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Eklics K, Csongor A, Hambuch A, Fekete JD. Diverse Integration of Simulated Patients in Medical Education for Communication, Language, and Clinical Skills in Hungary. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2024; 15:301-312. [PMID: 38618523 PMCID: PMC11016270 DOI: 10.2147/amep.s438102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 03/11/2024] [Indexed: 04/16/2024]
Abstract
Medical education and communication training has been undergoing substantial changes recently in our globalized environment. Multidisciplinary simulation-based methods worldwide focus on improving effective clinical skills including history taking, physical examination, diagnostic skills, critical thinking, therapeutic skills, and others via interactions between medical students, trainees, and patients. Recently, Hungary has joined such global trends. The first simulated patient program in Hungary was developed at the University of Pécs Medical School in 2019 to aid effective patient-interviewing skills in language and communication classes. Under the supervision of linguists, communication specialists and medical professionals, the multidisciplinary program uses lay people to perform as simulated patients while using the languages of Hungarian, German, and English. Our simulated patient program plays a specific role in supporting students to learn languages for medical purposes, aiming to prepare them for handling the medical, linguistic, at the same, time emotional and sociocultural difficulties encountered while taking patient histories. Medical and linguistic experts evaluate student performance, provide feedback, and give tailored instruction so that students can advance their communicative and professional skills. This study discusses working formats and the role of constructive feedback exploring potential advantages and disadvantages, sharing ideas, and proposing recommendations on language- and communication-based integration of simulated patients. In our elective communication courses, undergraduate medical students learn to cope with a variety of patient situations through practicing medical emergencies, misunderstandings, and disagreements in a safe atmosphere provided by the MediSkillsLab. Among the benefits, we should emphasize that any course with a growing number of students can be accommodated by carefully designing the program, which allows for interprofessional collaboration. This program contributes to higher-quality medical education, promoting more skilled and compassionate healthcare specialists.
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Affiliation(s)
- Kata Eklics
- Department of Languages for Biomedical Purposes and Communication, Medical School, University of Pécs, Pécs, Hungary
| | - Alexandra Csongor
- Department of Languages for Biomedical Purposes and Communication, Medical School, University of Pécs, Pécs, Hungary
| | - Anikó Hambuch
- Department of Languages for Biomedical Purposes and Communication, Medical School, University of Pécs, Pécs, Hungary
| | - Judit Diana Fekete
- Department of Languages for Biomedical Purposes and Communication, Medical School, University of Pécs, Pécs, Hungary
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Zemlin C, Nourkami-Tutdibi N, Schwarz P, Wagenpfeil G, Goedicke-Fritz S. Teaching breaking bad news in a gyneco-oncological setting: a feasibility study implementing the SPIKES framework for undergraduate medical students. BMC MEDICAL EDUCATION 2024; 24:134. [PMID: 38347593 PMCID: PMC10863240 DOI: 10.1186/s12909-024-05096-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 01/24/2024] [Indexed: 02/15/2024]
Abstract
BACKGROUND It is a crucial task for physicians to deliver life threatening information to patients (breaking bad news; BBN). Many aspects influence these conversations on both sides, patients, and doctors. BBN affects the patient-physician relationship, patients' outcome, and physicians' health. Many physicians are still untrained for this multi-facetted task and feel unprepared and overburdened when facing situations of BBN. Therefore, any faculties should aim to integrate communication skills into their medical curricula as early as possible. The SPIKES protocol is an effective framework to deliver BBN. Aim of this study is to evaluate the feasibility and obstacles of a BBN seminar and its acceptance and learning curve among undergraduate medical students. METHODS 158 2nd year undergraduate medical students attended a compulsory BBN seminar. The task was to deliver a cancer diagnosis to the patient within a patient - physician role-play in a gyneco-oncological setting before and after a presentation of the SPIKES protocol by the lecturer. The students evaluated important communication skills during these role-plays respectively. Self-assessment questionnaires were obtained at the beginning and end of the seminar. RESULTS Most students indicated that their confidence in BBN improved after the seminar (p < 0.001). They like the topic BBN to be part of lectures (76%) and electives (90%). Communication skills improved. Lecturer and seminar were positively evaluated (4.57/5). CONCLUSION The seminar significantly increased confidence and self-awareness in delivering life-threatening news to patients among undergraduate medical students. Important learning aspects of BBN and communication skills could be delivered successfully to the participants within a short time at low costs. The integration of communication skills should be implemented longitudinally into medical curricula starting before clinical education to increase the awareness of the importance of communication skills, to decrease anxiety, stress, and workload for future doctors and- most importantly- to the benefit of our patients.
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Affiliation(s)
- Cosima Zemlin
- Department of Gynecology and Obstetrics, Faculty of Medicine, Saarland University, Homburg, Germany
| | | | - Pascal Schwarz
- Department of Gynecology and Obstetrics, Faculty of Medicine, Saarland University, Homburg, Germany
| | - Gudrun Wagenpfeil
- Institute of Medical Biometry, Epidemiology and Medical Informatics, Saarland University, Homburg, Germany
| | - Sybelle Goedicke-Fritz
- Department of General Pediatrics and Neonatology, Saarland University, Homburg, Germany.
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Dahmen L, Linke M, Schneider A, Kühl SJ. Medical students in their first consultation: A comparison between a simulated face-to-face and telehealth consultation to train medical consultation skills. GMS JOURNAL FOR MEDICAL EDUCATION 2023; 40:Doc63. [PMID: 37881523 PMCID: PMC10594035 DOI: 10.3205/zma001645] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 05/07/2023] [Accepted: 07/07/2023] [Indexed: 10/27/2023]
Abstract
Objective A simulated conversation between a physician and a family member, i.e., a medical conversation, was changed from a conventional face-to-face conversation (SS 2019) to a telehealth conversation (SS 2020) due to the COVID-19 pandemic. The medical education conversation is part of the biochemistry seminar "From Genes to Proteins" which second semester human medicine students take. The objective of this study was to analyze to what extent the switch from face-to-face to telehealth conversations affected student satisfaction and motivation. Methodology In the seminar, students study biochemical as well as competency-oriented content, such as how to talk to family members. In the summer semester of 2019, students were trained how to talk to their patients' family members in a traditional conversation setting with the help of lay actors in a classroom format. In the summer semester of 2020, this conversation took place under comparable conditions, but in the form of an online telehealth conversation instead. Student satisfaction and motivation were surveyed by means of an evaluation questionnaire following the seminar in both semesters. Results Both conversation formats achieved a high level of satisfaction from students (school grade A-B). For some evaluation items, such as "realistic conversation simulation", the face-to-face conversation was perceived as more satisfying (Md=5.0, IQR=1.0) than the telehealth conversation (Md=5.0, IQR=2.0). In addition, the face-to-face conversation resulted in higher subjective motivation from students (Md=5.0, IQR=1.0) than that of the telehealth conversation (Md=4.0, IQR=2.0). Conclusion The high student satisfaction and acceptance of both didactic concepts leads to the conclusion that the simulated telehealth conversation is an adequate substitute for the simulation of a traditional face-to-face conversation with regard to the parameters that were studied.
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Affiliation(s)
- Lena Dahmen
- University of Ulm, Faculty of Medicine, Institute of Biochemistry and Molecular Biology, Ulm, Germany
| | - Maike Linke
- Dresden University of Technology, Carl Gustav Carus Faculty of Medicine, Psychosocial Medicine and Developmental Neurosciences, Dresden, Germany
| | - Achim Schneider
- University of Ulm, Faculty of Medicine, Dean of Studies Office, Ulm, Germany
| | - Susanne J. Kühl
- University of Ulm, Faculty of Medicine, Institute of Biochemistry and Molecular Biology, Ulm, Germany
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Maksymowicz S, Libura M, Malarkiewicz P. Overcoming therapeutic nihilism. Breaking bad news of amyotrophic lateral sclerosis—a patient-centred perspective in rare diseases. Neurol Sci 2022; 43:4257-4265. [PMID: 35149928 PMCID: PMC9213364 DOI: 10.1007/s10072-022-05931-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 02/03/2022] [Indexed: 11/24/2022]
Abstract
Amyotrophic lateral sclerosis (ALS) is a rare, incurable, and fatal neurodegenerative disease with median survival time from onset to death ranging from 20 to 48 months. Breaking bad news about ALS diagnosis is a challenging task for physicians and a life-changing experience for patients. Several protocols for delivering difficult information are available, including SPIKES and EMPATHY. Our goal was to assess to what extent these guidelines are followed in Polish ALS patients’ experience as well as to identify any other patients’ preferences not addressed by the guidelines. Participants of our study were recruited via a neurology clinic. Twenty-four patients with confirmed ALS diagnosis were interviewed using in-depth interview and a self-constructed questionnaire: 9 females, 15 males in age ranging from 30–39 to 60–69. The analysis showed a pattern of shortcomings and fundamental violations of available protocols reported by ALS patients. Patients also had to deal with therapeutic nihilism, as they were perceived as “hopeless cases”; unlike in oncological setting, their end-of-life needs were not accommodated by some standard schemes. As a conclusion, we recommend using extended breaking bad news protocols with special emphasis on preparing a treatment plan, giving the patient hope and sense of purpose, offering psychological support and counselling directed to patients and caregivers, and providing the patient with meaningful information about the disease, social support, treatment options, and referral to appropriate health care centres.
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Affiliation(s)
- Stanisław Maksymowicz
- Department of Psychology and Sociology of Health and Public Health, School of Public Health, Collegium Medicum of the University of Warmia and Mazury, Olsztyn, Poland
- Instytut Terapii Komórkowych S.A., Olsztyn, Poland
| | - Maria Libura
- Medical Education and Simulation Department, School of Medicine, Collegium Medicum of the University of Warmia and Mazury, Olsztyn, Poland
| | - Paulina Malarkiewicz
- Department of Obstetrics and Gynaecology, School of Medicine, Collegium Medicum of the University of Warmia and Mazury, Olsztyn, Poland
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Novais F, Ganança L, Barbosa M, Telles-Correia D. Communication skills in psychiatry for undergraduate students: A scoping review. Front Psychiatry 2022; 13:972703. [PMID: 36032255 PMCID: PMC9402997 DOI: 10.3389/fpsyt.2022.972703] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 07/21/2022] [Indexed: 11/25/2022] Open
Abstract
Communication skills are paramount in all areas of medicine but particularly in psychiatry due to the challenges posed by mental health patients and the essential role of communication from diagnosis to treatment. Despite the prevalence of psychiatric disorders in different medical specialties, particularly in primary care settings, communication skills in psychiatry and their training are not well studied and are often not included in the undergraduate medical curriculum. Our paper explores the relevance of teaching communication competencies in psychiatry for undergraduate medical students. Our work focused on reviewing the methods for teaching communication skills to undergraduate students in Psychiatry. Eleven studies were selected to be included in this review. We found considerable heterogeneity among methods for teaching communication skills but also some common elements such as the use of simulated patients and providing feedback. This review has identified two models: the Calgary-Cambridge interview model and the Kolb cycle-based model. However, most studies still lack a theoretical background model. We believe that the inclusion of communication skills training in medical curricula is fundamental to teaching medical students general communication skills but also specific training on establishing adequate communication with psychiatric patients. However, more research is needed to determine the best method for training but also regarding its translation to patient care and cost-effectiveness.
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Affiliation(s)
- Filipa Novais
- Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.,Centro Hospitalar Universitário Lisboa Norte, Santa Maria Hospital, Lisbon, Portugal.,ISAMB - Instituto de Saúde Ambiental - Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Licínia Ganança
- Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.,Centro Hospitalar Universitário Lisboa Norte, Santa Maria Hospital, Lisbon, Portugal
| | - Miguel Barbosa
- Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.,Faculdade de Psicologia, Universidade de Lisboa, Lisboa, Portugal
| | - Diogo Telles-Correia
- Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.,ISAMB - Instituto de Saúde Ambiental - Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
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Dec-Pietrowska J, Szczepek AJ. A Study of Differences in Compulsory Courses Offering Medicine Humanization and Medical Communication in Polish Medical Schools: Content Analysis of Secondary Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413326. [PMID: 34948930 PMCID: PMC8706785 DOI: 10.3390/ijerph182413326] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/14/2021] [Accepted: 12/16/2021] [Indexed: 11/30/2022]
Abstract
Medical humanity is an essential element of medical education, and the respective courses are introduced to the curricula of medical schools worldwide. However, significant differences in this type of medical education were identified in Italy, Spain, and the UK. In Poland, this issue was not yet analyzed. The classes offered on a compulsory and not elective basis secure the uniform skills of future physicians. Therefore, we were prompted to ask a question: do Polish medical students receive equal compulsory education in medical humanities? To answer that question, we performed a content analysis of mandatory classes’ frequency, types, and content on medical humanization and communication in Polish medical schools. The study used publicly available information provided on the home pages of the universities to perform content and comparative analyses. Of 22 identified universities, 15 had publicly listed teaching programs, and nine had freely available syllabi. The names and types of courses varied from school to school. The number of hours the courses offered throughout medical education ranged from 15 to 216. In some medical schools, the classes were scheduled during the early, pre-clinical part of the study, whereas in other schools they were offered each year. The content of the courses always covered the topics of physician–patient communication but rarely offered protocols, such as the Calgary Cambridge guide. We conclude that the medical humanities represented by medical humanization and communication courses are included in the publicly available compulsory curriculum of most Polish medical schools. However, to secure equal education of future Polish physicians, there is a need to unify the medical humanities program.
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Affiliation(s)
- Joanna Dec-Pietrowska
- Faculty of Medicine and Health Sciences, University of Zielona Góra, 65-046 Zielona Góra, Poland
- Correspondence: (J.D.-P.); (A.J.S.)
| | - Agnieszka J. Szczepek
- Faculty of Medicine and Health Sciences, University of Zielona Góra, 65-046 Zielona Góra, Poland
- Department of Otorhinolaryngology, Head and Neck Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
- Correspondence: (J.D.-P.); (A.J.S.)
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Huwendiek S. Interesting read. GMS JOURNAL FOR MEDICAL EDUCATION 2021; 38:Doc85. [PMID: 34056074 PMCID: PMC8136341 DOI: 10.3205/zma001481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 03/11/2021] [Accepted: 03/11/2021] [Indexed: 06/12/2023]
Affiliation(s)
- Sören Huwendiek
- University of Bern, Medical Faculty, Institute for Medical Education, Department for Assessment and Evaluation, Bern, Switzerland
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