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Leicester & Warwick undergraduate

Communication Skills

The overall aim of the clinical skills module in Year 1 of the new curriculum is “to introduce students to the knowledge, skills and attitudes required to communicate sensitively and effectively with, and perform physical examinations upon, others”.

The communication skills component seeks to provide the students with an understanding of the “patient-centred approach” to the consultation and the importance and complexity of “doctor-patient communication”.

A key element of a patient-centred approach requires a doctor to clarify why the patient has come. This involves not just obtaining the details of the presenting complaint, but exploring patients’ ideas, feelings about and expectations of their problems because this is essential information needed by doctors to make diagnoses and negotiate management plans with patients.

This approach is more likely to result in patients complying with advice given than one in which the doctor has ignored the patient’s viewpoint and the patient who feels that his problem has been dealt with by a friendly, interested doctor who shows concern and respect will be more likely to entrust that doctor with information of a sensitive or embarrassing nature than if the doctor is disrespectful and uninterested.

Patients’ complaints about doctors are more often about the doctors’ poor communication and interpersonal skills than about their diagnostic skills.

Communication between doctors and patients consists of the following skills:

Objectives of the Communication Skills Module

Below are listed the communication objectives of the undergraduate curriculum as a whole.

The Year 1 communication skills teaching aims to introduce students to the following objectives: the satisfactory attainment of these objectives should be achieved by the end of the undergraduate curriculum. It will be essential for all those who teach the students in Phase 1 and Phase 2 to reinforce these objectives at every phase of the curriculum. This will help to ensure students receive consistent messages about what they are expected to achieve.

The objectives particularly relevant to teaching with simulated patients are highlighted.

Knowledge:

Skills: a student should be able to

1. elicit from patients accurate stories of their problems
2. elicit from patients and appropriate informants key information about their medical, family, and psychosocial histories as appropriate
3. recognise and respond appropriately to another's emotions
4. communicate effectively both orally and in writing with colleagues and others
5. abstract relevant information both by observation and from written sources and re-order and synthesise that information into an appropriate sequence
6. present organised information in an accurate and legible manner
7. employ language appropriate to particular audiences.

Attitudes: a student should have

1. an unconditional positive regard for patients and their carers, and for colleagues
   Unconditional positive regard describes the way in which a doctor should relate to patients or colleagues, unbiased by their colour, race or social standing 
2. a willingness to work with and learn from patients with diverse backgrounds and personal styles
3. a desire to support peers in learning and personal development
4. a realisation of the critical importance of accurate written communication in the team approach to medical care.

The Course Content

The Course involves 3 small group seminars spread through the first year. Students are taught in a group of 12 using actors who play the role of simulated patients. These patients scenarios are carefully constructed, based on real patients, to give students clinical problems to solve. The scenarios are also used in other parts of the Medical Course. The students are taught how to communicate effectively with the actor playing the role. The advantage of this approach is that the scenario can run and re-run after discussion to observe the effects of different methods of communication.

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