Oh, I wish I had a pound for every time a patient has relayed a thoroughly believable and, often, cringeworthy story of how they've been subjected to a healthcare consultation delivered with the grace and style of the Spanish Inquisition or the bluntness of Henry VIII's chief executioner's second-best axe. Why, when we are (supposedly) highly intelligent and extensively trained professionals, are we — often, though not always — so bad at communicating with our patients? If we were in the commercial sector, many of our ‘customers’ would have voted with their feet. But, of course, they can't do that. They're stuck with us for the most part. Good communication skills, thankfully, have been recognised as an essential part of effective clinical practice and their teaching and practice have gained more prominence in both undergraduate and postgraduate curricula. Attention to the way in which we communicate with our patients should be a lifelong process.
The opening quote of the books — ‘If you can't communicate, it doesn't matter what you know’ — immediately sets the tone for the reader. It's been quite some time since I've come across clinical skills-centred texts that are such an easy and immensely pleasurable read. The thought of ploughing through a ‘how to’ guide on communication is seldom anticipated with excitement but these books dispel any such apprehension.
Alhough written by a transatlantic team, the authors manage to avoid being biased towards either British or US healthcare systems. I would even go so far as to say that the ‘Cambridge–Calgary guide’ to communicating with patients could be transferred to almost any healthcare setting, if not to the larger world that exists outside medicine. The layout and language are clear and unambiguous throughout. Important points are emphasised where necessary, and at no time does reading become laborious. Far more importantly, however, the authors have employed an evidence-based approach that moves these titles from the realm of personal opinion and musings to an authoritative work. The frequent use of examples further serves to promote this series as a ‘useable’ guide.
In Skills for Communicating with Patients, the authors use a logical approach to analyse the various aspects of communication relevant throughout the consultation process, which are then explored in greater depth over six chapters. They move from the initiation of a consultation, through information gathering, structuring, and relationship building, to the often neglected areas of explaining and planning and, finally, closing the encounter. A final chapter relating core communication skills to specific, and often difficult, clinical situations, completes this faultless package. Far from delving into minutiae and insignificant or impractical observations, they instead highlight relevance to the everyday clinical setting, and the model can be related easily to individual practice.
The companion volume, Teaching and Learning Communication Skills in Medicine, translates the first book into a framework that can be used in designing and delivering curricula for communications skills teaching in both the academic and clinical setting. The same clarity of language and process is employed and results in a format that facilitates teaching, learning, and assessment through an evidence-based approach to the methods available to the medical educator, whether the setting is a university medical school, hospital out-patient clinic, or rural general practice.
At no point prescriptive, these texts fulfil their aims admirably and are both reader-centred and practical. Any clinician, no matter where they see themselves on their career path, would find both of great benefit.
- © British Journal of General Practice, 2005.