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Teaching Communication Skills at the End of Life

American medical schools are beginning to respond to concerns expressed by patients, patient families and many medical professionals for the need to improve physician communication skills. The communication skill workshops are developed in order to develop better doctor-patient relationships on behalf of terminally ill patients and families coping with how to understand and receive medical prognosis from doctors or other medical personnel, according to the website Journal of Clinical Oncology.

  1. Importance of Communication Skills

    • The difficulty in effectively communicating cancer diagnoses and necessary medical updates to patients is can be difficult for practicing oncologists. Unfortunately, only about 5 percent of oncologists have received even basic communication skills training. In fact, the National Cancer Institute, the American Society of Clinical Oncology and other national medical organizations have identified "communication as a necessary core clinical skill," according to the Journal of Clinical Oncology.

    Curriculum Development and Components

    • Some end-of-life communication skill development programs took the form as workshops and others were short curriculum-based classes in medical school. The workshops were designed to assist the new learner by "following three types of formal learning activities: large-group overview presentations, small-group communication skills practice, and reflective self-awareness exercises," according to the Journal of Clinical Oncology. The training was designed to include the student's own knowledge, skills and attitudes and incorporate them into the training environment "where good communication was highly valued and learners could feel that they would be supported in the work required to acquire these skills," the Journal of Clinical Oncology reported.

    Use of Scripts and Role Playing

    • Role-playing and the use of scripts was an essential and helpful method for trainers as well students in effectively developing improved communication skills. For example, if a doctor were going to give bad news, he would role-play with some guidance on how to approach the task. Instead of standing over the patient in an authoritative manner, the doctor would be asked to sit beside the patient on the bed or touch the patient's hand or shoulder, while setting the stage with, "I'm afraid I have some bad news." The workshop attendee was encouraged to explain the diagnosis or problem as well as the proposed procedure and potential risks, according to the University of Texas.

    Results of Communication Skills Training

    • Communication skills training has shown to be a benefit for many workshop attendees. Doctors that went through a three-day course in end-of-life communication training in Britain improved their ability to respond "appropriately to patient cues and to express empathy," according to the Journal of Clinical Oncology. Sixty out of 108 students who responded to a survey rated the course as excellent. In addition, in a six-month training followup, a majority of respondents felt prepared to address end-of-life issues with a patient and agreed the workshops prepared them for the clinical skill, according to the website NCBI.

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