These include small group discussions/seminars, student interviews with simulated patients, student observations
of faculty with real patients, student interviews with real patients, role-playing with peers, rounds, video trigger tapes with discussion,39,40 videotapes of student-patient interactions, instructional videotapes, literature study, especially personal accounts about physician illness41–43 among other modalities. When students see their own real-life performance on videotape followed by a non-threatening and constructive analysis by classmates and instructors this process has a powerful impact. Faculty development in the area of communication skills Inhibitors,research,lifescience,medical and teaching is essential, so that the messages of the teaching are not only not eroded but are reinforced all along the years in medical school. In an era of managed care and Galunisertib chemical structure increasing economic pressures on physicians, students will often point out that in real life one does not have
enough time in the patient encounter to Inhibitors,research,lifescience,medical apply what they learn in the courses on communication. It is certainly true that were one to have a half hour for each encounter it would be much easier to deal more effectively with the more personal aspects of the patients’ problems. Nevertheless there are data which show that more depends on the skill Inhibitors,research,lifescience,medical of the physician than on the time available. A study in a large and busy emergency room Inhibitors,research,lifescience,medical in a pediatric hospital showed10 that mothers’ satisfaction with the physicians’ communication did not depend on the number of minutes spent with the patient. An experienced family physician has described the manner of proper and effective physician–patient communication even in a 5–7-minute patient encounter.44 EVALUATION OF SKILLS Critical to the success of any program of teaching communication is the evaluation process.45 It is no secret that medical students, like their student colleagues elsewhere, are motivated strongly by
the evaluation process. Unless there is a serious evaluation process at each Inhibitors,research,lifescience,medical portion of the course there will be a tendency to slight the course. Students who do not demonstrate acceptable performance skills should receive remedial training until TCL they achieve the appropriate level of performance. The introduction of the clinical skills part to the United States Medical Licensing Examination (USMLE) process in 2004, with a major component consisting of communication skill evaluation, has been very important in providing a message to medical students and physicians that these skills are essential sine qua non for practicing medicine. IMPACT OF COMPUTERIZATION There have been a number of recent changes in the practice of medicine that have complicated the issue of communication still further and that require specific attention.
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