The need for physicians to have patient-centered communication skills is reflected in the educational objectives of numerous medical schools' curricula and in the competencies required by groups such as the Accreditation Council for Graduate Medical Education. An innovative method for teaching communications skills has been developed at the University of Colorado School of Medicine as part of its three-year, longitudinal course focusing on basic clinical skills required of all physicians. The method emphasizes techniques of open-ended inquiry, empathy, and engagement to gather data. Students refer to the method as ILS, or Invite, Listen, and Summarize. ILS was developed to combat the high-physician-control interview techniques, characterized by a series of "yes" or "no" questions. The authors began teaching the ILS approach in 2001 as one basic exercise and have since developed a two-year longitudinal communications curriculum. ILS is easy to use and remember, and it emphasizes techniques that have been shown in other studies to achieve the three basic functions of the medical interview: creating rapport, collecting good data, and improving compliance. The skills are taught using standardized patients in a series of four small-group exercises. Videotaped standardized patient encounters are used to evaluate the students. Tutors come from a variety of disciplines and receive standardized training. The curriculum has been well received. Despite the fact that the formal curriculum only occurs in the first two years, there is some evidence that it is improving students' interviewing skills at the end of their third year.
Findings from this study suggest that SPETAs can effectively teach foundational physical examination skills to medical students at a similar and sometimes better performance level as physician faculty.
An interdisciplinary, introductory pharmacy practice experience course that students are required to take during their third professional year was started during the spring semester 2002. The course goals were to enhance students' abilities to work with primary care practitioners and to promote their understanding of the working environment of these individuals. Each student was assigned to a family physician, internist, or nurse practitioner, completed ten 2-hour visits to the professional's practice site, undertook tasks assigned by their preceptor, and completed a writing assignment. Most of the students were involved in direct patient-care activities. Students and preceptors agreed that the course goals were met and that the students made useful patient-care contributions. Pharmacy students were able to use self-directed learning skills to gain experience in working with primary care practitioners, develop insight into the working environment of these individuals, and provide valuable patient-care services. The course also demonstrated that physicians and nurse practitioners can be willing, active, and valuable partners in pharmacy education.
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