Consensus on communication curriculum content in Danish undergraduate medical education: A Delphi study

Abstract

Background

The acquisition of skills in patient-centered communication is a critical aspect of medical education which demands both resource-intensive instruction and longitudinal opportunities for learning. Significant variation currently exists in the content and timing of communication education. The aim of this study was to establish consensus regarding communication curriculum content for undergraduate medical education (UME) within the country of Denmark.

Methods

This study employed a Delphi process which is a widely accepted method for establishing consensus among experts and can be utilized to guide planning and decision-making in education. For this study, consensus was based on greater than 60% agreement between participants. Diverse stakeholders, representing all four universities with medical schools in Denmark, participated in an iterative three-round Delphi process which involved: (1) identifying key curricular elements for medical student education, (2) rating the importance of each item, and (3) prioritizing items relative to one another and rating each item based on the level of mastery that was expected for each skill (i.e. knowledge, performance with supervision, or performance independently).

Results

A national sample of 149 stakeholders participated with a 70% response rate for round 1, 81% for round 2, and 86% for round 3. The completed Delphi process yielded 56 content items which were prioritized in rank order lists within five categories: (1) establishing rapport, engaging patient perspectives and responding to needs; (2) basic communication skills and techniques; (3) phases and structure of the encounter; (4) personal characteristics and skills of the student; (5) specific challenging patient groups and context-dependent situations.

Discussion

Using a Delphi process, it was possible to achieve consensus regarding communication curriculum content for UME. These findings provide an important foundation for ensuring greater uniformity in UME, as well as supporting the important longitudinal goals of communication skill development across medical training.

Keywords:

• Patient-centered communication
• curriculum content consensus
• undergraduate medical education
• communication skills training

Disclosure statement

The authors have no declarations of interest to declare. All authors contributed to the design of the study, analysis of the results and preparation of the manuscript.

Glossary

Patient-centered communication: Communication between providers and patients which incorporates the following components: (1) eliciting and understanding patient perspectives (concerns, ideas, expectations, needs, feelings, and functioning), (2) understanding the patient within his or her unique psychosocial and cultural contexts, and (3) reaching a shared understanding of patient problems and the treatments that are concordant with patient values.

Epstein RM, Street RL., Jr . Patient-Centered Communication in Cancer Care: Promoting Healing and Reducing Suffering. Bethesda, MD: National Cancer Institute; 2007. National Institutes of Health Publication 07-6225.

Delphi method: The Delphi survey technique is a group facilitation technique, which is an iterative multistage process, designed to transform opinion into group consensus..

Hasson et al. (2000).

Additional information

Notes on contributors

Kirsten Greineder Engel

Kirsten G. Engel, MD, is currently an attending physician in the Division of Palliative Care and Geriatric Medicine at Massachusetts General Hospital and Instructor at Harvard Medical School in Boston. She was a physician consultant and course director at Copenhagen Academy for Medical Education and Simulation from 2016 to 2019.

Kamilla Pedersen

Kamilla Pedersen, PhD, is assistant professor at Centre for Educational Development. Her area of expertise is patient-centered approaches applied to patient cases for clinical training. She is founder of teaching concept, PsychSim which makes use of video and VR simulation, portraying clinical meetings with psychiatric patients in acute hospital settings.

Mette Dencker Johansen

Mette Dencker Johansen, MSc, PhD, is former Head of School of Medicine and Health at Aalborg University and former coordinator of clinical skills including communication at the medical bachelor’s program. She is now working with health care prioritizations as Head of Health Science at the Danish Health Technology Council.

Katrine Rahbek Schoennemann

Katrine Rahbek Schønnemann, MD, PhD, assistant professor, Odense University Hospital, University of Southern Denmark. She is an experienced clinical communication skills teacher and coordinator of communication at the medical bachelor’s program. She is now working in the field of specialized palliative care with focus on integration of early palliative care.

Louise Binow Kjaer

Louise Binow Kjær, MSc, is a PhD-Student at Centre for Educational Development. Her research focus is patient-centeredness, student autonomy and professional development. She is an experienced clinical communication skills teacher, and former Head of the Professional Courses at the Medical Master’s Program at Aarhus University, Denmark.

Leizl Joy Nayahangan

Leizl Joy Nayahangan, RN, MHCM, MHPE, is a research scientist at the Copenhagen Academy for Medical Education and Simulation (CAMES). Her research interest centers on simulation-based education with focus on needs assessment, assessment and implementation. She currently serves as co-chair for the AMEE Simulation Committee.