Communication skills teaching comes of age

The doctor–patient relationship (a good bedside manner) has always been recognised as central to medicine. However, the systematic teaching of communication skills and assessment of students communicating with their patients is a relatively new element in medical education. It is only recently that we have moved from the belief that entrants to medical school, by virtue of their intelligence, are innately effective and sensitive communicators, and that any who aren’t can pick up the skills by osmosis and good intentions. Now, communication skills teaching to undergraduates has come of age. Building on pioneering work introducing the use of simulated patients (e.g. Barrows in North America and Whitehouse and colleagues in the UK), communication skills education has now developed to the point where, for example, medical students in the UK are expected to learn core skills in all components of the medical interview, such as information gathering, and explanation and planning, as well as those required in challenging communication situations such as the breaking of bad news, and to be assessed in their performance of these tasks before they can qualify. However, there is evidence of considerable variability in course content, timing, duration and methods of assessment, which means that students at different schools may have very different experiences.