Transcript Pottecher – Communication in medical education

Communication in medical
education
T. Pottecher, T. Pelaccia, B. Ludes, J. Sibilia
Ped. Res. Lab. University of Medicine
Strasbourg
Communication in medical
practice
• Paramount importance on a daily basis
– With patients and relatives
– Within the medical team
• Mandatory for medical teachers
– At the bedside
– To give a lecture
• No formal teaching in medical curriculum
• State of practice in medical universities
• Tools for communication’s assessments
• Results
Survey of «old » residents in
anesthesia
• Training in communication : 21%
– 1/3 : simulated patient
– ½ : « osmosis » with senior
– 1/6 : lectures
• Needing additional training : 88 %
Prochilo C. SFAR 2O11
• State of practice in medical faculties
• Tools for communication’s assessments
• Results
Assessment of patient’s problem and situation
Appropriate questionning
Asked 1 question at a time
Understanding patient’s beliefs
Asked SP views about illness
Accuracy of understanding
Summarized SP story
Patient Education and Counseling
Elicits patient’s perspectives
Asked SP views of need of action
Provides clear instructions
Information in segments smal
enough to be absorbed
Assesses patient’s understanding Ascertained what SP understood
Communication skills checklist (partial)
OSCE : Objective structured clinical examination
Clinical cases for simulated patients
Feedback
Giving feedback : core element in medical education
But : thin evidence base to guide medical educators
Algorithm for giving feedback ?
self-feeling
mini-cex
Thomas JD.Giving feedback. J. Palliat Med 2011 Feb;14(2):233-9
• State of practice in medical faculties
• Tools for communication’s assessments
• Results
Survey of «old » residents in
anesthesia
• Training in communication : 21percent
– 1/3 : simulated patient
– ½ : « osmosis » with senior
– 1/6 : lectures
• Needing complementary training : 88 percent
• Comfortable for communication
– 81% if previous training
– 60 % without previous training
Prochilo C. SFAR 2O11
Results
OSCE improves also time management
The Netherlands Institute of Primary Health Care (Amsterdam, June 1998) highlighted
this consensus statement to both graduate and continuing medical education
programmes:
1. teaching and assessment should be based on a broad view of communication in medicine;
2. communication skills and clinical teachings should be consistent and complementary;
3. teaching should define, and help students achieve, patient-centred communication tasks;
4.
communication teaching and assessment should foster personal and professional growth;
5. there should be a planned and coherent framework for communication skills teaching;
6. students' ability to achieve communication tasks should be assessed directly
7.
communication skills teaching and assessment programmes should be evaluated;
8. faculty development should be supported and adequately resourced.
Patient Educ Couns. 1999 Jun;37(2):191-5.
Do you teach medical
communication….
• If yes : How?
• If no : Why?