Integrating the art and science of medical practice: innovations in teaching medical communication skills.

BACKGROUND AND OBJECTIVES: This paper describes the content and methods used to teach communication skills in Undergraduate Medical Education for the 21st Century (UME-21) schools and provides suggestions for future efforts.

METHODS: Faculty leaders of curriculum projects at UME-21 schools provided reports describing new communication curriculum projects. Reports were reviewed and analyzed, curriculum content and methods were categorized into themes, and findings were confirmed through phone interviews with lead faculty at each participating school.

RESULTS: Curriculum projects were designed to improve medical students' communication skills during the clerkship years at 12 participating UME-21 schools. These skills were addressed through a variety of teaching methods and applied in interactions with patients, health teams, and community members. Curricular themes included conflict resolution, delivery of bad news, addressing patient preferences for end-of-life care, patient and community health education, communicating with families, and working effectively with patients from diverse backgrounds. Students' communication skill competencies were assessed through a variety of methods including objective structured clinical examinations, focused observation and feedback, and debriefing sessions based on recall, audiotapes, or videotapes of encounters.

CONCLUSIONS: Opportunities for students to develop, apply, and refine their communication skills can be embedded throughout the medical school curricula. Our findings illustrate the variety of methods that may be used to teach and evaluate medical students' communication skill competencies. Future challenges include development of comprehensive longitudinal curricula, practical teaching methods, valid evaluation tools, and faculty development.