Over the course of March 2020, the everyday life of most people changed from normal to extraordinary around the globe. By the beginning of March, there had been serious outbreaks of COVID-19 in a limited number of countries, such as China, South Korea, Iran and Italy, while many others experienced a lull before the storm. People in unaffected countries understood that the Corona SARS CoV-2 virus might reach their shores at one point; the question was when and how hard it would hit. By the end of March, many governments had ordered drastic measures. Schools and university campuses were shut down. Shops, restaurants and companies were closed. People in many different jobs were asked to work from home, and many were in quarantines.

Context Interest 1 in the teaching of communication skills in medical schools has increased since the early seventies but, despite this growing interest, relatively limited curricular time is spent on the teaching of communication skills. The limited attention to the teaching of these skills applies even more to the physicians' clinical years, when attention becomes highly focused on biomedical and technical competence. Continuing training after medical school is necessary to refresh knowledge and skills, to prohibit decline of performance and to establish further improvements.Objective This review provides an overview of evaluation studies of communication skills training programmes for clinically experienced physicians who have ®nished their undergraduate medical education. The review focuses on the training objectives, the applied educational methods, the evaluation methodology and instruments, and training results.Methods CD-ROM searches were performed on MedLine and Psychlit, with a focus on effect-studies dating from 1985.Results Fifteen papers on 14 evaluation studies were located. There appears to be some consistency in the aims and methods of the training programmes. Course effect measurements include physician self-ratings, independent behavioural observations and patient outcomes. Most of the studies used inadequate research designs. Overall, positive training effects on the physicians' communication behaviour are found on half or less of the observed behaviours. Studies with the most adequate 2 designs report the fewest positive training effects.Conclusion Several reasons are discussed to explain the limited ®ndings. Future research may bene®t from research methods which focus on factors that inhibit and facilitate the physicians' implementation of skills into actual behaviours in daily practice.

Background Although doctor±patient communication is important in health care, medical specialists are generally not well trained in communication skills. Conventional training programmes are generally time consuming and hard to ®t into busy working schedules of medical specialists. A computer-assisted instruction (CAI) programme was developed ±`Interact-Cancer' ± which is a time-ef®cient learning method and easily accessible at the workplace.Objective To investigate the effect of the CAI training, Interact-Cancer', on the communication behaviour of medical specialists, and on satisfaction of patients about their physician interaction.Design Consultations of medical specialists with cancer outpatients were videotaped at 4 speci®c stages, 2 before and 2 after Interact-Cancer, with intervals of 4 weeks.Patients/participants Participants were 21 medical specialists, mainly internists, working in 7 hospitals, and 385 cancer outpatients.Methods Communication behaviour was assessed on 23 observation categories derived from the course content.Frequencies were rated as well as judgements about the quality of the performance of each target skill. Satisfaction was measured by the Medical Interview Satisfaction Scale. Data were analyzed by means of multilevel statistical methods. ResultsThe behavioural assessment showed course effects on ratings of the physicians' quality of performance. No course effects were found on the frequencies of physicians' behaviours and on the patient satisfaction ratings.Conclusions CAI is a promising method to supply medical specialists with postgraduate training of communication skills. The application of judgement ratings of communication behaviour proved to be valuable to evaluate course effects in real-life patient encounters.

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