Teaching Counselling Skills to Fourth-year Medical Students: A Dilemma Concerning Goals

Abstract

Advocacy of communication skills training in medical curricula is common, but this paper highlights some paradoxes which become apparent when such training is instituted. Fourth-year medical students completed a standardized questionnaire measure of empathy, before and after intensive training in counselling and communication in general practice. Low rates of empathetic responding were shown, and no increase occurred after training. The results are discussed in terms of an emerging dilemma within medical education and practice, namely the conflict between the traditional view of the doctor as problem-solver and recent evidence of the health benefits of a more patient-centred style of medical practice.

Emotion skills training for medical students: a systematic review

“…Inter‐rater agreement was 100%. A hand search of article reference lists yielded 4 additional publications for a total of n = 26 articles to be used in the comprehensive review 24–49 . A full flow chart of article selection is shown in Fig.…”

Evaluating the outcome of communication skill teaching for entry-level medical students: does knowledge of empathy increase?

“…The outcome of training was assessed using a 10-item empathy scale (see Table 1) which requires respondents to write brief responses to trigger statements modi®ed from materials prepared originally by Danish & Hauer. 16,17 Students took about 15 minutes to complete the scale, and it was then scored by one of two trained raters, neither of whom had used this system before although both were experienced at coding psychotherapy transcripts. The coding rules are as follows: Where a written response includes several different elements, it is scored as the highest of the possible ratings.…”

Patient communication pattern scale: psychometric characteristics

“…However, many difficulties are reported in the implementation of this model: partial disclosure of information (on both sides), inadequate provision of information, interrupting patient, difficulties in addressing patient's feelings and worries, discussing patient's preferences and collaborative decision making. Predominant difficulties in open and collaborative communication between the parties especially exist when the patients suffer from severe and terminal diseases, although the importance of open and collaborative communication in such conditions is greater . In an effort to understand this situation, research has focused on the physician's communication patterns while studies on the patient's role in this dyad are rare .…”