title: Teaching communication skills to medical students, a challenge in the curriculum?
abstract: BACKGROUND
  As communication skills become more and more important in medical practice, the new medical curriculum at Ghent University (1999) implemented a communication curriculum.
  
  
  METHODS
  Communication training or experiences in 'real life' settings are provided every year of the medical curriculum. The training starts with simple basic skills but gradually slips into medical communication or consultation training and results in communication in different contextual situations or with special groups of patients. Rehearsal is important and seen as inevitable. Poorly performing students get extra training. Several didactical methods are used: the skills are demonstrated by means of videotapes and paper cases of patient stories. Skills are trained in small groups (10-15 students), with focus on role-playing with colleague students or simulated patients (SP). Videotapes of real consultations give an idea of the performance of each student. Every year the students are assessed by means of an OSCE (objective structured clinical examination).
  
  
  CONCLUSIONS
  After 6 years of experience with the new curriculum, several remarks and questions need to be answered. Small group training gives a huge workload and with different trainers discrepancies between groups can appear. Choosing the most suitable trainer for communication skills is not easy; several options are available: specialists in communication like psychologists with interest in medical practice, GPs with interest in medical communication, medical specialists for communication topics concerning medical problems within their domain. As the most important didactical approach lies in practising the skills, the selection and training of simulated patients remains a challenge.
  
  
  CONCLUSIONS
  A communication continuum during the whole curriculum seems to be worthwhile. Students with specific communicative problems are detected early, remediation is provided. Rehearsal every year seems to lead to better acquisition. The most positive point is that communication is embedded in a global patient-, student- and community-oriented curriculum and that communication skills are seen as core elements of good doctoring.
authors: Department of General Practice and Primary Health Care, Ghent University, UZ-1K3, De Pintelaan 185, B9000 Gent, Belgium. myriam.deveugele@ugent.be
authors: Myriam
authors: M
authors: Deveugele
authors: Anselme
authors: A
authors: Derese
authors: Stéphanie
authors: S
authors: De Maesschalck
authors: Sara
authors: S
authors: Willems
authors: Mieke
authors: M
authors: Van Driel
authors: Jan
authors: J
authors: De Maeseneer
mesh_terms: D001530:Belgium; D003142:Communication; D003479:Curriculum; D004501:Education, Medical; D006801:Humans; D016544:Patient Simulation; D010817:Physician-Patient Relations; D013663:Teaching / Q000379:methods*; D014743:Videotape Recording