Digest

Short reports of the latest research in Medical Education

Talking cure?
Patient-doctor communication can be taught, learned and retained
Toni Suzuki Laidlaw, David M Kaufman, Heather MacLeod, Sander van Zanten, David Simpson, William Wrixon. Relationship of resident characteristics, attitudes, prior training and clinical knowledge to communication skill performance. Medical Education 2006; 40: 1825.

a study into patient-doctor communication skills with the goal of developing a programme to increase their ability in this important area. The researchers, from Dalhousie University, Nova Scotia, Canada, asked three key questions: What is the relationship between residents individual characteristics and communication skills performance? What is the relationship between previous communications skill training and communications skills performance?

What is the relationship between clinical knowledge and communications skills performance? Almost 80 rst- and early second-year residents the Canadian equivalent of senior house ofcers took part in the study. They each completed a four-station objective structured clinical examination. Each 15minute scenario presented a range of communication and clinical knowledge challenges. Residents were rated 15 (poor-excellent) on skills such as initiating the session and understanding the patients point of view. There was also a clinical content checklist of

A strong, positive relationship between communication skills and clinical knowledge needs further investigation, Canadian researchers have urged. They discovered that having good communication skills was closely related to good clinical knowledge application in what is understood to be one of the rst studies to make such a denite link. Their nding came as part of

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a series of specic tasks for each interview. One questionnaire focused on demographic data such as age and gender, while another asked about their attitudes towards medical communication. The residents were assessed by raters who did not know them. Signicant relationships were observed between resident characteristics, attitudes, prior communication skills training, clinical knowledge and communication skills performance. Females scored higher than males Those with English as a rst language scored higher than those with English as a second language Under-30s scored higher than over-30s Dalhousie graduates, who had followed an integrated communications skills programme throughout medical school, scored higher than non-Dalhousie graduates. Some of these differences were less marked on the clinical

content checklist. Attitudes were a poor predictor of communication skills performance, except in the case of gender; females scored higher than males. Residents with previous communication skills training also performed better on both the communications and clinical content checklists. The authors say the ndings support theories that the characteristics of gender, language and age are predictors of communication skills competency and conrm that prior communication skills training is a signicant positive factor. The team suggests the role played by age in demonstrating good communication skills indicates that such skills should be reinforced throughout the continuum of medical education to ensure students and residents do not unlearn them. The researchers claim it is essential that residency programmes offer communications skills support and training for residents who face communication skills obstacles such as those not working in their native

tongue and those without prior training. The researchers point out: Patient-doctor communication can be taught, learned and retained effectively with appropriate training. But it is the high correlations uncovered between clinical knowledge application (biomedical and ethical), prior communication skills training and communication skill prociency that make this study different. The authors say: Our ndings suggest that people with good communication skills are better able to draw out key clinical information, synthesise it and then convey to the patient the relevant clinical knowledge during each interview. They warn that there are possible limitations to their study in regard to the ndings between clinical knowledge and communication skills: It is important to note that content elicited through communication skills is not a guarantee that the information will be used effectively in diagnostic and therapeutic processes. The ndings are, however, certainly worthy of further study.

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