title: Teaching communication skills: beyond wishful thinking.
abstract: Communication skills tend to decline with time unless they are regularly recalled and practiced. However, most medical schools still deliver clinical communication training only during pre-clinical years although the clinical environment is considered to be ideal for acquiring and teaching clinical communication. The aim of this article is to review the barriers that prevent communication skills teaching and training from occurring in clinical practice and describe strategies that may help enhance such activities. Barriers occur at several levels: students, junior doctors and clinical supervisors sometimes have negative attitudes towards communication training; structured training in communication skills is often insufficient; clinical supervisors behave as poor role models and lack effective communication and teaching skills; finally, there are organisational constraints such as lack of time, competing priorities, weak hierarchy support and lack of positive incentives for using, training or teaching good communication skills in clinical practice. Given the difficulty of assessing transfer of communication skills in practice, only few studies describe successful educational interventions. In order to optimise communication skills learning in practice, there is need to: (1.) modify the climate and structure of the working environment so that that use, training and teaching of good communication skills in clinical practice becomes valued, supported and rewarded; (2.) extend communication skills training to any field of medicine; (3.) provide regular structured trainings and tailor them to trainees' needs. Practical implications of such findings are discussed at the end of this review.
authors: Division of Primary Care, Department of community care, primary care and emergency, Geneva University Hospitals, Switzerland, and Unit of Development and Research in Medical Education, University of Geneva Faculty of Medicine, Switzerland.
authors: Noelle
authors: N
authors: Junod Perron
authors: Unit of primary care medicine, University of Geneva Faculty of Medicine, Switzerland.
authors: Johanna
authors: J
authors: Sommer
authors: Service of general internal medicine, Department of internal medicine, rehabilitation and geriatric medicine, Geneva University Hospitals, Switzerland.
authors: Martine
authors: M
authors: Louis-Simonet
authors: Unit of Development and Research in Medical Education, University of Geneva Faculty of Medicine, Switzerland, and Service of general internal medicine, Department of internal medicine, rehabilitation and geriatric medicine, Geneva University Hospitals, Sw.
authors: Mathieu
authors: M
authors: Nendaz
mesh_terms: D001291:Attitude of Health Personnel; D002983:Clinical Competence; D004504:Education, Medical, Undergraduate / Q000379:methods*; D058015:Health Communication; D006801:Humans; D010817:Physician-Patient Relations; D013337:Students, Medical / Q000523:psychology; D013663:Teaching