Teaching and Learning Communication Skills in

Univ. of Calgary, Alberta, Canada. Text is the companion to Skills for Communicating with Patients, 2nd edition, c2005. Examines how to construct communication skills curricula at all levels of medical education and across specialities. Documents the individual skills necessary for effective communication skills. Previous edition: c1998. Softcover.

Suzanne Kurtz: Professor of Communication, Faculties of Education and Medicine, University of Calgary, Alberta, Canada Jonathan Silverman: Associate Clinical Dean and Director of Communication Studies, School of Clinical Medicine, University of Cambridge, UK Juliet Draper: Director, Eastern Deanery Cascade Communication Skills Teaching Project, UK

Forewords

vii

Preface

xi

About this book

xv

About the authors

xvi

Acknowledgements

xvii

Introduction

1

(10)

Part I An overview of communication skills teaching and learning

11

(94)

1 The 'why': a rationale for communication skills teaching and learning

13

(16)

Introduction

13

(1)

Why teach communication skills?

14

(6)

Can you teach and learn communication skills?

20

(5)

Is the prize on offer to doctors and their patients worth the effort?

25

(4)

2 The 'what': defining what we are trying to teach and learn

29

(28)

Introduction

29

(1)

Why facilitators and programme directors need help with knowing what to teach

30

(2)

Types of communication skills and how they interrelate

32

(4)

The problem of separating content and process skills in teaching and learning about the medical interview

33

(3)

An overall curriculum of doctor-patient communication skills

36

(13)

The Calgary-Cambridge Observation Guide

36

(2)

The enhanced Calgary-Cambridge Guides

38

(11)

The need for a clear overall structure

49

(2)

Choosing the process skills to include in the communication curriculum

51

(4)

Summary

55

(2)

3 The 'how': principles of how to teach and learn communication skills

57

(20)

Introduction

57

(1)

Why take a skills-based approach to communication teaching and learning?

58

(5)

Which teaching and learning methods work in practice?

63

(1)

Why use experiential learning methods?

63

(9)

Why use a problem-based approach to communication skills teaching?

72

(4)

What place is there for more didactic teaching methods?

76

(1)

4 Choosing and using appropriate teaching methods

77

(28)

Introduction

77

(1)

Choosing appropriate teaching methods

77

(2)

Using methods from the left half of the methods continuum

79

(3)

Introducing cognitive material into the curriculum

80

(2)

Using methods from the right half of the methods continuum

82

(27)

Audio and video feedback

83

(2)

Real patients

85

(3)

Simulated patients

88

(12)

Role play

100

(5)

Part 2 Communication skills teaching and learning in practice

105

(104)

5 Analysing interviews and giving feedback in experiential teaching sessions

109

(22)

Introduction

109

(1)

Carrying out analysis and feedback in communication skills teaching sessions

109

(13)

Conventional rules of feedback

110

(3)

Agenda-led outcome-based analysis of the consultation

113

(9)

Phrasing feedback effectively in communication skills teaching sessions

122

(9)

6 Running a session: facilitating communication skills teaching in different learning contexts

131

(24)

Introduction

131

(1)

Agenda-led outcome-based analysis in practice

132

(17)

Examples of how to use agenda-led outcome-based analysis in different contexts

133

(16)

'In-the-moment' teaching in the clinic or at the bedside

149

(6)

7 Running a session: facilitation tools to maximise participation and learning

155

(30)

Introduction

155

(1)

Relating facilitation to communication with patients

155

(2)

Strategies for maximising participation and learning

157

(13)

Strategies for dealing with difficulties

170

(15)

8 Running a session: introducing research and theory; expanding and consolidating learning

185

(24)

Introduction

185

(1)

An overview: how to introduce didactic teaching and expand and consolidate experience and discussion

186

(4)

Practical suggestions for introducing theory and research evidence and consolidating learning

190

(19)

Part 3 Constructing a communication skills curriculum

209

(96)

9 Principles of designing communication skills curricula

213

(20)

Introduction

213

(1)

A conceptual framework for systematic communication training

214

(2)

How do we ensure that learners not only master an increasing range of skills but also retain and use them over time?

216

(3)

How do we select and organise the content of our communication programmes?

219

(7)

How do we select appropriate methods for each component of the communication programme?

226

(1)

How do we integrate communication with other clinical skills and the rest of the curriculum?

226

(7)

10 Specific issues of communication curriculum design at different levels of medical education

233

(20)

Introduction

233

(1)

Undergraduate medical education

233

(6)

Residency and continuing medical education

239

(9)

How do we co-ordinate the communication curriculum across all levels of medical education?

248

(5)

11 Assessing learners' communication skills

253

(22)

Introduction

253

(1)

Formative and summative assessment

254

(3)

What are we trying to assess?

257

(1)

Characteristics of assessment instruments

258

(5)

What form should assessments take?

263

(5)

What formats are available for feedback from both formative and summative evaluations?

268

(4)

Who does the actual assessments?

272

(3)

12 Enhancing faculty development for communication skills teaching

275

(16)

Introduction

275

(1)

Why is training for facilitators so important?

276

(1)

Enhancing facilitators' skills

277

(11)

How do we maximise the status and reward of undertaking such teaching?

288

(3)

13 Constructing a curriculum: the wider context

291

(14)

Introduction

291

(1)

Promoting the further development and acceptance of communication curricula within medical education

291

(6)

Looking to the future: where next?

297

Appendices

Appendix 1 Example of a communication curriculum

305

(10)

Appendix 2 The two-guide format of the Calgary-Cambridge Process Guide

315

(8)

Appendix 3 A protocol for writing simulated patient cases

323

(6)

Appendix 4 Sample OSCE marking sheets

329

(6)

Appendix 5 Medical skills evaluation: communication process skills

335

(2)

Appendix 6 Notes on using the Calgary-Cambridge Guides

337

(2)

References

339

(20)

Index

359

(6)

Author index

365

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Teaching and Learning Communication Skills in Medicine, Second Edition

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