Communication Skills Program Division of Medical Education Director Joan Evans PhD, RN

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Communication Skills ProgramDivision of Medical
EducationDirectorJoan Evans PhD, RN

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The CSP Team

• Program Secretary Ms Linda MacNutt
• UME Faculty Coordinators
• LRC Coordinators
• CSP Tutors
• PGME Faculty Coordinator
• Event-based LRC Coordinators
• CME Pending

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Program Vision and Philosophy

• The Communication Skills Program supports the
  Faculty of Medicines mission to prepare highly
  competent, caring and socially responsible
  physicians. This is realized through
  teaching/learning activities that affirm and
  strengthen the patient-doctor relationship and
  build communication skills for effective
  scholarly and collaborative practice.

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Program Goals

• To strengthen the patient-doctor relationship
  through effective communication
• To prepare the learner/physician to adapt
  communication skills across challenging patient
  encounters and diverse patient populations
• To promote effective communication skills for
  physicians in their role as teachers/learners and
  collaborators within an intra and
  inter-professional context

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Frameworks Used in the Program

• Calgary Cambridge Guide
• Patient Centered Clinical Method
• Teaching Methods
• Lectures
• Small group tutorials (13)
• LRC sessions practice interviewing with SPs
• Agenda-led outcome-based analysis (ALOBA)

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Educational and Professional Standards and
Competencies

• UME 147 LCME Standards (8)
• CanMeds Communicator
• PGME CanMeds Communicator
• Scholar
• Collaborator
• 4 Principles of Family Medicine

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CSP Contribution to LCME Standards

• ED-1-A
• Objectives of the ed program must be stated in
  outcome-based terms that allow assessment of
  student progress in developing competencies that
  the profession and the public expect of a
  physician
• ED-3
• Objectives must be made known to medical
  students and to the faculty, residents and others
  with direct responsible for med student education
• Med 1 Communication Skills Program Manual

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CSP Contribution to LCME Standards

• ED-19
• There must be specific instruction in
  communication skills as they relate to physician
  responsibilities, including communication with
  patients, families, colleagues, and other health
  professionals
• Med 1 to 3 patient-doctor is primary focus
• More curriculum development needed re intra and
  inter-professional communication

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CSP Contribution to LCME Standards

• ED-21
• The faculty and students must demonstrate an
  understanding of the manner in which people of
  diverse cultures and belief systems perceive
  health and illness and respond to various
  symptoms, diseases, and treatments
• Communication frameworks encompass cultural
  diversity
• Medical History Tutorial (2 hrs)

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CSP Contribution to LCME Standards

• ED-23
• A med school must teach ethics and human values,
  and require its students to exhibit scrupulous
  ethical principles in caring for patients, and in
  relating to patients families and to others
  involved in patient care
• Each school should assure that students receive
  instruction in appropriate medical ethics, human
  values and communication skills before engaging
  in patient care activities

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CSP Contribution to LCME Standards

• ED-24
• Residents who supervise or teach med students,
  as well as grad students and postdoc fellows in
  the biomedical sciences who serve as teachers or
  teaching assistants, must be familiar with the
  educational objectives of the course or clerkship
  be prepared for their roles in teaching
  evaluation
• Provide invited workshops/grand rounds on
  feedback working with the challenging
  learner to residents faculty
• CSP tutor training

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CSP Contribution to LCME Standards

• ED-28
• There must be evaluation of problems solving,
  clinical reasoning, and communication skills
• Formative and summative feedback methods
  identified in Med 1 Manual
• self-assessment
• feedback from peers and tutors
• video-recorded patient interviews with feedback
• Medical Interview Checklist
• OSCEs (Med 2 3). Stns include communication
  items

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CSP Contribution to LCME Standards

• ED-33
• There must be integrated institutional
  responsibility for the overall design,
  management, evaln of a coherent coordinated
  curriculum
• Logical sequencing
• Content coordinated and integrated
• Methods of pedagogy and student evaluation
  appropriate to educational objectives

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Postgraduate

• PGME Scheduled teaching/learning activities
• Annual Resident Workshop PGY1
• IMG Orientation
• Lecture presentation to large groups
• Invited workshops by individual departments
• Communicator role (pt-dr interaction)
• Scholar role (feedback, challenging learner)
• Collaborator (feedback, conflict management)
• Invited grand rounds
• Scholar role (feedback)
• Collaborator role (team dynamics)

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Faculty Development

• CSP Workshops
• Scholar role feedback/assessment, challenging
  learner
• CSP Grand Rounds
• Scholar role feedback/assessment
• Collaborator role team dynamics, conflict
  resolution
• Other Workshops
• Qualitative research

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CME

• Workshop
• Talking with Patients - Sharing Stories
  Strategies
• Offered only once in last 3 yrs with support of
  CPSNS
• Scheduled over 2 evenings
• No Communication Skills Program CME Rep since
  2008

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New Brunswick

• CSP tutors work with small groups of learners in
  tutorial groups and LRC sessions
• Need to identify (42) and train
• LRC sessions provide practice interviewing with
  standardized patients
• Existing patient cases will be used across sites
• Need to identify and train standardized patients
• Need LRC Coordinator to be in place
• Plenary Sessions (2)
• Can be accessed from Halifax

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Curriculum Renewal

• If the patient is at the center of medical
  education and practice the challenge is to
  actually ensure that this focus is integrated
  throughout the curriculum so that
  learners/teachers dont lose sight of the patient
  and the unique individual and socio-cultural
  perspectives that influence health and illness
• COPS cases, clinical practice

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Wish ListHow the CSP Can Contribute

• Clerkship Program Expansion
• 1) Add 2 LRC sessions in Med 3
• Communicator challenging patient-doctor
  interaction
• Collaborator inter intra-professional
  communication
• 2) Expand ALOBAs in clerkship years one ALOBA
  in each rotation
• Resources Needed
• for LRC costs
• more CSP trained tutors

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Conclusion

• Communication Skills Program Challenges
• Lack of visibility of communication skills
  curriculum and tutors in the undergraduate
  program
• Lack of physician communication skills champions
  across residency programs