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| MINI-REVIEW ARTICLE |
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| Year : 2012 | Volume
: 1
| Issue : 1 | Page : 2-4 |
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Communication skills courses: A plea for inclusion in the medical curriculum
Mohammad Y AL-Shehri
Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| Date of Web Publication | 13-Apr-2012 |
Correspondence Address:
Mohammad Y AL-Shehri
Professor of Surgery, College of Medicine, King Saud University, P. O. Box 245, Riyadh 11411
Saudi Arabia
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/2278-0521.94976
Communication is an essential skill in the armory of any worker in the health field. It is an integral part of the skills required, not only in medical doctors, but in all health workers. Communication is more than history taking; it includes all methods of interaction with patients, patient's relatives, members of the health care team, and the public. Many studies stressed that the main complaints of patients are related to communication problems and not to clinical competency. This has contributed to an increase in the number of law suits, non-adherence to medical regimens, and the tendency of patients to keep changing physicians and hospitals. Also, it has been shown that health outcome is positively affected by proper communication. This includes patient's satisfaction and cooperation, decrease in treatment duration, decrease in painkillers requirements, and decrease in hospital stay. Also, it has been shown that communication skills can be taught and important changes in physician's behavior and in their communication skills have been demonstrated after courses of communication skills. Thus, many medical colleges in the world are including communication skills courses in their undergraduate and graduate curricula. We should do the same in our medical colleges in Saudi Arabia. Keywords: Communication skills, medical curriculum, Saudi Arabia
How to cite this article:
AL-Shehri MY. Communication skills courses: A plea for inclusion in the medical curriculum. Saudi J Health Sci 2012;1:2-4 |
| Introduction | |  |
Communication is an essential skill in the armory of any worker in the health field. It is an integral part of the skills required, not only in medical doctors, but in all health workers. [1],[2] Communication is more than history taking and eliciting signs and proper communication requires adequate knowledge, suitable skills, and the right attitude.
The importance of formal teaching of communication skills has been recognized. Many medical colleges in the world and an increasing number of nursing schools have included communication skills courses in their undergraduate as well as postgraduate curriculum. [2],[3] This paper is a review of the issue of communication skills from the following points of view:
What are communication skills?
What is the importance of communication skills in the health care?
Can communication skills be taught?
How can communication skills be taught?
What are communication skills?
History taking is an essential component of communication by which information can be retrieved from patients. But, communication with patients is more than just history taking; it includes all methods of interaction with patients. This includes the ability to:
- Take a complete history of the disease including past, social, and family history.
- Discuss diagnosis, treatment options, prognosis, and possible complications.
- Understand the physical, psychological, social, and religious concerns and needs of patients.
- Convey trust, comfort, and relieve mental blocks.
- Deliver bad and distressing news.
- Deal with ethical and controversial issues.
- Deal with difficult or distressed patients and their relatives.
- Communicate with patient's relatives, colleagues, health workers, administrators, and decision makers.
What is the importance of communication skills in the health care?
The Toronto Consensus statement stressed that the main complaints of patients are related to communication problems and not to clinical competency. [4] Furthermore, substantial communication deficiencies were noticed in physicians including residents and trainees. [4] Similarly, the main remark made by patients in the primary health care centers in Riyadh was that physicians were not listening enough to their complaints. [5] The magnitude of the problem of poor communication is demonstrated by the increase in patient's complaint, the increasing number of law suits against doctors and hospitals, the tendency of patients to keep changing physicians and hospitals, and non-adherence to medical regimen. [4],[6],[7] The association between specific communication patterns and law suits was found in a study done on primary care physicians. [8] Many hospital administrators, heads of departments and other health care leaders will testify to the fact that a great deal of their daily energy is spent in issues related to patient's complaints. The majority of these are related to poor communication and most of them could have been solved by a proper communication. Another important observation is the tendency of the same person to have one complaint against him after another. Many of these are related to a fault in communication rather than a mistake in management.
Effect on health outcome
Many studies reiterate that effective communication and relationship-building are important in the delivery of high-quality health care. [9],[10],[11] Stewart, [11] in a review of several studies about effective physician-patient communication and health outcome concluded that health outcome is positively affected by probing the thoughts, feelings, and expectations of patients, encouraging them to ask questions, and allowing patients to share in the decision making. These effects are documented in the reduction of anxiety, psychological distress, pain relief, symptom resolution, mood improvement, and reduction of high blood pressure. Improved communication has also been shown to increase satisfaction of patients, cooperation of patients, decrease in the duration of treatment, decrease in the intake of painkillers, and decrease in hospital stay. [12],[13],[14],[15]
Can communication skills be taught?
Evidence is clear that communication skills of physicians can be changed and this change can last. [16],[17],]1[8] Important changes in physicians' behavior and in their communication skills have been demonstrated after a short course of communication skills. [19] In a recent review of communication skills training, it was shown clearly that there was strong evidence for the positive effect of communication skills training. [2] This includes medical students, students of dentistry, nursing students, junior doctors, senior doctors, and oncology nurses. [2] Furthermore, it was shown that students, who scored least on the pretest, benefited the most. [2]
The General Medical Council in UK and the Association of American Medical Colleges recommend that communication skills training should be an integral part of any medical curriculum. [1],[3] Communication skills are an obligatory course in 139 medical schools in the United States of America, 26 of these as a separate course. The other 25 medical schools offer communication skills as an elective. [20] In Canada, all the 17 medical schools offer the course as an obligatory part of the curriculum. [20]
How can communication skills be taught?
There is some evidence to suggest that short courses of one day or less are not sufficient. [2] Also, learning communication skills during clinical rotations is probably more beneficial than in the pre-clinical period. [2] Learning by doing has been shown to be more effective than by the traditional lecture approach and feedback is valuable in the learning process. [21],[22],[23] Therefore, experiential methods should be used rather than the traditional instructional methods. Video tape or audio tape recordings can be used for demonstrations. Consultations can be done using real patients, simulated patients, or even role plays. [24] The most commonly used teaching methods in the British medical colleges are tutorials, video feedback, role playing, and lectures. [25],[26],[27] Some communication skills teaching models have been well described in the literature, with instructions on how to teach the model. [24] One can choose among these according to the objectives of the course. [24]
| Conclusions | | |
Communication skills are an important component of the learning objectives of medical doctors and health care workers in general. The lack of which can adversely affect the health outcome of patients. Similarly, it can be a source of conflict, stress, and waste of resources. Communication skills can be taught and many medical colleges in the world are including communication skills courses in their undergraduate and graduate curricula. We should do the same in our medical colleges in Saudi Arabia.
| References | | |
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