Dear Sir
Very few articles clearly report the basic strategies for empathic communication and Communication Skills Training (CST) in medical education. A successful communication is mainly the use of verbal and non-verbal skills to improve the patient well-being through an empathic approach. Although CST does not automatically generate the anticipated outcomes (van den Eertwegh et al., Citation2013), it remains the pivotal factor for the excellence in health care professions (Rotthoff et al., Citation2011). In this study, a grounded theory approach examined the transcripts of experts in communication interacting with real patients. This generated the codes and categories of empathic communication: Listening: understanding and active attention to patients’ emotions and concerns; Learning: unveiling patients’ feelings by using open questions (“What you are feeling is …”); Predicting: making a mental map of forthcoming interpersonal scenarios (“If I say this, then what happens to this patient?”); Checking: clarifying with patients if the practitioner's hypotheses on what they are feeling are correct (“If I understood, what you’re saying is …”); Reframing: verifying the patient's understanding and modifying the own communication accordingly; Metaphorising: using simple metaphors to explain complex medical information (e.g., “Your heart is like a pump”); Counselling: moving patients to a desired course of actions (“About some exercise?”); Recapping: summarising what was told and understood (“Let's do a recap!”). These steps can also be cyclic. Besides, role-playing with virtual patients and observers, during CST, helps learners become self-reflective ‘during’ the on going communications with patients (“How would others evaluate my communication now?”). However, what cannot be taught during CTS is a ‘correct’ style of communication. Style is ‘a way of using language’ (Oxford Dictionary Online: http://oxforddictionaries.com), it affects empathy in communication, and it is influenced by the practitioner's personality, values, leadership style and philosophy of well-being and caring.
References
- Rotthoff T, Baehring T, David DM, Bartnick C, Linde F, Willers R, Schäfer RD, Scherbaum WA. The value of training in communication skills for continuing medical education. Patient Educ Counsel 2011; 84: 170–175
- van den Eertwegh V, van Dulmen S, van Dalen J, Scherpbier AJJA, van der Vleuten CPM. Learning in context: Identifying gaps in research on the transfer of medical communication skills to the clinical workplace. Patient Educ Counsel 2013; 90: 184–192