Communications Skills, Version 1.2

British Medical Journal, Oct 24, 1998 by Muiris Houston

Communications Skills Version 1:2 Department of Behavioural Sciences, University of Nottingham 10 [pounds sterling] to medical schools ISBN 0 85358 068 5

Rating: (**)

Byrne and Long were the first with Doctors talking to Patients, a seminal book published back in 1976. Up to then it just happened. Talking to patients, I mean. The problem is, a lot of it was talking at patients. Pendleton and colleagues followed with The Consultation--An Approach to Learning and Teaching, truly a great book. My own favourite has always been Stott and Davis's Model of the Consultation. I recall hanging a copy of their framework over my desk during my trainee year.

There are several drawbacks to these books, no matter how good they are. Firstly, they are books--not videos or audiotapes--very good at outlining concepts but severely handicapped when it actually comes to learning how to do it. Secondly, they are aimed at postgraduate students and are really not suited to undergraduates with basic needs in communications skills.

Back in the early 1980s we were blessed to have Professor James McCormack teach us in Trinity College Dublin. The teaching videos at that time were good, and, fortuitously, we were exposed to one of the first interactive videos to become available to medical educators. Fast forward to my beginnings as an undergraduate tutor in the 1990s: Professor Bill Shannon taught us how to teach them. This was really good stuff--full. time actors, two way mirrors, and consulting rooms with purpose built video monitors. As an example of how to do it, this was it.

So, when this CD ROM landed on my desk, it brought with it the realisation that technology has moved on again. Produced by the Department of Behavioural Science at the University of Nottingham, it is aimed at the undergraduate consumer. A central "router" leads into seven separate teaching modules. There is extensive video and audio footage to illustrate principles from "how to explain procedures to patients" to counteracting the use of "medical jargon." The CD also has an interactive element to it; you are asked what phrases you would use in certain situations as well as given the opportunity to "correct" the simulated movie consultations.

The best part of the CD for me was the section dealing with "negative emotions" You are brought through dealing with anxiety, embarrassment, and, so important these days, facing the angry patient.

I have two criticisms. The first is the complete absence of material on breaking bad news. The second is that the loading of the software was difficult; more explicit instructions with regard to the use of Quick Time Movie within Windows 95 would help.

The verdict? A good adjunctive teaching aid to give to undergraduates to work through. However, I wouldn't offer redundancy money to the actors and the video cameramen just yet.

Muiris Houston, CME tutor, County Meath, Republic of Ireland