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

BACKGROUND: Communication is important for the quality of clinical practice, and programs have been implemented to improve healthcare providers' communication skills. However, the consistency of programs teaching communication skills has received little attention, and debate exists about the application of acquired skills to real patients. This study inspects whether (1) results from a communication program are replicated with different samples, and (2) results with standardized patients apply to interviews with real patients. METHODS: A structured, nine-month communication program was applied in two consecutive years to two different samples of healthcare professionals (25 in the first year, 20 in the second year). Results were assessed at four different points in time, each year, regarding participants' confidence levels (self-rated), basic communication skills in interviews with standardized patients, and basic communication skills in interviews with real patients. Data were analyzed using GLM Repeated-Measures procedures. RESULTS: Improvements were statistically significant in both years in all measures except in simulated patients' assessment of the 2008 group. Differences between the two samples were non-significant. Differences between interviews with standardized and with real patients were also non-significant. CONCLUSIONS: The program's positive outcomes were replicated in different samples, and acquired skills were successfully applied to real-patient interviews. This reinforces this type of program structure as a valuable training tool, with results translating into real situations. It also adds to the reliability of the assessment instruments employed, though these may need adaptation in the case of real patients.

Learning clinical communication skills: outcomes of a program for professional practitioners.

OBJECTIVE: To assess the effects of a communication skills program on professional practitioners' performance and self-confidence in clinical interviewing. METHODS: Twenty-five health professionals took 3 months of basic communication skills followed by 3 months of advanced communication skills. An additional quarter dealt with self-awareness and communication in special situations. Participants' performances were evaluated in clinical interviews with standardized patients before, during and after the program by external observers and standardized patients, using standardized instruments. Participants assessed their own confidence in their communication skills before and after the program. Data were analysed using GLM repeated-measures procedures in SPSS. RESULTS: Basic communication skills and self-confidence improved throughout the 6 months; competencies declined but self-confidence continued to increase 4 months later. Compared with taking no course, differences were statistically significant after the 6 months (external observers only) and 4 months later (external observers and participants). CONCLUSION: The program effectively improved communication skills, although significantly only when assessed by external observers. Four months later, effects were significant in communication skills (external observers), despite the decline and in self-confidence. PRACTICE IMPLICATIONS: While periodical enrollment in programs for the practice of communication skills may help maintain performance, more knowledge on communication and self-awareness may enhance self-confidence.

[Teaching doctor-patient communication - a proposal in practice]. / O ensino da comunicação na relação médico-doente - uma proposta em prática.

Traditionally, doctor-patient communication was considered a matter of <> and <>, and a topic for informal learning. Recently, studies have shown the importance of communication skills in medical practice. Doctor-patient communication skills, such as knowing how to listen, how to observe, and how to inform are today considered important components of Medical Education, although they are often difficult to integrate in Medical Curricula. In the current work, the authors describe the program of Communication in the Doctor-Patient Relationship, initiated in 2001 in the Medical School of the University of Porto, part of its undergraduate program. Future studies will allow us to assess the effectiveness of the learning and application of these skills in clinical practice.