The effects of the participation of patients with cancer in teaching communication skills to medical undergraduates: a randomised study with follow-up after 2 years (vol 35, pg 1448, 1999)

The importance of good doctor-patient communication is widely recognised. T he aims of this study were to evaluate the immediate effects of the partici pation of patients with cancer on the attitudes and skills of undergraduate medical students receiving an interview skills training programme, and to assess the effects of the participation of patients with cancer on the atti tudes and interview performance of students 2 years later. It was hypothesi sed that the participation of cancer patients would have specific beneficia l effects on attitudes and interview performance. Before participating in a 6-session interview methods course in third year, students were randomised to be taught with patients who had cancer (experimental group) or with pat ients with other diagnoses (control group). Before and after participating in the course, 233 students (94% response rate) completed an Attitudes Ques tionnaire. When they reached their fifth year, 54 students again completed the Attitudes Questionnaire and, in addition, made a video recording of an interview with a patient who had gynaecological cancer. These recordings we re rated independently by two researchers using the Interview Rating Instru ment. Immediately after the course, a number of differences were found betw een the two groups. For example, students in the experimental group were mo re Likely to consider the ability to listen an extremely important characte ristic of hospital doctors and to consider more strongly that trust is an e ssential part of the doctor-patient relationship. 2 years after the course, the ability of hospital doctors to communicate with patients, and the need for clinical decisions to reflect patients' wishes, were considered to be more important by students in the experimental group, although even 96% of controls felt both these issues were very or extremely important. As hypoth esised, the experimental group had better ratings in terms of responding em pathically, showing regard and concern for the patient, and assessing the i mpact of the symptoms on the patient's Life, The participation of patients with cancer has beneficial and enduring effects on the attitudes and interv iew performance of medical undergraduates. Medical schools should consider how best patients with cancer can make an important contribution to communi cation skills training. (C) 1999 Elsevier Science Ltd. All rights reserved.