The communication curriculum includes the following key components:
1. Core medical interviewing skills:
The communication skills teaching framework we use at Dalhousie Medical School is the Calgary-Cambridge Guide to the Medical Interview – A Comprehensive Clinical Method (Kurtz S, Silverman J, Draper J. Teaching and Learning Communication Skills in Medicine. 2nd Edition. Radcliffe Publishing: Oxford, 2005; Silverman J, Kurtz S, Draper J. Skills for Communication with Patients. 2nd Edition. Radcliffe Publishing: Oxford, 2005). See the guide.
Based on evidence based research, the Calgary Cambridge Guide (CCG) integrates traditional clinical method with effective communication skills. The purpose is to enable doctor and patient, in partnership, to rationally explore, diagnose and manage both disease (the biomedical cause of sickness in terms of pathophysiology) and illness (the individual patient’s unique experience of sickness). This framework teaches collaborative partnership with patients, encouraging communication techniques that enable patients to become more involved in the consultation.
2. Specific communication issues and challenges
The curriculum also explores specific communication issues and challenges.The range of communiction skills addressed includes:
- Breaking bad news
- Expressing empathy
- Dealing with patient emotions (anger, fear, sadness)
- Cultural diversity
- End of life discussion
- Informed consent
- Communicating with children and adolescents
- Special needs patients (learning disability, low literacy)
- Disclosing adverse events
- Establishing boundaries
- Peer and interprofessional communication
Although these specific issues may call for special adaptations and even additional techniques, the skills of the Calgary Cambridge Guide to the Medical Interview remain the primary resource we use for effective management of communication issues and challenges. The skills delineated in the guide are the core communication skills required in most circumstances, providing a secure platform on which specific communication issues and challenges can be addressed.
3. Communication with self perceptual skills:
Perceptual skills in medical communication are also addressed. They involve learners' internal decision making, clinical reasoning and problem solving processes; their awareness of feelings and thoughts about the patient, about the illness and about other issues that may be concerning them; and, their awareness of their own self concept and confidence, biases and distractions.
- Thought processes
- Clinical reasoning and problem solving
- Dealing with stress and tension
- Handling mistakes and failures