Communication skills teaching and learning in undergraduate medical education: from classroom to bedside

Communication is a central element of healthcare service. Effective communication by doctors practising patient-centred care has been shown to have a positive influence on patient health outcomes. Despite the importance of these skills, research has revealed that problems occur when students attempt to transfer these skills from the classroom to clinical environments. The primary aim of this thesis was to explore the factors that contributed to the problems of transferring communication skills in different learning environments in undergraduate medical education. The thesis comprised five studies: an overview of reviews of communication skills teaching and assessment; a cross-sectional study on the current practice of teaching and assessing communication skills in undergraduate medical education in Australia and New Zealand; a scoping review of faculty development for communication skills teaching; a qualitative study that explored the perceptions of facilitators and students on communication skills teaching and assessment; and a mixed-methods study to evaluate students’ communication skills in the different learning environments and opportunities. The findings of this thesis show that experiential learning and objective performance methods of communication skills teaching are applied in undergraduate medical education. The strongest impact of communication skills intervention occurred when feedback was incorporated into training using experiential learning methods. However, training is most often conducted by ill-prepared facilitators due to limited availability of faculty development for communication skills teaching. Furthermore, each setting emphasises different communication tasks, highlighting a misalignment of teaching and assessment of communication skills. The findings suggest a need to develop a communication skills curriculum which includes opportunities for students to practise all communication tasks, to be observed in every learning environment, and to be evaluated through work-based assessment. In addition, the training needs to be conducted by trained facilitators. A further longitudinal study is needed to evaluate the impact of the training on students’ practice.