Teaching medical students what they think they already know.

OBJECTIVES To discuss the problems encountered teaching interviewing skills to first year medical students and describe their responses to a structured workshop in interviewing skills. METHODS Focus groups and a short evaluation questionnaire filled in by 56 first year medical students before and after a workshop in interviewing skills were used. RESULTS All students evaluated their skills very highly prior to the workshop. After participating in the workshop, students evaluated their skills as lower than before. DISCUSSION When communication skills are taught in an informal, unstructured manner, medical students might view this knowledge as unspecialized, repetitive, and even boring. It is suggested that employing a structured model for teaching doctor-patient communication skills awards psycho-social issues the status of formal knowledge. This can lead to students viewing communication skills as a relevant and consistent body of knowledge. Introducing a structured model can overcome two kinds of problems: over-confident students are formally introduced to unique aspects of medical interviewing, whilst those who lack confidence are offered a lifeline in the form of a structured model. Identifying possible sources of resistance to communications training has important implications for medical education as it allows for appropriate course planning and follow up.