EXPERIENCE OF A WORKSHOP ON COMMUNICATION SKILLS


Brief Report

EXPERIENCE OF A WORKSHOP ON COMMUNICATION SKILLS IN HEALTH PROFESSIONAL EDUCATION

Khalid U. Al-Umran, FRCPCH(UK), Balachandra V. Adkoli, Ph D

Medical Education Unit, College of Medicine, King Faisal University, Dammam, Saudi Arabia

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مقدمة: يتزايد الشعور بأهمية تدريس مهارات التواصل في الكليات الصحية وتهدف هذه الدراسة, من خلال إلقاء الضوء على تجربة قامت بها وحدة التعليم الطبي بكلية الطب جامعة الملك فيصل, إلى رفع مستوى الوعي حول هذا الموضوع والاستفادة من النتائج للناشط المقبلة.

طرق الدراسة :ورشة العمل أقيمت لمدة يوم واحد وتم التطرق إلى المواضيع التالية :-

العناصر الأساسية للتواصل , تواصل الطبيب مع المريض , الطرق المثلى للإبلاغ عن الأخبار السيئة , حل الخلافات , إعطاء النصائح.

المشاركون و المشاركات من أعضاء هيئة التدريس , أطباء الامتياز ,والطلبة وكان عددهم 168 احتوت الورشة على محاضرات تفاعليه وعروض فيديو وتمثيل الأدوار.

نتائج الدراسة :التغذية الراجعة من المشاركين أفادت أن الأهداف المرجوة في الورشة تم تحقيقها بدرجة عالية وأن مستوى تقديم المادة العلمية كان عالياً ولكن المشاركين أبدوا رغبتــهم في وجود عدد أكبر من محاورات المجموعات الصغيرة وعروض الفيديو وأن يتم التركيز على المشـاكل المحلية .

الخلاصة :أن أقــامة ورشة عمل لمدة يوم واحد يعتبر مثالاً يمكن تطبيقه بنجاح وذلك من أجل زيادة الشعور بأهمية هذا الموضوع .هناك حاجة ماسة لمزيد من الأنشطة المركزة لرفع كفـاءة العاملين في المجال الصحي حول مهارات التواصل.

الكلمات المرجعية : مهارات الاتصال ، تطوير أعضاء هيئة التدريس، تعليم العاملين في المجال الصحي

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Background:The teaching of communication skills is gaining increasing attention. However, the opportunities for faculty development are limited. This study highlights an attempt by the Medical Education Unit, King Fahd Hospital of the University, Al-Khobar, to raise the awareness of faculty to this vital area by organizing a one-day workshop.

Method: A one-day workshop was organized to improve the awareness of the participants to the role of communication skills such as doctor-patient interaction, breaking bad news, counseling and conflict management. In all, 168 participants consisting of faculty members, interns and students, both male and female participated. The sessions included interactive lectures, video demonstrations and role play.

Results: The feedback from the participants indicated that the objectives of the workshop were largely realized. The presentations by speakers were of high quality. However, the participants wanted more small group activities and video-demonstrations that were relevant to the local environment.

Conclusion: By and large, the one-day workshop was found to be a practical model for an initial attempt to raise awareness. Further work is needed to organize more intensive workshops on specific issues related to communication skills.

Key Words: Communication Skills, Faculty Development, Health Professional Education.

J Fam Community Med.2009;16(3):115-118.

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Correspondence to:

Prof. Khalid U. Al-Umran, Medical Education Unit, King Fahad Hospital of the University, P.O. Box 2208, Al-Khobar 31952,

Saudi Arabia

E-mail: kalumran@yahoo.com


INTRODUCTION

Over the years, there has been an increasing emphasis on the need to develop communication skills amongst the health professionals.1 Communication skills are required for tasks such as interviewing patients to obtain medical history, explaining a diagnosis, prognosis, giving instruction and information to patients about to undergo diagnostic or therapeutic procedures and providing counseling to motivate the patients in the course of treatment. Closely associated with these are the interpersonal skills such as respect for patients, and ability to appreciate patients' ideas, values and concerns. An effective doctor-patient communication is vital for the achievement of the satisfaction of patients' needs and expectations.

The teaching of communication skills is emphasized a great deal at all levels of medical education in the western world. An increasing number of medical schools and regulatory agencies have underlined the need to develop communication skills amongst students, in order to establish effective communication with patients/relatives, health team members and the general public, including the media.2

However, concerns have been expressed on the lack of training in Saudi Arabia, which has a mixed health manpower and a population, a large proportion of which is expatriate.3 There is therefore, the need to include communication skills in the curriculum of medical education, and also organize seminars and workshops to improve the performance of practising doctors.4

The College of Medicine, King Faisal University (KFU), Saudi Arabia, follows a conventional curriculum. A course on communication skills is taught in Family and Community Medicine. It is also mentioned in the course specification document throughout the curriculum. The teaching of communication skills is synchronized with clinical teaching and assessment. However, the general feeling is that this is inadequate, there being a gap between what is taught and what is practised. Thus, it was felt that the teaching of communication skills across board should be improved.

The Medical Education Unit of the College of Medicine, King Faisal University has organized workshops for faculty on various themes, such as curriculum planning, teaching learning strategy, student assessment and the writing of MCQs. In continuation of its earlier efforts, the Unit decided to organize a one-day workshop particularly for medical teachers, teachers from dental, nursing and applied medical sciences, as well as interns and students in the final years (5th and 6th level). This was indeed to demonstrate the role of communication skills in a multi-professional setting and also to raise awareness of a large number of people in the limited time available.

METHOD

Letters were sent to the Chairpersons of various departments/colleges of medicine, dental, nursing and applied medical sciences to nominate members of their departments to participate in the workshop. Posters were also put up to publicize the workshop. The response was overwhelming, with the registration of 168 participants and a good mix of males (101) and females (67). Out of 168 participants, 113 were faculty members, 12 were interns and 43 were students, belonging to 5th or 6th level of the MBBS course.

The objectives of the workshop were to outline the principles and role of communication in strengthening patient care, education and organizational effectiveness; to apply the principles to doctor-patient interaction and adopt strategies for the handling of specific communication issues, namely, breaking bad news, providing counseling and dealing with conflicts. The topics/sessions included in the workshop as well as with the strategy adopted for each session are shown in the Table 1. The resource faculty consisted of three faculty members from the Medical Education Unit and a consultant from psychiatry involved in the counseling of patients. All participants were supplied with a folder containing handouts and a list of reading materials including excerpts of lead articles from journals relevant to the theme of the workshop. The lectures were interactive and were supplemented with video-demonstrations on different models of patient-doctor relationship (paternalistic, consumerist, default and mutuality) and how to break bad news. The session on conflict management included role-play enacted by the resident doctors depicting successful and unsuccessful modes of resolving a conflict between a consultant and a chairperson of a department. During the last session, a questionnaire was administered to the participants to evaluate the program.


Table 1: Outline of the program of workshop on "Communication Skills in Health Professional Education"

Time

Topic/Session

Strategy

8:00-9:00

Principles of communication

Lecture and video-demonstration

9:00-9:30

Correlation between academic performance and communication skills

Lecture

9:30-10:30

Specific issues in doctor-patient interaction

Lecture and video-demonstration

11:00-12:00

Conflict management

Brief lecture by the resource person, role play enacted by two volunteers, de-briefing.

1:00-2:00

Breaking bad news and counseling

Lecture demonstration

2:00-2:30

Program evaluation and closing

Administration of questionnaire to the participants

Registration 7:00-7:30; Coffee break 10:30-11:00; Prayer and Lunch Break 12:00-1:00

Table 2: Feedback from the participants (N=81)

Feedback statements

Strongly agree

Agree

Neutral

Disagree

Strongly disagree

The duration of the workshop was about right

20

35

11

5

-

The venue of the workshop was convenient

20

31

14

3

1

The time allocation for each speaker was appropriate

21

34

23

2

-

Overall goals of the workshop were well-defined

12

41

14

3

-

Workshop materials were adequate

8

25

25

11

1

The content of the workshop was relevant to my practice

12

41

15

3

-

The speakers were resourceful

19

36

15

1

-

The workshop provided hands-on activities

8

24

16

13

2

My overall evaluation of the workshop is:

Excellent = 10, Very Good = 28, Good = 36, Fair =6 and Poor =1


RESULTS

A feedback from 81 participants out of total 168 who registered for the workshop (48.2% response) was obtained. Table 2 shows the analysis of the feedback received from the respondents. This indicates that the program was largely successful in attaining the objectives. Most of the respondents either ‘strongly agreed’ or ‘agreed’ that the overall goals of the workshop had been well-defined, the content relevant to their practice, the speakers resourceful, duration adequate, and venue convenient. However, participants wanted more hands-on experience and group activities rather than didactic presentations. The major strengths of the workshop were the quality of presentations made and the role-play, which stimulated the interest of the participants. The deficiency observed was that some examples, especially of the video demonstrations were not relevant to the local context. Many participants also felt that more group work was required.

On the topics to be included or emphasized in future workshops, the participants cited ''breaking bad news'', counseling, ethical aspects, interpersonal relationship, critical thinking, decision-making, team building, body language and stress management.

DISCUSSION

Our experience of the one-day workshop was by and large successful, considering that it was our maiden attempt to raise the awareness of all faculty. Participants' request to include more group activities needs to be taken seriously. The lack of space hindered the organization of group work. However, it is expected that future workshops would be more ''intensive'' rather than ''extensive''. The comment on lack of relevance of video clips to the local context also needs to be addressed, since clips produced in the west are not always relevant in the Islamic world. For instance, advice to make eye contact and awareness of body language in communicating with female patients would have different connotations in this culture. We recognize the need to develop resource material that would be relevant to the local context.

Experience across the world suggests that training would certainly contribute to the development of skills. Studies have shown a positive relationship between exposure, confidence and performance of students with respect to training in communication skills.5 While some medical schools have designed courses exclusively for communication skills, others have integrated them in clinical courses.6 The authors at Mayo Clinic, report a specially designed curriculum for new faculty in the Department of Internal Medicine.7

Based on the availability of resources, time and faculty, KFU should evolve its own model of training students, and improve faculty awareness.

The program evaluation indicates that this one-day workshop at King Faisal University was a small step taken in the right direction. Work with both teachers and students in a single forum was a means of creating the awareness at a low cost. However, further work is required to extend the scope of the workshop in terms of its content and quality. An evaluation of the impact of this workshop should also be carried out, but investing in the training of faculty is perhaps the best means of enhancing the quality of patient care in the region.

ACKNOWLEDGMENT

The workshop was funded and supported by King Faisal University, Dammam.

REFERENCES

1. Tavakol M, Torabi S. A 38-Year Analysis of Communication Skills in Undergraduate Medical Education: A Content Analysis. Med Educ online 2007;12. http://www.med-ed-online.org/pdf (accessed on 6/2/2009).

2. Dube C, O'Donnell JF, Novack DH. Communication Skills for Preventive Interventions.

Acad Med. 2000;75: S 44-54

3. Elzubier AG. Doctor - Patient communication: A skill needed in Saudi Arabia. J Fam Community Med. 2002;9(2):51-6.

4. Elzubier AG. About patients and doctors (ed) J Fam Community Med.2004;11(3):

5. Kaufman DM, Laidlaw TA, MacLeod H. Communication Skills in Medical School: Exposure, Confidence and Performance. Acad Med. 2000;75: S 90-92

6. Kidd J, Patel V, Peile E, Carter Y. Clinical and Communication Skills Need to be Learnt Side by Side. BMJ. 2005; 330:374-5

7. Duncan AK, Multari A, Li J. Curriculum in Physician-Patient Communication Skills for New Faculty. Acad Med. 2002;77:462.



2010-03-09