Communication skills teaching

Is the consultation important to study?

  • The medical model is particularly inappropriate for general practice
  • The consultation is central to our work – 200,000 per lifetime!
  • The prize on offer: improved clinical competence, not just patient-centredness
  • Clinical competence:
    1. 1. knowledge base,
    2. 2. communication skills
    3. problem-solving ability
      Together these three are the essence of good clinical practice

      • Communication skills turn theory into practice: a core clinical skill.
      • How we do things is crucial -just as crucial as what we do

What is there to study in communication?

  1. Content – what we do or need to do – e.g. the traditional medical history
  2. Process – how we do it – communication skills per se
  3. Perceptual – what we are thinking and feeling as we go and how this affects the above two

These three mesh completely together to make a consultation and cannot be studied in isolation.

Are there problems in doctor-patient communication?

Yes, in all of the following areas:

  • Why the patient has come
  • Gathering information
  • Explanation and planning
  • Patient adherence
  • Recall and understanding
  • Medico-legal issues
  • Lack of empathy and understanding

Evidence for communication skills being valuable

  • Process of the interview
  • Satisfaction
  • Recall and understanding
  • Adherence
  • Outcome: symptom resolution and physiological parameters
  • Decreased patient concern

Many studies now validate specific communication skills as being able to achieve favourable results with all of the above measures- it is not just subjective and no longer can we say that what we are promoting is just an alternative.

What are the goals of effective communication?

(What is the prize on offer for patients and doctors?)

  • Accuracy
  • Efficiency
  • Supportiveness (a much bigger prize than just being nice or patient-centred)
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