Medical students acquire knowledge, apply theory, and develop skills during their undergraduate training. At medical school, formal teaching sessions tend to focus on the communication between doctor and patient, often with only passing reference to more complex everyday scenarios in which doctors find themselves. There are many situations and diverse interactions demanding effective communication in which the future clinician may be undertrained. These could be with, but are not limited to, members of the patient’s family or other healthcare professionals and through different media such as by telephone, email, or with legal personnel. The nature of medical training regarding communication is too one-dimensional. The importance of multiprofessional teamwork is emphasised throughout our training, but opportunities to consolidate this theory in real-life scenarios are all too rare. As a newly qualified doctor or when later holding a position of increased responsibility, a lack of experience of real-life professional interactions may contribute to difficulties with colleagues and lead to increased stress in the workplace. For example it would be helpful to provide strategies for confrontation resolution when in challenging situations. At the other end of the spectrum, introducing students to the art of communicating a referral to another healthcare professional would be beneficial. The focus during training needs to broaden.
Difficult decisions may have to be made in parallel with communicating in unfamiliar settings. Thus the lack of experience of communicating in these situations may affect the development of clinical decision-making skills; skills that are indispensable to a competent clinician. For instance, when faced with the uncertainty that often permeates general practice, it is imperative to both arrive at and communicate a well-reasoned, decisive plan of action. This can be complicated further if the setting of the communication is foreign to the clinician. GPs familiar with personal and emotional experiences of these situations will be better equipped to deal with the challenges posed by time, language, cultural, and sensitive issues, and the patient’s agenda, while still establishing rapport and trust. The lack of exposure to such scenarios, whether real life or simulated, will surely be to the detriment of future skills as a clinician and also in the short term potentially, in achievement in the Situational Judgement Test.
- © British Journal of General Practice 2012
