Abstract
Background
Communication skills training (CST) remains poorly represented and prioritised in medical schools despite its importance. A systematic scoping review (SSR) of CST is proposed to better appreciate current variability in their structure, content, and assessment. This is to guide their future design in medical school curricula.
Methods
The Systematic Evidence-Based Approach (SEBA) was used to guide concurrent SSRs of teaching and assessment in CST. After independent database searches, concurrent thematic and content analysis of included articles were conducted separately. Resultant themes/categories were combined via the jigsaw perspective to provide a more holistic view of the data. These were then compared to tabulated summaries of the included articles to create funnelled domains.
Results
52,300 papers were identified, 150 full-text articles included, and four funnelled domains were identified: Indications, Design, Assessment, and Barriers and Enablers of CST. CSTs confer numerous benefits to physicians and patients. It saw increased confidence, improved diagnostic capabilities and better clinical management, as well as greater patient satisfaction and treatment compliance. Skills may be divided into core, prerequisite competencies, and advanced skills pertinent to more challenging and nuanced scenarios – such as population or setting-specific situations. CST teaching and assessment modalities were found to align with Miller’s Pyramid, with didactic teaching gradually infused with experiential approaches to enhance their understanding and integration. A plethora of CST frameworks, teaching and assessment methods were identified and are presented together.
Conclusion
While variable in approach, content and assessment, CST in medical schools often employ stage-based curricula to instil competency-based topics of increasing complexity throughout medical school education. This process builds on the application of prior knowledge and skills, influencing practice and, potentially, the students’ professional identity formation. In addition, the institution plays a critical role in overseeing training, ensuring longitudinal guidance and holistic assessments of the students’ progress.
Acknowledgements
The authors would like to dedicate this paper to the late Dr. S Radha Krishna whose advice and ideas were integral to the success of this study.
Disclosure statement
Conflicts of Interests and Source of Funding VV, EKYL, CJWW, JWY, AYTT, CSYC, DJMF, FT, JL, VR, LCLC, SX, KC, SLQ, CLLC, RQET, CWHN, EGL, SL, KTT, AC, EWLC, LHST, YTO, KS, JXN, AMCC, JXZ, MC, AL, SM, and LKRK have no competing interests and no funding was received for this review.
Authors’ Contributions
VV, EKYL, CJWW, JWY, AYTT, CSYC, DJMF, FT, JL, VR, LCLC, SX, KC, SLQ, CLLC, RQET, CWHN, EGL, SL, KTT, AC, EWLC, LHST, YTO, KS, JXN, AMCC, JXZ, MC, AL, SM, and LKRK were involved in data curation, formal analysis, investigation, preparing the original draft of the manuscript as well as reviewing and editing the manuscript. All authors have read and approved the manuscript.
Data availability statement
Availability of Data and Materials All data generated or analysed during this review are included in this published article and its supplementary files.
Additional information
Notes on contributors
Vaishnavi Venktaramana
Ms Vaishnavi Venktaramana is a medical student at the Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Eleanor Kei Ying Loh
Ms Eleanor Loh Kei Ying is a medical student at the Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Clarissa Jing Wen Wong
Ms Clarissa Jing Wen Wong is a medical student at the Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Jun Wei Yeo
Mr Jun Wei Yeo is a medical student at the Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Andrea York Tiang Teo
Ms Andrea York Tiang Teo is a medical student at the Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Celest Sin Yu Chiam
Ms Celest Sin Yu Chiam is a medical student at the Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Dillon Jie Ming Foo
Mr Dillon Jie Ming Foo is a medical student at the Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Faith Teo
Ms Faith Teo is a medical student at the Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Jonathan Liang
Mr Jonathan Liang is a medical student at the Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Vijayprasanth Raveendran
Mr Vijayprasanth Raveendran is a medical student at the Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Luke Cheng Lin Chng
Mr Luke Cheng Lin Chng is a medical student at the Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Shiwei Xiao
Ms Shiwei Xiao is a medical student at the Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Kevin Chong
Mr Kevin Chong is a medical student at the Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Seng Leong Quek
Mr Seng Leong Quek is a medical student at the Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Christine Li Ling Chiang
Ms Christine Li Ling Chiang is a medical student at the Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Rachelle Qi En Toh
Ms Rachelle Qi En Toh is a medical student at the Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Caleb Wei Hao Ng
Mr Caleb Wei Hao Ng is a medical student at the Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Elijah Gin Lim
Mr Elijah Gin Lim is a medical student at the Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Shariel Leong
Ms Shariel Leong is a medical student at the Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Kuang Teck Tay
Dr Kuang Teck Tay graduated from the Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Amos Chan
Dr Amos Chan graduated from the Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Elisha Wan Ying Chia
Dr Elisha Wan Ying Chia graduated from the Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Laura Hui Shuen Tan
Dr Laura Hui Shuen Tan graduated from the Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Yun Ting Ong
Ms Yun Ting Ong is a medical student at the Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Krish Sheri
Dr Krish Sheri graduated from the Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Jun Xuan Ng
Dr Jun Xuan Ng graduated from the Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Annelissa Mien Chew Chin
Ms Annelissa Mien Chew Chin is a Senior Librarian at the Medical library, National University of Singapore Libraries, Singapore.
Jamie Xuelian Zhou
Dr Jamie Xuelian Zhou is a Consultant at the Division of Supportive and Palliative Care, National Cancer Centre Singapore. Dr JXZ holds faculty appointments with Duke-NUS Medical School and the Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Min Chiam
Ms Min Chiam is a researcher at the Division of Cancer Education, National Cancer Centre Singapore, Singapore.
Alexia Sze Inn Lee
Ms Alexia Sze Inn Lee is a researcher at the Division of Cancer Education, National Cancer Centre Singapore, Singapore.
Stephen Mason
Dr Stephen Mason is the Research and Development Lead at the Palliative Care Unit Liverpool, University of Liverpool, United Kingdom.
Lalit Kumar Radha Krishna
Dr Lalit Kumar Radha Krishna is a Senior Consultant at the Division of Supportive and Palliative Care, National Cancer Centre Singapore. Dr LKRK holds faculty appointments with the Centre for BioMedical Ethics, Duke-NUS Medical School and the Yong Loo Lin School of Medicine, National University of Singapore.