Teaching communication skills in clinical settings: comparing two applications of a comprehensive program with standardized and real patients

AIMS: To report the experience with teaching of anesthesiology to medical students in a practical and interactive way, using simulators in clinical scenarios of anesthesia with predetermined tasks.EXPERIENCE REPORT: In the Medical School of the Pontifical Catholic University of Rio Grande do Sul simulated clinical settings are used in general anesthesia and anesthetic blockage teaching. Complete equipment and drugs specific to each simulation are available. Students have direct performance in the simulator to perform in the presented situations. For each conduct, choice of drugs and doses required, filming are performed with the purpose of fixing and improve knowledge.CONCLUSIONS: Medical teaching of anesthesiology with the use of simulators tends to be increasingly used, since it inserts the student in simulated situations close to the reality of the anesthetic process, in an interactive and attractive way without the real risk. Clinical situations of anesthesia or complications can be repeated until the fixation of knowledge and skills, before facing a situation with real patients.

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Empathy, Emotions and Patient-centredness: a Case Study on Communication Strategies

HERMES - Journal of Language and Communication in Business ◽

10.7146/hjlcb.v59i1.116990 ◽

2019 ◽

Vol 59 (1) ◽

pp. 71-89

Author(s):

Ana Muñoz-Miquel

Keyword(s):

Communication Skills ◽

Medical Information ◽

Communication Strategies ◽

Role Play ◽

Extensive Literature ◽

Written Communication ◽

Doctor Patient Communication ◽

Healthcare Settings ◽

Real Patients

One of the abilities most often associated with patient-centred communication (PCC) is empathy. But how can it be achieved? There is an extensive literature acknowledging the importance of communication skills in healthcare settings. However, few studies focus on the specific strategies that can help overcome the challenges posed by PCC, especially in dealing with, understanding and responding to emotions. This is especially evident in the field of written communication. Starting from the assumption that the way in which medical information is conveyed can significantly influence receivers’ emotional response, and thus their understanding, this paper explores oral and written communication strategies that might be useful for fostering empathy. These strategies are based on the results of two funded research projects carried out by the Gentt Group (Universitat Jaume I, Spain), in which qualitative methods (interviews, focus groups and role-play with real actors) were used to improve doctor-patient communication in intralingual and interlingual contexts, in two genres: fact sheets for patients and medical consultations. The results show that avoiding ambiguous and alarming words, providing explicit explanations, using ‘you’ or the inclusive plural when addressing the patient, framing statements in a positive way, and explaining medical terms can all help enhance empathy, both in oral and written modes. In oral genres, non-verbal communication can also play a key role in showing genuine understanding. The importance of obtaining feedback from real patients and the potential of intralingual translation and role-play for improving the communication skills of medical professionals, translators and interpreters are also discussed.

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Parents Working With Speech-Language Pathologists to Foster Partnerships in Education

Language Speech and Hearing Services in Schools ◽

10.1044/0161-1461.2901.24 ◽

1998 ◽

Vol 29 (1) ◽

pp. 24-34 ◽

Cited By ~ 2

Author(s):

Judith G. Farber ◽

Marilyn K. Goldstein

Keyword(s):

Academic Achievement ◽

Parent Involvement ◽

Communication Skills ◽

Learning Experiences ◽

School Personnel ◽

Educational Programs ◽

Speech Language Pathologists ◽

Comprehensive Program ◽

Partnerships In Education ◽

Parent Program

This article outlines a parent involvement program that was developed and implemented by speech-language pathologists as part of a comprehensive program to improve academic achievement and literacy by focusing on communication skills. The basis of the program was to help parents become active participants in their child’s educational and learning experiences. The organization and content of the parent program are explained and information needed to replicate the program is provided. Results of descriptive evaluations of the sessions and feedback from school personnel indicate a need for continued parent-focused educational programs.

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The Net Generation of Nursing: Keeping Empathetic Communication Alive

Creative Nursing ◽

10.1891/1078-4535.19.1.21 ◽

2013 ◽

Vol 19 (1) ◽

pp. 21-25 ◽

Cited By ~ 1

Author(s):

Sharon Metcalfe ◽

Amy Putnam

Keyword(s):

Online Education ◽

Communication Skills ◽

Degree Completion ◽

Electronic Communication ◽

Nursing Profession ◽

Net Generation ◽

Clinical Settings ◽

Nursing Educators ◽

Profound Impact ◽

Degree Completion Programs

Electronic communication has had a profound impact on generations, in the nursing profession as well as in society as a whole. Nursing educators struggle with facilitating verbal communication skills in didactic and clinical settings, particularly with the Net Generation. Online education is rapidly becoming the norm in degree-completion programs. Nursing educators must assure that empathetic communication with patients will not become a lost art.

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Medical-care systems for long-duration space missions

Clinical Chemistry ◽

10.1093/clinchem/39.1.13 ◽

1993 ◽

Vol 39 (1) ◽

pp. 13-21 ◽

Cited By ~ 20

Author(s):

B A Houtchens

Keyword(s):

Medical Care ◽

Health Care Providers ◽

Space Station ◽

Transportation Systems ◽

Clinical Settings ◽

Care Providers ◽

Long Duration ◽

Care Systems ◽

Manned Space ◽

Real Patients

Abstract As in the opening of frontiers on Earth, human physiological maladaptation, illness, and injury--rather than defective transportation systems--are likely to be the pace-limiting variables in efforts to expand the presence of humans into the solar system. Because of the inability of individuals to return to Earth rapidly and conveniently, the capability of delivering medical care on site will be key to the success of a manned space station, lunar base, and Mars mission. Spaceflight medical care equipment must meet stringent constraints of size, weight, and power requirements, and then must function accurately in remote, self-contained, microgravity settings after extended intervals of storage, with neither expert operators nor repair technicians on site. Satisfying these unusually rigorous requirements will require sustained direct involvement of clinically up-to-date health-care providers, medical scientists, and biomedical engineers, as well as astronauts and aerospace engineers and managers. Solutions will require validation in clinical settings with real patients, as well as in simulated operational settings.

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Effectiveness of simulated clinical teaching in general practice: randomised controlled trial

Journal of Primary Health Care ◽

10.1071/hc12281 ◽

2012 ◽

Vol 4 (4) ◽

pp. 281 ◽

Cited By ~ 10

Author(s):

C Raina Elley ◽

Tara Clinick ◽

Chris Wong ◽

Bruce Arroll ◽

John Kennelly ◽

...

Keyword(s):

General Practice ◽

Medical Students ◽

Randomised Controlled Trial ◽

Communication Skills ◽

Controlled Trial ◽

Community Based ◽

Medical Undergraduate ◽

Randomised Controlled ◽

Tract Infections ◽

Real Patients

INTRODUCTION: There are shortages in community-based general practice placements for medical students. Innovative ways to teach the skills required in general practice are needed. AIM: To assess the effectiveness of simulated general practice clinics using actors, compared with standard community-based general practice attachments in medical undergraduate education. METHODS: Randomised controlled trial involving medical students. Outcome measures included self-reported knowledge, clinical confidence, communication skills, and attitudes within general practice assessed at baseline and after one week. Intervention students participated in 24 simulated consultations with actor-patients over four days. Control students spent four days working with community-based general practitioners and real patients. RESULTS: Of 138 eligible medical students in the first clinical year, 128 (93%) participated and 106/128 (82%) completed the study. Those participating in simulated clinics improved in confidence in history-taking (p=0.03), communication skills (p=0.04), and ability to detect depression (p<0.001) compared with those undertaking community attachments. Those in community-based attachments felt more confident in managing upper respiratory tract infections (p<0.001), screening in general practice (p=0.03) and managing illness in the patients home (p=0.04). There was no difference between the groups in other measures. DISCUSSION: Simulated clinics may assist with development of communication skills within the general practice consultation and may also be used to supplement community-based attachment with real patients. Even so, confidence in the management of common conditions and procedures improves more with real patients. KEYWORDS: Medical education; patient simulation; primary health care; randomised controlled trial

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Key tips for teaching in the clinical setting

BMC Medical Education ◽

10.1186/s12909-020-02283-2 ◽

2020 ◽

Vol 20 (S2) ◽

Author(s):

Annette Burgess ◽

Christie van Diggele ◽

Chris Roberts ◽

Craig Mellis

Keyword(s):

Health Professional ◽

Communication Skills ◽

Clinical Setting ◽

Professional Education ◽

Clinical Training ◽

Medical Knowledge ◽

Early Career ◽

Clinical Environment ◽

Professional Students ◽

Real Patients

AbstractTeaching with real patients in the clinical setting lies at the heart of health professional education, providing an essential component to clinical training. This is true of all the health disciplines – particularly medicine, nursing, dentistry, physiotherapy, and dietetics. Clinical tutorials orientate students to the culture and social aspects of the healthcare environment, and shape their professional values as they prepare for practice. These patient-based tutorials introduce students to the clinical environment in a supervised and structured manner, providing opportunities to participate in communication skills, history taking, physical examination, clinical reasoning, diagnosis and management. It is only through participation that new practices are learnt, and progressively, new tasks are undertaken. The aim of this paper is to provide health professional students and early career health professionals involved in peer and near peer teaching, with an overview of approaches and key tips for teaching in the clinical setting. Although there are many competencies developed by students in the clinical setting, our tips for teaching focus on the domains of medical knowledge, interpersonal and communication skills, and professionalism.

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Simulation-Based Communication Skills Training for Experienced Clinicians to Improve Family Conversations About Organ and Tissue Donation

Progress in Transplantation ◽

10.1177/1526924817731881 ◽

2017 ◽

Vol 27 (4) ◽

pp. 339-345 ◽

Cited By ~ 5

Author(s):

Julie Elizabeth Potter ◽

Jonathan J. Gatward ◽

Michelle A. Kelly ◽

Leigh McKay ◽

Ellie McCann ◽

...

Keyword(s):

Communication Skills ◽

Skills Training ◽

Communication Training ◽

Tissue Donation ◽

Clinical Settings ◽

Communication Skills Training ◽

Balanced Approach ◽

Simulation Based ◽

Deceased Organ Donation ◽

Descriptive Statistical Analysis

Introduction: The approach, communication skills, and confidence of clinicians responsible for raising deceased organ donation may influence families’ donation decisions. The aim of this study was to increase the preparedness and confidence of intensive care clinicians allocated to work in a “designated requester” role. Design: We conducted a posttest evaluation of an innovative simulation-based training program. Simulation-based training enabled clinicians to rehearse the “balanced approach” to family donation conversations (FDCs) in the designated requester role. Professional actors played family members in simulated clinical settings using authentic scenarios, with video-assisted reflective debriefing. Participants completed an evaluation after the workshop. Simple descriptive statistical analysis and content analysis were performed. Results: Between January 2013 and July 2015, 25 workshops were undertaken with 86 participants; 82 (95.3%) returned evaluations. Respondents were registered practicing clinicians; over half (44/82; 53.7%) were intensivists. Most attended a single workshop. Evaluations were overwhelmingly positive with the majority rating workshops as outstanding (64/80; 80%). Scenario fidelity, competence of the actors, opportunity to practice and receive feedback on performance, and feedback from actors, both in and out of character, were particularly valued. Most (76/78; 97.4%) reported feeling more confident about their designated requester role. Discussion: Simulation-based communication training for the designated requester role in FDCs increased the knowledge and confidence of clinicians to raise the topic of donation.

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A Shared Decison-Making Virtual Patient in Medical Education: A mixed methods evaluation (Preprint)

10.2196/preprints.22745 ◽

2020 ◽

Author(s):

Simon Jacklin ◽

Neal Maskrey ◽

Stephen Chapman

Keyword(s):

Communication Skills ◽

Structured Interviews ◽

Post Intervention ◽

Early Theory ◽

Mixed Methods Evaluation ◽

Informed Preferences ◽

Or Practice ◽

Observed Behaviour ◽

Future Work ◽

Real Patients

BACKGROUND Shared decision-making (SDM) is a process where clinicians and patients work together to select tests, treatments, management or support packages, based on clinical evidence and the patient’s informed preferences. Like any skill, SDM requires practice to improve. Virtual Patients (VPs) are simulations that allow one to practice their communication skills. VPs could be used to help professionals and students practice the communication skills required to engage in SDM, but this specific focus has not received much attention within the literature. OBJECTIVE To evaluate a VP workshop for medical students aimed at developing the communication skills required for SDM. METHODS A pre and post-intervention questionnaire followed by semi-structured interviews. RESULTS The interviews and questionnaires suggested that the VP was enjoyable and easy to use. When the participants were asked to rank their priorities in a consultation both pre and post-VP, there was a statistically significant change in the rank position of “respecting patient choices” (P = 0.038) with the median rank changing from 2nd to 1st. The VP allowed the participants to explore a consultation in a way that they could not with simulated or real patients; this may be part of the reason that the VP was suggested as a useful intervention for bridging from the early, theory focused years of the curriculum to the more patient focused ones later on. CONCLUSIONS The VP was well accepted by the participants. The multiple choice system of interaction was reported as both useful but also restrictive. Future work should look at further developing the mode of interaction and explore whether the VP results in any changes in observed behaviour or practice.

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Nurses’ Assertive Communication: A Review and Future Directions

LSP International Journal ◽

10.11113/lspi.v2n2.26 ◽

2018 ◽

Vol 2 (2) ◽

Author(s):

Nur’ain Balqis Haladin ◽

Noor Aireen Ibrahim ◽

Azizah Rajab

Keyword(s):

Health Care ◽

Communication Skills ◽

Health Care Professionals ◽

Daily Basis ◽

Clinical Settings ◽

Future Directions ◽

Good Communication ◽

Potential Barriers ◽

Work Settings ◽

Workplace Factors

Nurses interact with patients, colleagues and other health care professionals on a daily basis and this interaction is improved when nurses have good communication skills. Becoming more assertive can lead to increased respect and recognition as a person and as a nurse. This paper aims to gain more insights on nurses’ assertive communication at the workplace by reviewing current research on assertiveness and nursing. There is an abundance of studies to support the use of assertiveness skills in clinical settings. Although forms of assertive behaviour have been investigated in many situations, there is still insufficient empirical evidence with regard to the frequency and the use of assertiveness skills by nurses in clinical settings. Moreover, there is also a lack of research describing potential barriers to this, and it has been suggested that the factors in nurses’ work settings that promote or inhibit assertive behaviour need to be explored and identified. This paper will conclude with a discussion of a proposed study which will examine the level of assertiveness among nurses in Malaysia, the influence of workplace factors, the factors supporting the use of assertive behaviour and the factors that hinders the use of assertive behaviour.

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