Using videoed simulated clinical interaction to promote communication skills and reflective practice for overseas-born medical students.
Issue: Vol 10 No. 1 (2013)
Journal: Communication & Medicine
This paper describes a teaching intervention designed to promote the clinical communications skills of overseas-born medical students through critical reflection on the practice of others. Using a staged process and a video recording of a simulated medical interaction it investigated the extent to which the participants were able to anticipate, identify and resolve the targeted communication issues, and demonstrate selected skills in a simulated interaction. Data comprised worksheet notes, transcriptions (group discussions) and completed questionnaires (ratings and comments). Analysis was thematic (worksheet notes, transcription, questionnaire feedback) and quantitative (questionnaire ratings). The results suggest the notion of reflective practice could be productively extended to take account of current developments in pedagogy and learning. This includes providing opportunities for students to share ideas, resolve differences and ambiguities, and address gaps in their communication skills as well as to apply learned concepts and receive targeted feedback. While the intervention specifically targeted overseas-born medical students, the approach described in the paper has potential for developing the communication skills of ‘local’ medical students and healthcare professionals more generally.
Author: Kathryn Hill, Jan Hamilton
Aspegren, K. and Lonberg-Madsen, P. (2005) Which basic communication skills in medicine are learnt spontaneously and which need to be taught and trained? Medical Teacher 27 (6): 539–543. http://dx.doi.org/10.1080/01421590500136501
Atiomo, W. (2009) A constructivist's strategy for medium/large student groups – the contextual learning model. The Open Medical Education Journal 2: 1–9. http://dx.doi.org/10.2174/1876519X00902010001
Bosher, S. and Smalkoski, K. (2002) From needs analysis to curriculum development: Designing a course in health-care communication for immigrant students in the USA. English for Specific Purposes 21 (1): 59–79. http://dx.doi.org/10.1016/S0889-4906(01)00002-3
Branch, B. and Paranjape, A. (2002) Feedback and reﬂection: Teaching methods for clinical settings. Academic Medicine 77: 1185–1188. http://dx.doi.org/10.1097/00001888-200212000-00005
Carr, S. and Carmody, D. (2006) Experiential learning in women’s health: Medical student reflections. Medical Education 40: 768–774. http://dx.doi.org/10.1111/j.1365-2929.2006.02536.x
De Leng, B., Dolmans, D., Van de Wiel, M., Muijtjens, A. and Van der Vleuten, C. (2007) ‘Media attributes’ study: How video cases should be used as authentic stimuli in problem-based medical education. Medical Education 41: 181–188. http://dx.doi.org/10.1111/j.1365-2929.2006.02671.x
Donaghy, M. and Morss, K. (2000) Guided reflection: A framework to facilitate and assess reflective practice within the discipline of physiotherapy. Physiotherapy Theory Practice 16: 3–14. http://dx.doi.org/10.1080/095939800307566
Duffy, D., Gordon, G., Whelan, G., Cole-Kelly, K. and Frankel, R. (2004) Assessing competence in communication and interpersonal skills: The Kalamazoo II report. Academic Medicine 79 (6): 495–507. http://dx.doi.org/10.1097/00001888-200406000-00002
Epstein, R. M. (1999) Mindful practice. The Journal of the American Medical Association 282 (9): 833–839. http://dx.doi.org/10.1001/jama.282.9.833
Epstein, R. M. (2008) Reflection, perception and the acquisition of wisdom. Medical Education 42: 1048–1050. http://dx.doi.org/10.1111/j.1365-2923.2008.03181.x
Epstein, R. and Hundert, E. (2002) Defining and assessing professional competence. Journal of the American Medical Association 287 (2): 226–235. http://dx.doi.org/10.1001/jama.287.2.226
Field, M., Burke, J., McAllister, D. and Lloyd, D. (2007) Peer-assisted learning: A novel approach to clinical skills learning for medical students. Medical Education 41 (4): 411–418. http://dx.doi.org/10.1111/j.1365-2929.2007.02713.x
Hawthorne, L., Minas, I. and Singh, B. (2004) A case study in the globalisation of medical education: Assisting overseas-born students at the University of Melbourne. Medical Teacher 6 (2): 150–159. http://dx.doi.org/10.1080/0142159032000150539
Kalet, A. L., Janicik, R., Schwartz, M., Roses, D., Hopkins, M. A. and Riles, T. (2005) Teaching communication skills on the surgery clerkship. Medical Education Online [serial online] 1 (16): 1–8 [http://www.med-ed-online.org].
Ker, J. (2003) Developing professional clinical skills for practice – the results of a feasibility study using a reflective approach to intimate examination. Medical Education 37 (Supplement 1): 34–41. http://dx.doi.org/10.1046/j.1365-2923.37.s1.4.x
Kolb, D. A. (1984) Experiential Learning. Englewood Cliffs, NJ: Prentice Hall.
Lang, F., Everett, K., McGowen, R. and Bennard, B. (2000) Faculty development in communication skills instruction: Insights from a longitudinal program with ‘Real-time Feedback’. Academic Medicine 75 (12): 222–228. http://dx.doi.org/10.1097/00001888-200012000-00022
Meier, E., Back, L. and Morrison, R. (2001) The inner life of physicians and care of the seriously ill. Journal of the American Medical Association 286 (23): 3007–3014. http://dx.doi.org/10.1001/jama.286.23.3007
Miller, G. E. (1990) The assessment of clinical skills/competence/performance. Academic Medicine 65 (9): 63–67. http://dx.doi.org/10.1097/00001888-199009000-00045
Morell, V., Sharp, P. and Crandall, S. (2002) Creating student awareness to improve cultural competence: Creating the critical incident. Medical Teacher 24 (5): 532–534. http://dx.doi.org/10.1080/0142159021000012577
Pendleton, D., Schofield, T., Tate, P. and Havelock, P. (2004) The New Consultation: Developing doctor–patient communication. Oxford: Oxford University Press.
Perron, N., Sommer, J., Hudelson, P., Demaurex, F., Luthyi, C., Louis-Simoneti, M., Nendaz, M., De Grave, W., Dolmans, D. and Van der Vleuten, C. (2009) Clinical supervisors’ perceived needs for teaching communication skills in clinical practice. Medical Teacher 31 (7): 316–322. http://dx.doi.org/10.1080/01421590802650134
Rosen, J., Spatz, E., Gaaserud, A., Abramovitch, H., Weinreb, B., Wenger, N. and Margolis, C. (2004) A new approach to developing cross-cultural communication skills. Medical Teacher 26 (2): 126–132. http://dx.doi.org/10.1080/01421590310001653946
Roter, D., Larson, S., Shinitzky, H., Chernoff, R., Serwint, J., Adamo, G. and Wissow, L. (2004) Use of an innovative video feedback technique to enhance communication skills training. Medical Education 38 (2): 145–157. http://dx.doi.org/10.1111/j.1365-2923.2004.01754.x
Simpson, J. G., Furnace J. and Crosby, J. (2002) The Scottish doctor – learning outcomes for the medical undergraduate in Scotland: A foundation for competent and reflective practitioners. Medical Teacher 24 (2): 136–143. http://dx.doi.org/10.1080/01421590220120713
Smith, A. (1998) Learning about reflection. Journal of Advanced Nursing 28 (4): 891–898. http://dx.doi.org/10.1046/j.1365-2648.1998.00633.x
Spencer, J. (2003) ABC of learning and teaching in medicine: Learning and teaching in the clinical environment. British Medical Journal 326: 591–594. http://dx.doi.org/10.1136/bmj.326.7389.591
Swing, S. (2007) The ACGME outcome project: Retrospective and prospective. Medical Teacher 29: 648–654. http://dx.doi.org/10.1080/01421590701392903
Tsang, A. J. and Walsh, L. J. (2010) Oral health students’ perceptions of clinical reflective learning – relevance to their development as evolving professionals. European Journal of Dental Education 14 (2): 99–105. http://dx.doi.org/10.1111/j.1600-0579.2009.00598.x
Von Fragstein, M., Silverman, J., Cushing, A., Quilligan, S., Salisbury, H. and Wiskin, C. (2008) UK consensus statement on the content of communication curricula in undergraduate medical education. Medical Education 42 (11): 1100–1107. http://dx.doi.org/10.1111/j.1365-2923.2008.03137.x
Woodward-Kron, R., Hamilton, J., Rischin, I. and Remedios, L. (2007a) ‘I’m Feeling a Bit Crook’: Understanding and Managing Clinical Communication in Australia. Melbourne: University of Melbourne [DVD-ROM].
Woodward-Kron, R., Hamilton, J. and Rischin, I. (2007b) Managing cultural differences, diversity and the dodgy: Overseas-born students’ perspectives of clinical communication in Australia. Focus on Health Professional Education 9 (3): 30–43.