Is this an effective approach for teaching and learning clinical communication skills?

At the time of writing this blog (2015), “Talk to patients like you talk to your parents” is an assumption I heard a lot from institutional leaders and medical educators while campaigning for clinical communication skills courses in India. This assumption has its roots in the notion of traditional wisdom; you must always respect your elders and talk to them politely. It is assumed by medical educators that as students already practice this notion, they will know how to talk to their patients and colleagues. Therefore, they will not need any additional training in communication skills. This notion, no doubt, is a useful mantra, however it alone falls significantly short when it comes to teaching and learning clinical communication skills.

Why does it fall short? Here are some of the reasons:

• It makes the complex skill such as clinical communication simpler to achieve. In the system where apprenticeship and role modelling dominate statements like these from leaders/medical educators may have negative impact on new professionals.

• There is a danger that young doctors or doctors in training may not appreciate it as a key ‘professional skill’. There is a risk that they might assume that they don’t need to learn it as they know how to talk to parents (elders).

• It doesn’t offer any detail on the content and process of achieving communication skills

• We all vary in how we talk to parents and if not careful those who are extremely polite might find it hard to air their views in team meetings. There is also risk that those who don’t speak to parents or elders politely might continue the same behaviour which might have dire consequences on doctor- patient and inter-professional relationships

• It also assumes that everybody has parents and generalises that everybody talks to them politely

As we are (and hope you are) fundamentally serious about teaching and learning clinical communication skills in the right way, we must go beyond such assumptions and take the following steps. First, we should start being “critical” and challenge these ‘deeply embedded’ and ‘self-confirming’ assumptions. Second, teaching and learning communication skills require focused training, mentoring/coaching by experts in medical education.