A theory-based curriculum design for remediation of residents’ communication skills

Abstract

Problem: Residents requiring remediation are often deficient in communication skills, namely clinical interviewing skills. Residents have to digest large amounts of knowledge, and then apply it in a clinical interview. The patient-centered approach, as demonstrated in the Calgary-Cambridge model and Martin's Map, can be difficult to teach. Before implementing a remediation curriculum, the theoretical educational underpinnings must be sound; curriculum evaluation is often expensive. Before establishing metrics for curriculum evaluation, a starting point is to perform a mental experiment to test theoretical adherence.

Methods: This article describes an experiential remedial curriculum for communication skills. Educational theories of Kolb, Knowles, Bandura, and Bloom are used to design the curriculum into theory-based design components.

Conclusions: Kolb's experiential cycle models the natural sequence of experiencing, teaching, and learning interviewing skills. A curriculum structured around this cycle has multiple intercalations with the above educational theories. The design is strengthened by appropriately timed use of education strategies such as learning contracts, taped interviews, simulations, structured reflection, and teacher role modeling. Importantly, it also models the form of the clinical interview format desired. Through understanding and application of contemporary educational theories, a program to remediate interviewing skills can increase its potential for success.

Additional information

Notes on contributors

Fok-Han Leung

FOK-HAN LEUNG, MD CCFP MHSc, is an academic family physician at St. Michael's Hospital, University of Toronto. He is interested in clinical communication skills and works extensively with residents with a focus on international medical graduates.

Dawn Martin

DAWN MARTIN, M.Ed PhD, is Assistant Professor and Educational Consultant in the Department of Family and Community Medicine, University of Toronto. She is also Communications Specialist at the Office of Postgraduate Medical Education and works extensively with residents requiring remediation.

Helen Batty

HELEN BATTY, MD, CCFP, M.Ed, FCFP, is Professor and faculty member of the Department of Family and Community Medicine, University of Toronto. She is also the Founding Director for the Department of the Academic Fellowship and the Graduate Studies programs.