MEDICAL EDUCATION
Notes for the Primary Care Teachers
TEACHING DOCTOR-PATIENT COMMUNICATION IN FAMILY MEDICINE
AR Yong Rafidah FAFPM, FRACGP, PGCert Med Ed, Faculty of Medicine, Cyberjaya University College of Medical Sciences, Malaysia
Address for correspondence: Associate Professor Dr Yong Rafidah Abdul Rahman, Faculty of Medicine, Cyberjaya University College of Medical Sciences, 63000 Cyberjaya, Selangor, Malaysia. E-mail: yongrafidah@cybermed.edu.my
Conflict of interest: None
ABSTRACT
Doctor-patient communication skills are important in family medicine and can be taught and learned. This paper summarises the salient contents and main methods of the teaching and learning of doctor-patient communication, especially those applicable to the discipline.
Key words: Doctor-patient communication, family medicine, teaching
Yong Rafidah AR. Teaching doctor-patient communication in family medicine. Malaysian Family Physician. 2007;2(3):120-2
INTRODUCTION
The importance of effective communication in healthcare has been well established and proven to enhance patient satisfaction, health outcomes, and adherence to treatment.1 There is growing acceptance of the need to teach and assess communication skills in undergraduate as well as postgraduate medical programmes. However, teaching communication skills is different from teaching other subjects, with its own subject matter, teaching methods and teaching skills required of the teacher.
The intricacies of nature of work of the family medicine discipline can make the tasks of teaching communication skills more complex. Especially in family medicine, communication skills encompasses not only interaction with patients but also information exchange – verbally and written – with their families and other members of the healthcare team.2
Family doctors are usually known as well as expected to be good communicators, thus teachers of the discipline need to acquire the knowledge and skill to teach medical communication. This article discusses mainly teaching skills for the teaching of ‘doctor-patient communication’, that being the main type of communication expected in the discipline.
WHAT TO TEACH?
A sound teaching-learning activity begins with identifying the contents of the training – the ‘what’.1 Each consultation is complex and unique. Thus, having a memorable guide or model of doctor-patient communication to follow can prove easy for learners, so that they can do it ‘right’.
A wide range of models has been described and most do fit into the picture of family medicine consultation. These usually encompass a combination of the following:
- Verbal and non-verbal behaviours or communication ‘microskills’ (for example, eye contact, facial expression, open questions, summarising, empathy, etc), and
- Important tasks or communication elements to cover within a consultation (for example, building of a doctor-patient relationship, explanation & sharing of information, etc.)
The Kalamazoo Consensus Statement3 is probably a good example of an all-encompassing model of doctor-patient communication for ambulatory care such as family medicine. It outlines seven essential communication tasks that should be part of communication-oriented curricula and evaluation tools:
- Build the doctor-patient relationship
- Open the discussion
- Gather information
- Understand the patient’s perspective
- Share information
- Reach an agreement on problems and plans
- Provide closure
