Creativity in clinical communication: from communication skills to skilled communication

Abstract

Medical Education 2011: 45: 217-226 Objectives The view that training in communication skills produces skilled communication is sometimes criticised by those who argue that communication is individual and intuitive. We therefore examine the validity of the concept of communication as a skill and identify alternative principles to underpin future development of this field. Methods We critically examine research evidence about the nature of clinical communication, and draw from theory and evidence concerning education and evaluation, particularly in creative disciplines. Results Skilled communication cannot be fully described using the concept of communication skills. Attempts to do so risk constraining and distorting pedagogical development in communication. Current education practice often masks the difficulties with the concept by introducing subjectivity into the definition and assessment of skills. As all clinical situations differ to some extent, clinical communication is inherently creative. Because it is rarely possible to attribute specific effects to specific elements of communication, communication needs to be taught and evaluated holistically. Conclusions For communication teaching to be pedagogically and clinically valid in supporting the inherent creativity of clinical communication, it will need to draw from education theory and practice that have been developed in explicitly creative disciplines.

Designing a curriculum for communication skills training from a theory and evidence-based perspective

“…In Bachmann et al's list, when assessing whether the student 'Discusses with the patient the likely advantages, disadvantages and expected outcomes,' one might look for language related to benefits, risks, and possible outcomes associated with treatment options. Yet, as Salmon and Young [66] note, demonstrating communication skill is not the same as skilled communication. From this perspective, is adequate and formal assessment will require an evaluative approach where skilled communication is not a function of what the interactants did but how well they did it given the goals in a certain context for a certain patient.…”

Información médica a pacientes y familiares: aspectos clínicos, éticos y legales

“…Existen autores que tienen posturas entusiastas sobre los protocolos y la capacitación en IPYF [27][28][29] , otros mantienen una postura de activa evaluación sobre sus posibles beneficios 30 y algunos tienen actitudes muy críticas, respecto de las guías y protocolos de IPYF 31 . Lamentablemente, la evidencia sustentada en estudios metodológica-mente correctos es escasa y poco categórica 11,25,32,33 .…”

Conversion of the Communication Paradigm for People at the End of Their Life

“…Regarding the definition of clinical communication, Peter Salmon and Bridget Young stated, "Clinical communication is the vehicle for most patient care and can represent a treatment in its own right" [7]. However, many studies have used the term without clearly defining it.…”

“…However, many studies have used the term without clearly defining it. Majority of the existing studies have focused on the method of communication between a doctor and patient [7,8]. Although medical communication is also used without being clearly defined in many studies, it is used synonymously with clinical communication [9].…”