Teaching communication at the Medical School in Ljubljana
Keywords:
Curriculum changes, Early clinical exposure, Communication, Experience, DilemmasAbstract
Early clinical exposure helps medical students to develop appropriateattitudes towards their learning and future medical practice andgive them an opportunity for improving communication skills. Newcurriculum at the Medical faculty of Ljubljana introduced early clinicalexposure (ECE) for the first year medical students through thesubject “Communication”. We present the aims and the content of thecurriculum “Communication” and present our experience, students’feedback, dilemmas and ideas for the future development of the curriculum.Decision for the introduction of this subject is based on theresult of survey about the key competences of doctors, review of theliterature and empirical recognition of the fact that previous programmelacked the necessary knowledge and experience for good interpersonalcommunication. The main goals of our teaching are in improvingcommunication skills and understanding and assuming thatgood doctor-patients relationship is crucial for the successful treatment.The curriculum consists of theoretical part (lectures from medicalpsychology) and practical part (communication in a small groupusing prepared vignettes, interview with nursing home residents andobservation of general practitioners’ work during their 1-day practiceattachment). Students evaluated the curriculum as very valuable at thebeginning of their learning. The practical part of the programme, inwhich they had contact with patients and experienced the role of aphysician, better, was highly appreciated. ECE help medical studentsimprove their communication skills, they interact with more confidencein interaction with patients and develop appropriate personalattitudes for their future professional carrier.Downloads
References
Elestein M, Forbes JA. Early medical contact. BMJ. 1976;2(6027):97-8.
Larssen LC, Larsen JH, Almind G, Backer P. Medical students experience early patient contact in general practice. A descriptive and evaluation of new course in the medical curriculum. Scand J Prim Health Care. 1989;7(1):53-5.
Valkova L. First early patient contact for medical students in Prague. Family Practice. 1997;14(5):394-6.
Hampshire AJ. Providing early clinical experience in primary care. Med Educ. 1998;32(5):495-501.
Haffling AC, Hakansson A, Hagander B. Early patient contact in primary care: a new challenge. Med Educ. 2001;35(9):901-8.
Mietola J, Mantyselka P, Vaskilampi T. Doctor-patient interaction in Finish primary care BMC Med Educ. 2005; 5:34. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1242232/?tool=pubmed
Hopayian K, Howe A, Dagley V. A survey of UK medical school’s arrangements for early patient contact. Med Teach. 2007;29(8):806-13.
Von Below B, Helquist G, Rodjer S, Gunnarsson R, Bjorkelund C, Wahlqvist M. Medical students’ and facilitators’ experiences of an Early Professional Contact course: Active and motivated students, strained facilitators. BMC Med Educ. 2008: 8:56. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2614986/pdf/1472-6920-8-56.pdf.
Basak O, Yaphe J, Spiegel W, Wilm S, Carelli F, Metsemakers JF. Early clinical exposure in medical curricula across Europe: an overview. Eur J Gen Pract. 2009;15(1):4-10.
Littelwood S, Ypinazar V, Margolis SA, Scherpbier A, Spencer J, Dornan T. Early practical experience and the social responsiveness in clinical education: systematic review. BMJ. 2005;331(7513):387-91.
Pavlin S, Švab I, Kovačič H. Identification and development of key competences of doctors as a starting point for modernizing the educational programme. Slo J Public Health. 2008;47(2):106-16.
Odhayani AA, Ratnapalan S. Teaching communication skills. Can Fam Physician 2011;57(10):1216-18.
Švab I, Petek Šter M. Sporazumevanje: navodila za vaje in seminar: študijsko leto 2010/2011. 1. izd. Ljubljana: Združenje zdravnikov družinske medicine, 2010. Available from: http://www.mf.uni-lj.si/kdm/1091-gradiva. (In Slovene)
Švab I, Petek Šter M. Sporazumevanje: navodila za vodje vaj in seminarjev: študijsko leto 2010/2011. 1. izd. (CD-ROM). Ljubljana: Združenje zdravnikov družinske medicine, 2010. (In Slovene)
Woolliscroft JO, Calhoun JG, Maxim BR, Wolf FM. Medical education in facitilies for the elderly. Impact on medical students, facility staff, and residents. JAMA. 1984;252(24):3382-5.
Arnold L, Shue CK, Jones D. Implementation of geriatric education into the first and second year of a baccalaureate-MD degree program. Acad Med. 2002;77(9):933-4.
Mullen K, Nicolson M, Cotton P. Improving medical students’ attitudes towards the chronic sick: a role for social science research. BMC Med Educ. 2010;10:84. Available from:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2995790/?tool=pubmed
Joekes K, Noble LM, Kubacki AM, Potts HW, Lyoyd M. Does the inclusion of “professional development” teaching improve medical students’ communication skills? BMC Educ. 2011;11:41. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3141797/?tool=pubmed
Yedidia MJ, Gillenspeie CC, Kachur E, Schwarrtz MD, Ockene J, Chepaitis AE, et al. Effect of communications training on medical students performance. JAMA. 2003;290(9):1157-65.
Hodges B, Mclloroy JH. Analytic global OSCE rating is sensitive to level of training. Med Educ. 2003;37(11):1012-16.
Fischbeck S, Mauch M, Leschnik E, Beutel ME, Laubach W. Assessment of communication Skills with an OSCE among firs year medical students. Psychother Psychosom Med Psychol.
;61(11):465-71.
Zick A, Granier M, Makoul G. First-year medical students’ assessment of their own communication skills: A video-based, open-ended approach. Pat Educ Couns. 2007;68(2):161-6.
Makoul G, Krupat E, Chang CH. Measuring patient views if the physician communication skills: a development and testing of the Communication Assessment Tool. Patient Educ Couns.
;67(3):333-42.
Arnold L, Shue CK, Jones D. Implementation of geriatric education into the first and second year of a baccalaureate-MD degree program. Acad Med. 2002;77(9):933-4.
Turan S, Elcin M, Odabasi O, Sayek I, Senemoglu N. The impact of clinical visit on communication skills training. Patient Educ Couns. 2009;77(1):42-7.
Bell K, Boshunizen HP, Scherpbier A, Dornan T. When only the real things will do: junior medical students’ learning from real patients. Med Educ. 2009;43(11):1036-43.
Dornan T, Littlewood S, Margolis SA, Scherpbier A, Spencer J, Ypinazar V. How can experience in clinical and community settings contribute to early medical education? A BEME systematic review. Med Teach. 2006;28(1): 3-18.
G Hojat M, Vergare MJ, Maxwell, K, Brainard, Herrine SK, Isenberg GA, et al. The devil in the third year: a longitudinal study of erosion of empathy in medical school. Acad Med. 2009;84(9):1182-91.
Varkey P, Chutka DS, Lesnick TG. The aging game: improving medical students’ attitudes toward caring for the elderly. J Am Med Dir Assoc. 2006;7(4):224-9.
Sahin H, Akyol AD. Evaluation of nursing and medical students’ attitudes towards people with disabilities. J Clin Nurse. 2010;19(15-16):2271-9.
