TEACHING COMMUNICATION-SKILLS - PART OF MEDICAL-EDUCATION

Hypertension is generally a symptomless disease, but it needs lifelong treatment in most cases. This places enormous demands on individual doctors treating individual patients. Communication under these circumstances should be a skilful blend of patient education (for example about lifestyle, other risk factors, reasons for treatment) coupled with the development of a strong personal interest in, and relationship with, the patient in order to motivate that patient to follow advice and therapy. Communication skills in medicine are learnt slowly and often only by experience. Medical school deans are under enormous pressure to add extra items into an already crowded curriculum, and so education in communication tends to have a low priority. Before a school can take such interest in educating students in communication it first has to take an interest in the education of its teachers. Rather belatedly, medical schools are now taking such an interest. Previously academic promotion depended mainly on research publications and public profile and little on an assessment of an ability to teach. Increasingly both undergraduate and postgraduate teaching is now subject to assessment from those taught, and universities are now making formal assessments of their teachers' ability in communication. In Oxford all newly appointed teachers are asked to appear before a panel, give a short 10-15 min communication and to listen to criticism of their technique. Video filming of their performance is a valuable feedback in getting lecturers to see their own faults and to help improve their techniques. It is very important to begin such training not only at lecturer level but also at student level. As well as didactic sessions, it is equally important to teach students the basic skills in communication with individual patients, including non-verbal communication. Again video techniques are very useful in demonstrating deficiencies and rewarding good technique.