EFFECTIVE TEACHING OF COMMUNICATION-SKILLS FOR MEDICAL-PRACTICE - SELECTING AN APPROPRIATE CLINICAL CONTEXT

Increasingly, courses in communication skills are being incorporated i nto medical training. In order for communication skills to be effectiv ely maintained in post-training medical practice, they must be taught within an appropriate clinical context. The present paper describes an d provides rationale for seven criteria by which to select clinical is sues which are appropriate foci for communication skills courses. The criteria are: (1) the issue must be one which is encountered frequentl y in clinical practice; (2) the issue must be associated with a high b urden of illness; (3) there must be evidence that practitioners need t o improve skills for dealing with the issue; (4) there must be an inte rvention, of which communication skills are an integral component, tha t is demonstrably effective for dealing with the clinical issue; (5) t he intervention must represent a cost-effective means of dealing with the issue; (6) the intervention must be acceptable to doctors and be a ble to be incorporated into routine medical practice; (7) the interven tion must be acceptable to patients. Examples of clinical issues which fit these criteria are given in the paper and include smoking, hazard ous alcohol consumption, non-adherence to treatment instructions, over due cervical screening, inappropriate diet, recovery from medical inte rventions, and breaking bad news to patients.