The paper concludes with a developmental map that charts the complex influences on clinical communication teaching and learning and a brief commentary on the growing body of teachers who deliver and develop the subject today.

Findings indicate that more needs to be done to support, develop, and embed CCS into the professional practice of medical students in the clinical workplace. This may be achieved by greater collaboration of educators in the academic and clinical environments. Using the developmental transfer model applied to CCS learning may help foster this relationship.

Clinical communication education is now part of the core curriculum of every medical school in the United Kingdom and the United States. It has emerged over 30 years because of various societal, political, and policy drivers and is supported by an impressive evidence base.For a variety of reasons, however, clinical communication has become separated from other parts of medical education and tends to be positioned in the early years of the curriculum, when students have limited experience of being in the clinical workplace and working with patients. The teachers of clinical communication, whether medical-school-based or clinically based, may not share learning goals for the subject and this may, therefore, provide a disintegrated learning experience for students.Clinical communication teachers need to inject fresh thinking into the teaching and learning of the subject to unite it with clinical practice in the authentic clinical workplace. Engaging with theories of workplace learning, which aim to overcome the theory/practice gap in vocational education, may be the way forward. The author suggests various ways that this might be achieved-for example, by situating clinical communication education throughout the whole undergraduate curriculum, by integrating the topic of clinical communication with other areas of medical education, by developing coteaching and curriculum design partnerships between medical school and clinical workplace, and by developing a greater range of postgraduate education that offers opportunities for professional development in clinical communication for qualified doctors that is complementary with what is taught in undergraduate education.

Background: Classroom teaching of communication and clinical skills in the pre-clinical years does not reflect authentic practice in the clinical workplace. This paper describes an innovative hybrid simulation teaching session on male urinary catheterisation to large cohorts of undergraduate medical students, which aims to achieve a holistic approach to integrated skills acquisition. Evaluation of the session is described.

for successful study in our medical curriculum need to be identified. Using predictors that are more appropriate and addressing possible obstacles to student success in our curriculum should assist our school in its mission to select and retain more students from disadvantaged communities. What was done Artificial neural network analysis (ANNA) was applied to identify the predictors of success using input and output data for students admitted into our undergraduate medical programme since 1999. A total of 99 input variables in 3 categories were used: demographic (3); quantitative (16), and qualitative (80). Student demographics included gender, ethnic group and home language. Quantitative variables were academic performance in high school and the results of the national health sciences placement tests (HSPTs), which assess potential to succeed at tertiary education level. A set of 80 qualitative variables, related to generic skills, life views and attitudes, were obtained using a questionnaire completed by the students on admission to the programme. Success was measured by academic performance during the first study year according to whether a student passed, passed with distinction or failed. Evaluation of results and impactThe study population comprised 171 students for whom complete datasets were available. Ten (6%) of these students failed the first year. ANNA showed that, when using all the input variables, student performance could be predicted with close to 100% accuracy. The most powerful predictors were the results of the HSPTs. Using only these, the 10 failures could be predicted with 90% accuracy. A similar result was found using the 80 qualitative variables in isolation. The results also showed that the average mark achieved during the first year was significantly related to the studentÕs home language and ethnicity.Although future work will need to validate these findings against more data, especially for more unsuccessful students, they already have an impact on our selection process, particularly in helping to identify high-risk students. The study will be expanded to include all years of training, other university programmes, and other health sciences programmes in the country.

This teaching initiative was a practical attempt to bridge the theory-practice gap in clinical communication education, and to place learning in the clinical workplace for students. As such, it was enjoyed by all those who took part, and may be the way forward for clinical communication teaching and learning in the future.

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