title: Learning patient-centred communication: The journey and the territory.
abstract: OBJECTIVE
  The student entering medical school is about to undergo a socialisation process that profoundly shapes their development as a professional. A central feature is the formal and informal curriculum on the doctor-patient relationship and patient-centred communication. In this paper I will chart some of the features of the student journey which might impact on learning and practice.
  
  
  METHODS
  The medical undergraduate's role is largely that of observer and learner, rather than a provider of care, so much of the formal teaching on patient-centred communication is within simulated practice. Clinical practice environments are the most powerful influences on learning about professional behaviour. Challenges for educational practitioners include how to support authenticity in learners, respond to their agendas, and foster insight to enable flexibility about communication in different contexts. Parallels between the doctor-patient relationship and the student-tutor relationship are explored for their relevance. A number of educational theories can inform curriculum design and educational practice, notably Vygotsky's Zone of Proximal Development.
  
  
  CONCLUSIONS
  Application of this and other social learning theories, together with students' reflections can enrich our planning of educational interventions and understanding of their impact.
authors: Institute of Health Sciences Education, Barts and The London School of Medicine and Dentistry, Queen Mary, University of London, UK. Electronic address: a.m.cushing@qmul.ac.uk.
authors: Annie M
authors: AM
authors: Cushing
mesh_terms: D002983:Clinical Competence; D003142:Communication; D004504:Education, Medical, Undergraduate / Q000379:methods*; D006801:Humans; D007858:Learning; D018802:Patient-Centered Care / Q000379:methods*; D010817:Physician-Patient Relations; D013337:Students, Medical / Q000523:psychology*
keywords: Clinical communication; Communication skills; Educational theory; Medical education; Patient-centered communication; Social learning theory