Teaching communication skills in postgraduate medical education

An interdisciplinary, family-focused approach to relational learning in neonatal intensive care

OBJECTIVE

The aim of this study is to show the efficacy of the Program to Enhance Relational and Communication Skills-Neonatal Intensive Care Unit (PERCS-NICU).

STUDY DESIGN

In this study, 74 practitioners attended workshops and completed baseline, post-training and follow-up questionnaires.

RESULT

On yes/no questions, 93 to 100% reported improved preparation, communication skills and confidence post-training and follow-up. A total of 94 and 83% improved their ability to establish relationships, and 76 and 83% reported reduced anxiety post-training and follow-up, respectively. On Likert items, 59 and 64% improved preparation, 45 and 60% improved communication skills and confidence, 25 and 53% decreased anxiety and 16 and 32% improved relationships post-training and follow-up, respectively. Qualitative themes included integrating new communication and relational abilities, honoring the family perspective, appreciating interdisciplinary collaboration, personal/human connection and valuing the learning. In total, 93% applied skills learned, three-quarters transformed practice and 100% recommended PERCS-NICU.

CONCLUSION

After PERCS-NICU, clinicians improved preparation, communication and relational abilities, confidence and reduced anxiety when holding difficult neonatal conversations.

Teaching communication skills to clinical students

Seven years' experience in teaching communication skills to first year clinical students at St Mary's Hospital School of Medicine is described. The first component consists of a day during the introductory clinical course; this is divided into a lecture and small seminar groups and involves behavioural scientists and clinicians from many departments. The second component uses simulated patients and video feedback and takes place in small groups later in the year. Participation of the students through active critical discussion, role play, and interactive video feedback are important aspects in the success of the course. The methods have been refined through evaluation by students and tutors. This article aims to allow others, already running or considering such a course, to develop effective courses within the practical constraints of their own institutions.

Medical professional support and cardiac rehabilitation of males and females

In order to operationalize the concept of 'social support', myocardial infarction (MI) survivors were asked to describe others who had been 'specially helpful' to them during their recovery, using an adjective checklist. Doctors were more likely to be described with words denoting expertise than were friends and family. However, about a third of the adjectives used to describe doctors referred to emotional support. Subjects who had not mentioned a doctor amongst their 'specially helpful' others during the recovery period differed from those who had, in sex distribution, ideas about the cause of the MI, and rehospitalization experiences. Results have implications for the form of medical professional support valued by MI survivors, and also for alternative coping strategies used with apparently equal success by a proportion of survivors.