Teaching communication skills.

Communication is the act of conveying a message to another person, and it is an essential skill for establishing physician-patient relationships and effective functioning among health care professionals. Participants in the Toronto Consensus meeting in the early 1990s concluded there was enough evidence to prove that doctor-patient communication problems are common and that they adversely affect patient care.1 Traditionally, most medical trainees learn verbal and nonverbal communication skills by watching their teachers and preceptors. In family medicine settings, learners are expected to be actively coached in communication by their supervising teachers—family physicians and other members of the health care team. More recently, skills workshops and simulated practice sessions have been used to teach communication skills. In the United States, a cross-sectional survey of family physicians who had graduated from residency programs between 1998 and 2000 showed that physicians reported the most preparation in patient care skills, followed by interpersonal skills, communication skills, and then professionalism.2 However, patient-physician communications continue to need more emphasis and improvement, as shown by a recent study in which patients rated family medicine residents’ communication skills using the Communication Assessment Tool, developed by Makoul et al.3 The authors found that firstyear residents were rated considerably higher (77.0% of responses rated them as “excellent”) than second-year (69.5%) and third-year (68.1%) residents were.3 As programs expand and the number of trainees needing preceptors increases, some of the available strategies for ensuring excellent communication skills could be used to enhance training. This paper briefly reviews various methods that are used to teach communication skills to trainees and discusses assessment of communication skills.