title: Mind the gap: Learners' perspectives on what they learn in communication compared to how they and others behave in the real world.
abstract: OBJECTIVE
  To explore the lack of the learners' voice at previous international conferences on communication in healthcare.
  
  
  METHODS
  A group of medical students and recently qualified junior doctors were invited to give the learner's perspective on how communication skills are taught and how they are implemented in 'real life', at a 90min symposium at the EACH International Conference on Communication in Healthcare, 4th September 2008, Oslo.
  
  
  RESULTS
  We attempt to bridge the gap between learning communication skills formally in the medical classroom and actually implementing these in the real world between doctors and patients from a learners' perspective. In making this transition we highlight obvious weaknesses and potential pitfalls, whilst also drawing attention to the successful strategies used in our respective medical schools. Four key areas are discussed: (1) using simulated patients, (2) learning in the clinical setting, (3) barriers to utilizing communication skills, (4) future directions. We have drawn upon the learning experiences from both undergraduate and postgraduate environments in the UK, the USA and Norway.
  
  
  CONCLUSIONS
  Our experiences differed between universities from the same country, which widened across continents. The differences between how we behave in the classroom and how we are with real patients when unobserved have been highlighted; and we have attempted to explain why trainees sometimes modify their behavior in medical assessments with standardized patients for examinations as opposed to how we would perform on wards or in general practice. The teaching of communication skills will continue to develop over the forthcoming years.
  
  
  CONCLUSIONS
  Integrating communication skills into medical school curricula is essential. Identifying enthusiastic doctors who are effective communicators and have the initiative to help develop this is vital. It may be beneficial to train simulated patients to react to students in a variety of different ways to reflect the diversity of true patient responses. In addition, having a better understanding of the multidisciplinary roles and rapidly developing technology would facilitate not only communication between health professionals but would also help optimize patient care.
authors.affiliation: School of Clinical Medicine, University of Cambridge, UK. aneilmalhotra@gmail.com
authors.forename: Aneil
authors.initials: A
authors.lastname: Malhotra
authors.forename: Ian
authors.initials: I
authors.lastname: Gregory
authors.forename: Emily
authors.initials: E
authors.lastname: Darvill
authors.forename: Edward
authors.initials: E
authors.lastname: Goble
authors.forename: Adele
authors.initials: A
authors.lastname: Pryce-Roberts
authors.forename: Kristina
authors.initials: K
authors.lastname: Lundberg
authors.forename: Steinar
authors.initials: S
authors.lastname: Konradsen
authors.forename: Heidi
authors.initials: H
authors.lastname: Hafstad
mesh_terms: D002983:Clinical Competence; D003142:Communication; D003226:Congresses as Topic; D003479:Curriculum; D004501:Education, Medical; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D038622:Internationality; D007858:Learning; D009664:Norway; D010817:Physician-Patient Relations; D012938:Social Perception; D013337:Students, Medical; D006113:United Kingdom; D014481:United States