Communication skills training in psychiatry

SUMMARY Good communication skills are the basis of all effective doctor–patient relationships, and psychiatrists in particular have to manage many types of complex interaction. Research shows the benefits of communication skills training. This article describes strategies for teaching relevant clinical communication skills to trainee psychiatrists on MRCPsych courses and in local centres. The authors set out a sustainable training framework using higher trainees as tutors. There is a need for more widespread teaching of clinical communication skills in psychiatry and at an early stage of specialist training.

Compassionate Healthcare for Parents of Children with Life-limiting Illnesses: A Qualitative Study

Objectives: Premature death of a child from a serious illness is probably one of the most painful experiences for a parent. This study examined the clinical experiences of bereaved parents of children with a life-limiting illness to provide recommendations for quality care. Materials and Methods: Data were collected using semi-structured in-depth interviews with bereaved parents whose children had died at least 3 months before the interview. Parents were purposively sampled from two institutions offering end-of-life care to children with life-limiting illnesses. Data were analysed using thematic analysis. Results: Data analysis revealed three main themes: (1) Clinical communication, (2) Healthcare infrastructure and (3) Non-physical aspects of healthcare. The seven subthemes uncovered were as follows: (1) Honesty and clarity, (2) empathy, (3) interdisciplinary communication, (4) inconveniences in hospital, (5) home palliative care, (6) financial burden of illness and (7) psychosocial and spiritual support. Conclusion: Strategies to improve healthcare for children and their families are multifold. Underlying the provision of quality care is compassion; a child and family-friendly healthcare system with compassionate providers and compassionate institutional policies are vital components to achieving quality healthcare. Culturally sensitive psychosocial, emotional and spiritual support will need to be integrated as standard care.

Pilot Remote Clinical Communication Skill Session During COVID-19 Pandemic: Medical Education in New Normal

IntroductionClinical Communication teaching has relied heavily on face-to-face teaching using Patient Partners. The current situation with COVID-19 has led to lockdown, social isolation and travel difficulty. This leads to challenges in delivering this teaching. The study aim is to pilot a clinical communication teaching session remotely, using a virtual learning environment and video conferencing. This study evaluates the pilot about achieving learning outcomes on Musculo Skeleton disease and experience of student’s and patient partner.MethodsMixed qualitative and quantitative data are obtained through an online survey. The thematic framework is used to analyse the qualitative data and the descriptive statistics are used to evaluate the quantitative responses. Results The study provided satisfaction on proceeding this new pilot remote communication session to the routine medical curriculum, with 100% recommendation by the students. The majority of students had transformed their theoretical knowledge in the Musculo Skeleton disease system to consult with patient partners. The study also finds some gaps such as delays due to internet and device faults, limited time to build rapport with patients, nonverbal expressions are not being conveyed via the screen and difficulties in adapting to new remote sessions in short transition.ConclusionLooking into the future of new normal. Remote clinical communication session worked well during the pilot study. New innovatory methods in delivering remote teaching and more studies on different diseases topics should be implemented to analyse the sustainability and validity of the remote session for continuous delivery in medical education.

A Holistic Approach of Personality Traits in Medical Students: An Integrative Review

Personality is one of the most crucial aspects of human life, since it influences all human behaviours in both personal and social life, and might also trigger important conflicts with a person’s surroundings in the setting of incompatible traits and characteristics. It is true that ‘one must be born’ for a certain medical specialty, but several components of personality might be educated with proper training. Increased levels of Conscientiousness, Agreeableness, and Openness associated with lower levels of Neuroticism might represent the key combination for achieving professional satisfaction in the medical profession. Medical students should receive proper interprofessional education, since effective interprofessional relationships among healthcare providers definitely improve patients’ safety. Empathy contributes to effective patient–physician communication, improving patient trust, compliance, and satisfaction, being positively correlated with Openness, Agreeableness, Conscientiousness and Extraversion. Emotional intelligence—the capacity to respond to one’s own and others’ emotions—was proven to contribute, in a synergistic way with empathy, to increasing empathic ability. Clinical communication skills represent a key component in medical students in order to achieve the best patient care, and they are certainly related and/or influenced by empathy, interprofessional collaboration skills, emotional intelligence and, especially, personality traits. Taking into account the complex interactions mentioned above, the implementation of effective courses based on these concepts in medical students, intending to promote the development of clinical communication skills, represents a real emergency, since it might result in a reduction in medical errors and subsequent related deaths. A thorough understanding of students’ personality is mandatory before designing these courses in order to provide a training tailored to their personality styles.

Clinicians’ Voices on a Disciplinary Approach to Teaching Clinical Communication in the Chinese Context: Priorities, Challenges, and Scope

Background: In the absence of a well-rounded syllabus to teach clinical communication, emphasising both interpersonal and medical dimensions, medical students in the early stages of their career may find it challenging to effectively communicate with patients, especially those from different cultural backgrounds. Aims: To explore the priorities, challenges and scope of teaching clinical communication in a Chinese context using a disciplinary approach, and to investigate how medical educators and clinicians teach clinical communication in their respective clinical disciplines. Design: Interpretative phenomenological analysis. Data sources: Nine medical educators, all experienced frontline clinicians from 7 clinical disciplines, were recruited from 7 Hong Kong hospitals and 2 medical schools. They were interviewed to seek their views on teaching clinical communication in the Chinese context, specifically its priorities, challenges, and scope. Results: The interview data revealed 5 themes related to the priorities, challenges, and scope of teaching clinical communication across a wide range of clinical disciplines in the Chinese context, namely (1) showing empathy with patients; (2) using technology as a modern teaching approach to combine medical and interpersonal dimensions; (3) shared decision-making, reflecting the influence of Chinese collectivism and cultural attitudes towards death on communication with patients and their families; (4) interdisciplinary communication between medical departments; and (5) the role of language in clinician–patient communication. Conclusions: Taking a disciplinary perspective, the clinicians in this study approached the complex nature of teaching clinical communication in the Chinese context in different ways. The findings illustrated the need to teach clinical communication using a disciplinary approach in addition to teaching it generically across specialties. This is particularly important in the Intensive Care Unit (ICU), where clinicians frequently cooperate with physicians from other departments. This study also highlighted how non-verbal social cues, communication strategies, and the understanding of clinical communication in the Chinese context operate differently from those in the West, because of socio-cultural factors such as family dynamics and hierarchical social structures. We recommend a dynamic teaching approach using role-playing tasks, scenario-based examples, and similar activities to help medical students to establish well-rounded clinical communication experiences in preparation to overcome challenges in their future real-life clinical practice.

Coping with Hypertension among Indigenous Peoples in Brazil and the Role of the Primary Care Nurse: A Critical Review from a Transcultural Perspective

Our objective is to critically review the literature addressing the strategic role of nurses in the daily primary care of arterial hypertension in Indigenous communities in Brazil. We selected studies based on an initial keyword search of major bibliographic indexing databases for the years 2000 to 2020 and manual search. Further selection was based on topical, methodological, and thematic relevance, as well as evaluation of scholarship quality and pertinence to our chosen narrative. The literature demonstrates Indigenous peoples do not receive health services that measure up to national standards in large part due to a marked lack of academic and employer preparation for nurses operating in transcultural settings. Inequities were apparent in recurrent reports of victim-blaming, deficient clinical communication with patients, clinical malpractice, devaluation of hypertension as a problem for Indigenous peoples, insufficient intercultural training for nurses, and discrimination against Indigenous students in nursing education programs. This systemic problem needs to be addressed by universities and the Indigenous Health Care Subsystem in Brazil.