Clinicians’ Voices on a Disciplinary Approach to Teaching Clinical Communication in the Chinese Context: Priorities, Challenges, and Scope

Abstract

Background: In the absence of a well-rounded syllabus to teach clinical communication, emphasising both interpersonal and medical dimensions, medical students in the early stages of their career may find it challenging to effectively communicate with patients, especially those from different cultural backgrounds. Aims: To explore the priorities, challenges and scope of teaching clinical communication in a Chinese context using a disciplinary approach, and to investigate how medical educators and clinicians teach clinical communication in their respective clinical disciplines. Design: Interpretative phenomenological analysis. Data sources: Nine medical educators, all experienced frontline clinicians from 7 clinical disciplines, were recruited from 7 Hong Kong hospitals and 2 medical schools. They were interviewed to seek their views on teaching clinical communication in the Chinese context, specifically its priorities, challenges, and scope. Results: The interview data revealed 5 themes related to the priorities, challenges, and scope of teaching clinical communication across a wide range of clinical disciplines in the Chinese context, namely (1) showing empathy with patients; (2) using technology as a modern teaching approach to combine medical and interpersonal dimensions; (3) shared decision-making, reflecting the influence of Chinese collectivism and cultural attitudes towards death on communication with patients and their families; (4) interdisciplinary communication between medical departments; and (5) the role of language in clinician–patient communication. Conclusions: Taking a disciplinary perspective, the clinicians in this study approached the complex nature of teaching clinical communication in the Chinese context in different ways. The findings illustrated the need to teach clinical communication using a disciplinary approach in addition to teaching it generically across specialties. This is particularly important in the Intensive Care Unit (ICU), where clinicians frequently cooperate with physicians from other departments. This study also highlighted how non-verbal social cues, communication strategies, and the understanding of clinical communication in the Chinese context operate differently from those in the West, because of socio-cultural factors such as family dynamics and hierarchical social structures. We recommend a dynamic teaching approach using role-playing tasks, scenario-based examples, and similar activities to help medical students to establish well-rounded clinical communication experiences in preparation to overcome challenges in their future real-life clinical practice.