This chapter is designed to give an overview of a number of specific situations in teaching and research relating to anaesthesia where communication skills may be useful. Whilst there are many others, these have been chosen because, in the authors’ experience, they are often unfamiliar or poorly performed, or assumed to be part of the ‘tacit’ skill set that cannot be formally taught. Perhaps the most important interaction that occurs between anaesthetists is that which occurs during teaching. Communicating with trainees in order to bring about a change in knowledge, skills and attitude is probably the most sophisticated form of communication anaesthetists employ other than the context of therapeutic communication with patients. Scant attention is often paid to the unconscious way in which anaesthetics trainees learn. Anaesthesia, like surgery, is learnt, not taught. Much of the beliefs, behaviours and attitudes that trainees acquire comes implicitly as they observe and copy their mentors’ actions. Part of becoming an anaesthetist involves the acquisition of ‘anaesthetic culture’—the sense of professional identity which may be either a positive or a negative one. When working with trainees, not only should they be taught the knowledge and skills to do the job, but, more importantly, senior anaesthetists should be modelling, and explicitly teaching them, better ways to interact with colleagues. It is far beyond the scope of this chapter to address the issues surrounding education in anaesthesia. However, it is useful to explore one aspect of teaching—that is, feedback in order to highlight some basic principles. Everyone loves feedback—so long as it is positive! No-one likes to feel that they are being unfairly, or even fairly, criticized. So how can anaesthetists give the feedback our trainees so desperately crave? As in all communication the key lies in establishing a rapport. Most trainees spend long enough in a department to establish a reasonable relationship with at least one or two trainers. It is difficult to give feedback to a trainee whose baseline capabilities are uncertain. … ‘Does he always make a pig’s ear out of arterial cannulation or is he just having a bad day? ’ …
Improving therapeutic communication skills based on the COMFORT Communication curriculum
