Language (ASL) by medical professionals, a lack of educational resources in ASL, and poor experiences in health care. To address this need, a Deaf Culture Applied Anatomy session was incorporated into the first-year curriculum at Morehouse School of Medicine while medical students were studying anatomy of the ear and hearing. Panelists, who were culturally Deaf, hard of hearing, and hearing children of deaf adults, shared their experiences in healthcare, including challenges they faced with communication and care. Surveys were provided to students before and after the panel session. Surveys indicated a lack of knowledge prior to this session, while also demonstrating that this 90-min session improved students' understanding of effective communication with future patients and issues related to deafness. Qualitative feedback also suggested that the students found the session to be personally and professionally beneficial. Implementing the Deaf Culture session was an effective means for introducing students to Deaf culture and working with d/DHH patients.

Enseñanza secuencial de habilidades de comunicación en las facultades de Medicina

Communication skills in medicine are very important not only in the development of a physician’s clinical skills but in the doctor-patient relationship; and, besides, has beneficial results in the same patient. However, its learning is neither explicit nor structured in most of our medical schools. This article’s objective is to summarize a proposal in order that such skills be included in the curricular plans of our medical schools.

Addressing the Challenges of Training in Communication Skills in Medicine in India

Addressing the Challenges of Training in Communication Skills in Medicine in India

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.

Specifics of communication skills in medicine

Communication in medicine is considered a core skill of the doctor on the way to successful diagnosis and treatment, and establishing an adequate relationship with the patient. In a similar way, should take place and the communication process between physician-patient and nurse - patient, and between all actors of the medical team and patients. Good communication skills, patience and sensitivity to the problems of the patient are necessary to create mutual trust. It is important to be in communication with the patient never imposing your own views, even when we are deeply convinced that whatever we do, we do it for their own good. Communication in health care requires knowledge, competence and technical skills, including the need for continuing active learning and practicing communication skills of all members of the medical team, both doctors and nurses and other staff who work with patients.

Emotional intelligence in medical education: a critical review

Emotional intelligence (EI) is a term used to describe people's awareness of, and ability to respond to, emotions in themselves and other people. There is increasing research evidence that doctors' EI influences their ability to deliver safe and compassionate health care, a particularly pertinent issue in the current health care climate. This review set out to examine the value of EI as a theoretical platform on which to base selection for medicine, communication skills education and professionalism. We conducted a critical review with the aim of answering questions that clinical educators wishing to increase the focus on emotions in their curriculum might ask. Although EI seems, intuitively, to be a construct that is relevant to educating safe and compassionate doctors, important questions about it remain to be answered. Research to date has not established whether EI is a trait, a learned ability or a combination of the two. Furthermore, there are methodological difficulties associated with measuring EI in a medical arena. If, as has been suggested, EI were to be used to select for medical school, there would be a real risk of including and excluding the wrong people. Emotional intelligence-based education may be able to contribute to the teaching of professionalism and communication skills in medicine, but further research is needed before its wholesale adoption in any curriculum can be recommended.

Teaching and Learning Communication in Veterinary Medicine

Drawing on extensive evidence and experience in human medicine, this article offers a practical conceptual framework for thinking more precisely about how to teach and learn communication systematically and intentionally in veterinary medicine. The overarching goal is to promote the development of communication programs so as to improve communication in veterinary practice to a professional level of competence. A three-part conceptual framework is presented that first explores the rationale behind teaching and learning communication, including the evidence base regarding the impact of communication on clinician-client interactions and outcomes of care and the research on teaching and learning communication skills in medicine. The second part considers four ways to conceptualize what to teach and learn, as explicated by (a) the domains of communication in veterinary medicine; (b) ''first principles'' of effective communication; (c) evidence-based goals or outcomes for communication programs; and (d) delineation and definition of the specific individual skills that research evidence supports, as presented in the Calgary-Cambridge Guides. The last part of the conceptual framework examines how to teach communication, including the use of models, a primary focus on skill development as the backbone of communication programs, and the value of other methods supported by the evidence, such as simulated patients, videotape, small groups, and feedback and facilitation skills. Communication impacts the clinician- client interaction and outcomes of care in very significant ways. Communication can and should be taught and learned with as much rigor as other aspects of clinical competence. Veterinary programs at all levels should include the teaching of communication.

Relationship of resident characteristics, attitudes, prior training and clinical knowledge to communication skills performance

A substantial body of literature demonstrates that communication skills in medicine can be taught and retained through teaching and practice. Considerable evidence also reveals that characteristics such as gender, age, language and attitudes affect communication skills performance. Our study examined the characteristics, attitudes and prior communication skills training of residents to determine the relationship of each to patient-doctor communication. The relationship between communication skills proficiency and clinical knowledge application (biomedical and ethical) was also examined through the use of doctor-developed clinical content checklists, as very little research has been conducted in this area. A total of 78 first- and second-year residents across all departments at Dalhousie Medical School participated in a videotaped 4-station objective structured clinical examination presenting a range of communication and clinical knowledge challenges. A variety of instruments were used to gather information and assess performance. Two expert raters evaluated the videotapes. Significant relationships were observed between resident characteristics, prior communication skills training, clinical knowledge and communication skills performance. Females, younger residents and residents with English as first language scored significantly higher, as did residents with prior communication skills training. A significant positive relationship was found between the clinical content checklist and communication performance. Gender was the only characteristic related significantly to attitudes. Gender, age, language and prior communication skills training are related to communication skills performance and have implications for resident education. The positive relationship between communication skills proficiency and clinical knowledge application is important and should be explored further.

Teaching and Learning Communication Skills in Medicine Kurtz Suzanne , Silverman Jonathanand Draper JulietTeaching and learning communication skills in medicine Publisher Radcliffe No. of pages: 392 Price£35.0018577565841857756584

The intended audience for this text consists of programme directors and facilitators involved in teaching, planning and developing communication skills in medicine. This book is suitable for nurse practitioner and advanced nursing educators and as a core student text. Indeed, it has value for professions allied to medicine who are also communicating with patients on a regular basis.

Teaching and Learning Communication Skills in Medicine (2e)

Teaching and Learning Communication Skills in Medicine (2e)

Which basic communication skills in medicine are learnt spontaneously and which need to be taught and trained?

Students in the last semester of medical school and experienced junior doctors with no or little training in communication skills were observed while interviewing or informing simulated patients. There was a remarkable similarity in behaviour between the two categories. Communication skills characteristic of common social conversation were learnt spontaneously, while important professional basic communication skills were not learnt despite 10 or more years of clinical work. These discrepancies and subsequent gaps should be the focus of future training courses at both pre- and postgraduate level.

Skills for Communicating with Patients (2e)

By Jonathan Silverman , Suzanne Kurtz and Juliet Draper . Radcliffe Publishing Ltd , 2004 , PB £27.95 , 262 pp Difficult Conversations in Medicine . ISBN 1-85775-640-1 Skills for Communicating with Patients was first published in 1998, and has been extensively revised for the 2005 edition. There is a companion book, Teaching and Learning Communication Skills in Medicine, also first written in 1998, which is not addressed in this review. The book is unique among communication skills books in two important ways. The first is that it integrates the traditional medical interview approach with the patient-centred approach, thus not throwing diagnostic reasoning out with paternalistic approaches to the clinical encounter. The authors effectively integrate the two traditions to make a comprehensive, but practical guide to teaching communication skills in medicine. The second critical element that runs throughout the book is a comprehensive, but focused, review of the literature on effectiveness of communication skills. They join that with evidence that effective communication is rarely practiced in routine clinical encounters. This provides a powerful statement of need that was undertaken in the first edition, and is still relevant. In the intervening years, the evidence for effectiveness has mounted, and the literature is now much more convincing. In addition, the chapter on ‘Explanation and Planning’ has been expanded to include shared decision-making. This section explicitly includes shared decision-making as a necessary skill. As with the rest of the book, both effectiveness evidence and the rationale for the curriculum are provided. This allows the authors to present theoretical and research evidence to guide the choice of specific communication skills to include in the curriculum. They have answered both the ‘so what’ question and the ‘how to’ question. The book should prove useful to its intended audience, medical educators and programme directors in medicine, nursing, allied health and counselling. However, it is also useful to decision aid developers and others who design and implement enhancements to the clinical encounter. The book is organized into 8 chapters. The five follow their curricular outline, and the chronological flow of a clinical encounter. Chapter 1 provides an overview of the rationale and elements of the communication skills curriculum. The synthesis of the biomedical perspective disease-orientation (sequence of events, symptom analysis, relevant systems review), and the patient's perspective illness-orientation (ideas and beliefs, concerns, expectations, effects on life, feelings) is clearly laid out. The Calgary-Cambridge Guide is included. This short list of the 70 skills the authors believe to be necessary is justified in terms of the structure, skills identification, validity from research and articulation of the proper breadth of the communication skills curriculum. The authors identify the post-1998 research by others that both validates and strengthens the approach described. The final chapter is devoted to special issues, including breaking bad news, cultural and social diversity, age-related issues, depression and others. A short (10 page) middle chapter is called, ‘providing structure to the interview’. It shows how providing structure and building the relationship should happen throughout the interview. Here, as elsewhere, they cite the broad consensus on which their approach is based, citing the work of Pendleton, Neighbour, Cohen-Cole, van Theil and van Dalen, Kalet, Stewart, and others who have participated in consensus processes in Europe and the UK, North America and Australia. The core of the book is the discussion of the major sections of the medical encounter: initiating the session, gathering information, physical examination, explanation and planning, and closing the session. In each of these sections, the problems in communication that require explicit teaching, the objectives, and the skills are identified. Examples of questions and patient responses are provided that make it clear why these skills are needed. References to research literature consistently identify what improvements may be expected if the relevant skills are used. Of particular interest to readers of Health Expectations is the shared decision-making section of the chapter on explanation and planning. The authors review the literature that shows large deficits in young doctors’ information-giving skills, and the evidence that better communication process skills will both engage patients more effectively, and support reaching concordance. The literature review shows that patients want more information than they typically receive, and that patient recall and understanding can be improved if better communication skills are employed. The relationship between shared understanding, and shared decision-making is made explicit, and the reasons patients give for non-participation in clinical encounters reviewed. Overall, the synthesis of theoretical, empirical and practical perspectives make this book an important reference for educators and researchers interested in improving the quality of the clinical encounter, and enhancing the patient's role.

Book Review: Teaching and Learning Communication Skills in Medicine

Book Review: Teaching and Learning Communication Skills in Medicine

Patient centred medicine: reason, emotion, and human spirit? Some philosophical reflections on being with patients

The ideal of patient centred medicine remains only partially realised. Within modern Western society, the highly individualistic culture and religious decline linked with medicine's reluctance to relinquish an outmoded form...

Book Review: Teaching and learning communication skills in medicine

Book Review: Teaching and learning communication skills in medicine