Effective Communication

The competent graduate: listens attentively; communicates clearly with patients, families, and health care team members; understands the key elements of a professional therapeutic relationship; understands the importance of relationship-centered care to the healthcare outcomes of the patient, family, health system, and society; and can effectively and efficiently communicate using oral, written, and electronic means.

Glenda Westmoreland, M.D., M.P.H.
Competency Director, Effective Communication

View Video Clip
Kathleen Zoppi, Ph.D., M.P.H.
Former Competency Director, Effective Communication

Sample Learning Experiences:

• Breaking Bad News
  For the past three years, the communication competency director, faculty from the OB-GYN and Surgery departments, and chaplaincy staff of Clarian hospitals, have taught a mini-workshop with students on the third year OB-Surgery block intercession. This 1½ to 2-hour workshop has focused on the principles of breaking bad news (Buckman, Maynard) and applying the SPIKES protocol to clinical encounters. The presentation uses video vignettes, patient experiences, discussion and role play. The session is organized by Peter Marcus, M.D., Department of Obstetrics and Gynecology, and Kathy Zoppi, Ph.D., Department of Family Medicine.
• Assessment of Student-Physician by Patients
  Pediatrics Clerkship On the pediatrics clerkship, patients and family members are invited to give feedback about the student who has been helping take care of them using questions such as:
1. What did this student do to help you and your family understand the problem, treatment, or care of the patient?
2. How did she/he involve you in talking about preferences, beliefs, concerns or worries you might have?
3. What are this student’s strengths in working with patients?
4. What advice would you give this student to improve?

This activity is directed by Mitch Harris, M.D., Clerkship Director, Department of Pediatrics.

• Motivational Interviewing and Smoking Cessation: Teaching and Learning on the Family Medicine/Pediatrics Intersession and OSCEs
  In 2002, as part of a HRSA supported project in predoctoral education, we began to teach students a protocol for smoking cessation and health behavior counseling as part of the two-day family medicine/pediatrics intersession. The brief teaching session uses materials on motivational interviewing (Miller and Rollnick) and specific materials from Bothelho and colleagues (Motivating Healthy Habits) at University of Rochester. After introducing the principles of motivational interviewing to students, they are moved to small groups to practice these skills with faculty facilitators and standardized patients. This 1½-2 hour workshop has been repeated for four years.
  

  Students are tested on pre and post-intervention skills in the 2nd and 3rd year OSCEs with various cases involving patients requiring smoking cessation counseling at various stages of change (using the transtheoretical model). Data are being examined to see if student performance improves as a result of this teaching intervention and experience in the clerkship. This session is organized by Kathy Zoppi, Ph.D. and Ines Bardello, M.D., Department of Family Medicine, and Mitch Harris, M.D., Department of Pediatrics.

• Bloomington Communication Competency Workshop Integrating Competency-based Teaching and Assessment into a Workshop for First-Year Students
  Beginning in 1999, with support from the Clinical Skills Education Center (CSEC) and Medical Education and Curricular Affairs (MECA), the faculty of the Bloomington Center for Medical Education and the Department of Family Medicine have worked together to offer an immersion experience in clinical skills and communication competencies for first year medical students. Students rotate on a schedule among workshops on patient-centered communication (including active listening, eliciting basic patient concerns, identifying and responding to emotions, negotiating skills, and self-awareness) and basic clinical skills (including suturing, heart and lung examinations, joint examinations, and other introductory topics.) Mid-semester, students are transported by bus from Bloomington to the CSEC at IUPUI where they participate in videotaped interviews with standardized patients in a mock-OSCE. Upon completion, they receive feedback on their communication skills from the trained standardized patients. Copies of the videotapes of these standardized patient encounters are given to the students, who are asked to review their own tapes and present them in small groups in Bloomington the following week for discussion about similarities and differences in interviews with the same standardized patients. Students assess their own proficiency, writing a self-assessment log, after interviewing sessions with volunteer and standardized patients. They also select segments of videotaped interviews from the teaching OSCE for use in self-assessment. Collaborating faculty: John Watkins, Tal Bosin, Frank DiSilvestro, Tom Hrisomalos, Kathy Zoppi, Deborah Griffith, David Dinn, Mary Jane Hall, Lisa Jerrills, Lee McKinley, Faculty and Residents of Family Medicine.

Bibliography

For more details on this competency, please click here.