Residents' perceived barriers to communication skills learning: comparing two medical working contexts in postgraduate training.
OBJECTIVE
Contextual factors are known to influence the acquisition and application of communication skills in clinical settings. Little is known about residents' perceptions of these factors. This article aims to explore residents' perceptions of contextual factors affecting the acquisition and application of communication skills in the medical workplace.


METHODS
We conducted an exploratory study comprising seven focus groups with residents in two different specialities: general practice (n=23) and surgery (n=18).


RESULTS
Residents perceive the use of summative assessment checklists that reduce communication skills to behavioural components as impeding the learning of their communication skills. Residents perceive encouragement to deliberately practise in an environment in which the value of communication skills is recognised and support is institutionalised with appropriate feedback from role models as the most important enhancing factors in communication skills learning.


CONCLUSIONS
To gradually realise a clinical working environment in which the above results are incorporated, we propose to use transformative learning theory to guide further studies.


CONCLUSIONS
Provided it is used continuously, an approach that combines self-directed learning with observation and discussion of resident-patient consultations seems an effective method for transformative learning of communication skills.
Maastricht University, Maastricht, The Netherlands. Electronic address: v.vdeertwegh@maastrichtuniversity.nl.
Valerie
V
van den Eertwegh
Skillslab, Maastricht University, Maastricht, The Netherlands.
Jan
J
van Dalen
NIVEL (Netherlands Institute for Health Services Research), Utrecht, The Netherlands; Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; Buskerud University College, Drammen, Norway.
Sandra
S
van Dulmen
Department of Educational Development and Research, Maastricht University, Maastricht, The Netherlands; University of Copenhagen, Copenhagen, Denmark; King Saudi University, Riyadh, Saudi Arabia; Radboud University, Nijmegen, The Netherlands.
Cees
C
van der Vleuten
Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
Albert
A
Scherpbier
D000328:Adult; D003142:Communication; D005260:Female; D017144:Focus Groups; D058006:General Practice / Q000193:education; D013502:General Surgery / Q000193:education; D006801:Humans; D007396:Internship and Residency; D007858:Learning; D008297:Male; D020380:Needs Assessment / Q000458:organization & administration; D010817:Physician-Patient Relations; D011361:Professional Competence; D012017:Referral and Consultation; D011795:Surveys and Questionnaires; D017132:Workplace
Communication skills; Context; Effectiveness; Learning; Medical working context; Residents; Transformative learning