MDs to get more training in communications





In response to changing attitudes in healthcare and concerns over whether doctors are able to meet society’s expectations of them, medical schools are placing a greater emphasis on the importance of doctor-patient communication in medical education.


Communication refers not only to the verbal and written exchange of ideas, but also developing a context in which a doctor and patient can understand one another-based on social, religious, language and cultural backgrounds.


Changes in Medical School Curricula. In Jan. 1996, the Association of American Medical Colleges (AAMC) embarked on a major new national initiative—the Medical School Objective Project (MSOP)—to assist medical schools in their efforts to train students not only to effectively diagnose and treat disease but to also deliver care in a compassionate way.


The newest phase of the MSOP project focuses on the critical issue of communication with patients, families, colleagues and communities. Learning objectives, learning experiences and implementation strategies to achieve the objectives relevant to communication skills are set forth in a recently authored "white paper."


An example of how medical schools are addressing the issue of doctor-patient communication is demonstrated by a collaboration between New York University, Case Western Reserve University and the University of Massachusetts. The three schools created a national educational and training program to help improve physicians’ communication skills and facilitate better doctor-patient relationships.


The program, The Macy Initiative in Health Communications, developed a standard curriculum in communication skills, available to medical schools nationwide. The programs offer a course of study to train young doctors both to listen to their patients and to explain scientific concepts to patients in easily understood terms.


In medical education attention is also paid to areas of particular concern including end-of-life care, spirituality, cultural diversity and family-centered care. In order to communicate effectively with patients and their families, physicians need to understand how a person’s spirituality and culture affect their perceptions of health and illness, and their desires regarding end-of-life care.


Spirituality. Medical educators define spirituality as a patient’s search for meaning and purpose in life, especially in the midst of suffering through chronic illness or stressful life events. By understanding a patient’s pain, hopes and fears—and appreciating the patient’s point of view regarding religion or other spiritual beliefs—doctors may be better equipped to help ease a patient’s suffering and potentially improve the disease outcome.


Cultural diversity. Individuals experience illness and the health care system through the prism of their cultural background. Cultural identity, based on heritage, circumstances and personal choices, is affected by a number of factors including race, ethnicity, age and language.


It’s believed that doctors should not only have a strong awareness of their personal cultural identities and value systems, but be sensitive to their patients’ cultural issues and be able to use specific methods to deal effectively with those issues.


End-of-life care. The possibility of death is a major concern for the patient and his or her family-and for the physician. With increased communication, doctors are able to learn the fundamental knowledge, attitudes and skills necessary to treat the dying.


Family-centered care. The role of the family cannot be underestimated in the delivery of quality health care. Doctors, patients and families communicate with each other to ensure higher levels of satisfaction, better health outcomes and cost savings.


For more information and examples on doctor-patient communication and other initiatives designed to meet the changing needs of a diverse population and an increasingly complex health care system, visit the AAMC Web site at www.aamc.org/newsroom and go to "Doctoring 101" or call Jennifer Bush at (202) 828-0041.



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