Theme
2JJ Communication
INSTITUTION
Klinikum rechts der Isar, Technical University Munich - Psychosomatic Medicine and Psychotherapy
Klinikum rechst der Isar, Technical University Munich- TUM MeDICAL, Munich, Germany
Good communication is the key to good patient care (Fallowfield 1999).
Meta- Analysis has proven that communication skills can be taught in specific communication skills training (CST) (Barth, Lannen 2011).
There is consens that practising with standardized patients is effective for training, e.g. Goelz (2011), Wuensch (2010). However, it is unclear about the best way to train and which didactic elements might be most effective or best accepted by trainees. It is discussed that feedback seems to be an important didactic element.
We integrated theoretical and conceptual ideas of feedback (van der Ridder 2008) and created a new CST for medical students with focus on feedback. We asked our students for acceptance.
The new CST integrated various methods of providing feedback on three levels:
1. Standardized patients were trained in giving precise behavioral feedback. They marked communication skills and gave feedback about communication skills they missed.
2. Peers used an observational survey for feedback.
3. Facilitators summarized specific recommendations according to a checklist.
35 medical students participated in a research orientated CST after informed consent. After CST, participants were asked to evaluate the course and were asked to give a forced choice to evaluate specific elements.
- Results show a very good evaluation of CST by the participants: Feedback by standardized-patients was rated best with 1.12 (1:= best; 6:= worst), feedback by facilitator with 1.26, feedback by peers with 1.5.
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Table 1. Evaluation of acceptance of the new teaching model |
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Items: general evaluation |
Mean |
Range |
SD |
|
Practical relevance of topics |
1.5 |
1-5 |
0.83 |
|
Practice orientation |
1.5 |
1-5 |
0.86 |
|
Interesting format |
1.76 |
1-4 |
0.86 |
|
Opportunities for discussion |
1.15 |
1-3 |
0.44 |
|
Constructive learning environment |
1.18 |
1-2 |
0.39 |
|
Personal benefit |
1.53 |
1-4 |
0.75 |
|
Fulfilment of expectations |
1.50 |
1-3 |
0.62 |
|
Overall evaluation |
1.56 |
1-4 |
0.71 |
|
Theoretical introductions |
2.32 |
1-4 |
0.77 |
|
Memory Card |
2.15 |
1-6 |
1.18 |
|
Practicing with standardized-patients |
1.18 |
1-3 |
0.46 |
|
Observation tasks |
1.94 |
1-4 |
0.74 |
|
Self-reflexion |
1.76 |
1-4 |
0.83 |
|
Feedback by peers |
1.5 |
1-5 |
0.90 |
|
Feedback by standardized-patients |
1.12 |
1-2 |
0.33 |
|
Feedback by facilitator |
1.26 |
1-4 |
0.67 |
|
Personal feedback form |
1.94 |
1-6 |
1.15 |
|
Evaluation on a scale from 1 = ‘very good’ to 6 = ‘very bad’ |
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Items of didactic elements
- Students rated the forced choice question in the following order: Practicing with standardized patients, feedback by standardized patients and feedback by facilitator.
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Table 2. Ranking of forced choice questions Item Ranking |
|
|
Practicing with standarized-patients |
1 |
|
Feedback by standardized-patients |
2 |
|
Feedback by facilitator |
3 |
|
Feedback by peers |
4 |
|
Self-reflexion |
5 |
|
Observation tasks |
6 |
|
Theoretical introductions |
7 |
|
Personal feedback form |
8 |
|
Memory Card |
9 |
|
Evaluation on a scale from 1 = ‘most important’ to 9 = ‘least important’ |
|
Our new CST shows very good results, especially in the elements of feedback.
This study provides information about how communication skills can be taught and can trigger discussion on how to optimize teaching methods in CST.
Feedback is an important and well accepted element in CST.
Barth, J. and P. Lannen (2011). "Efficacy of communication skills training courses in oncology: a systematic review and meta-analysis." Annals of Oncology 22: 1030-1040.
Fallowfield, L. and V. Jenkins (1999). "Effective communication skills are the key to good cancer care." European Journal of Cancer 35(11): 1592-1597.
Goelz, T., A. Wuensch, et al. (2011). "Specific Training Program Improves Oncologists' Palliative Care Communication Skills in a Randomized Controlled Trial." Journal of Clinical Oncology 25(29): 3402-3407
van de Ridder JM, Stokking KM, et al (2008). “What is feedback in clinical education?” Med Education 42(2):189-197.
Wuensch, A., T. Goelz, et al. (2010). "Disclosing information about randomised controlled trials in oncology: training concept and evaluation of an individualised communication skills training for physicians COM-ON-rct." European Journal of Cancer Care: 1-7.
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