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Medical communication: the views of simulated patients
Author(s) -
Laughey William,
Sangvik Grandal Nora,
M Finn Gabrielle
Publication year - 2018
Publication title -
medical education
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.776
H-Index - 138
eISSN - 1365-2923
pISSN - 0308-0110
DOI - 10.1111/medu.13547
Subject(s) - active listening , empathy , mirroring , context (archaeology) , silence , psychology , virtuous circle and vicious circle , medical education , social psychology , medicine , communication , aesthetics , paleontology , philosophy , macroeconomics , economics , biology
Context Simulated patients ( SP s) are extensively used in the teaching of medical communication, both for students and doctors. They occupy a unique middle ground between patients and physicians: although free from the prejudices that medical training brings, they work closely with clinical tutors to promote the principles of patient‐centred consulting. Despite this, there is relatively little research around their views on what makes for good communication practice. This study aims to address this gap in the literature through a qualitative analysis of SP s’ opinions, especially in the context of medical student communication. Methods Eighteen SP s from two medical schools, Hull York Medical School and Durham, were interviewed, using an in‐depth, one‐to‐one, semi‐structured approach. Data, transcribed verbatim, were thematically analysed. Results Three global themes were identified: (i) listening and empathy and showing it, (ii) continual human connection and (iii) information flow from the patient. These three themes, termed the communication triad, form a type of virtuous circle, each facilitating the other. Listening and empathy were facilitated through attributes, including attentive non‐verbal communication, and through responding to cues, including making effective empathetic statements. Continual human connection was facilitated through successful beginnings, including preferring open questions to ‘robotic’ tick‐list questions and allowing patients time to have their say. Mirroring, professional appearance, appropriate physical contact and a human approach were amongst other factors facilitating connection with patients. Information flow was encouraged by factors including showing an interest in the patient and use of silence; flow was curtailed by undesirable attributes, including interrupting, dismissive communication and making assumptions about aspects such as sexuality. Conclusion This first in‐depth study of SP s’ views on medical consulting identifies a communication triad that both affirms and builds on the current literature base. Five novel teaching points emerge, with clear relevance for best practice communication teaching and curricula design.