Communication challenges for experienced clinicians: Topics for an advanced communication curriculum

We asked 111 experienced clinicians (MDs, RNs, PhDs, DMins) attending a con ference on medical interviewing for descriptions of communication challenge s they encountered while practicing in clinical health care settings. Eight y-one provided accounts analyzed in this study. Using narrative analysis, w e found that most of the accounts focused on conflicts between clinicians a nd patients based on differing beliefs about the nature and treatment of il lness and contrasting expectations about the doctor-patient relationship. T his article traces the clinician-narrators' use of plot, characterization, cause-effect relationships, and idealized images to make sense of challengi ng communication encounters. The results of our analysis point to several c ommunication competencies that experienced clinicians found they lacked, ev en after receiving communication training and developing an awareness of th e literature on teaching health communication skills. Building skills in th e identified areas could reduce clinician frustration and enrich the practi ce of medicine.