Promote Patient Safety: Teach a Doctor to Communicate!

[alb759]

The Joint Commission Sentinel Event Report of 2006 shows communication issues are the leading root cause of sentinel events. Their 2007 National Patient Safety Goals lists "improve the effectiveness of communication among caregivers" as goal number two.

Communication is a skill that is widely underappreciated in the sciences. However, in the light of its influence on patient well-being, wouldn't it make sense to include communication courses in medical school curriculae? If a student is taught the importance of clear, efficient communication even before he or she enters the clinical environment, then he or she will never have the opportunity to develop the bad habits and apathy that leads to communication failures.

Having witnessed first-hand the difficulty of re-teaching practicing resident physicians to verbalize patient information in transfer-of-care situations, I feel the only solution is to begin facilitating effective communication strategies from the very beginning of one's medical career. Although M1 and M2 years are already packed with objectives, I think that educational steering committees should seriously consider adding at least a week long seminar outlining communication techniques. This would lay a groundwork for effective practice which can then be monitored throughout the clinical years.

Is anyone involved in a program that actually teaches (not just mentions or advocates for) best-practices in communication? If so, how is your program structured?

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[Instatewaiter]

I think that educational steering committees should seriously consider adding at least a week long seminar outlining communication techniques. This would lay a groundwork for effective practice which can then be monitored throughout the clinical years.

Yeah that just wont happen the curriculum is already jam packed w/ too much stuff anyway. In the future they will need room for courses to teach new innovations. At my school in the past 2 decades, anatomy has gone from a 4 month course to a 2.5 month course because of all the curriculum additions.

That said, I feel that it is a very very common practice at most schools to teach communication during clinical exposure in the first 2 years. At MCV, we have a foundations of clinical medicine course where not only do we learn physical exams and history taking but effective communication is jammed down our throat.

 

[QuikClot]

Better to teach good communication, and accept that your graduates are not going to be walking encyclopedias. The things critical to the success or failure of therapy are, in my experience, the following:

1. A good history.
2. A successful theraputic alliance, in which the doctor's instructions reflect the patient's goals and the realities of their life, and the patient is committed to following the plan of care.
3. A successful healthcare team that communicates well.

None of those things rely on sophisticated technology or cutting-edge science, but they all require communication, and the ability to create good relationships both with your co-workers and your patients. That is the most important thing, period. I know some people feel these things are being "jammed down [their] throats" but that is only because they don't recognize them as equally as important as science and technique. And they aren't; they are far more important.

 

[MacGyver]

There's no room in the curriculum with all the crap they have on "diversity" issues and other liberal feelgood topics that they want to cram down our throats.

 

[QuikClot]

What is it with the right and their fantasies about having things crammed down their throats? What would Freud say?

 

[MidwestFM]

When we poll our graduates after they have been in practice for a few years, there are two topics they wish they had more exposure to:
1. billing and coding
2. communicating in difficult situations.
What topics do you think our current residents roll their eyes at most when we present them?
The first topic is very dry and frankly boring until you realize that your paycheck is tied to your production after residency. The second is just hard to evaluate and teach. A person's communication style -- good or bad-- is pretty much established by the time they make it to med school/residency. But for those who take it seriously, I have seen great improvements when they make the effort. Unfortunately, many who need the help aren't willing to make the effort.