Communication is something most people take for granted. It just comes naturally, doesn’t it? Therefore, it comes as a surprise to a lot of incoming Freshers to see that a fair amount of their timetable is allocated to ‘Communication Skills’ (or Comms for short). Sometimes in straight three-hour chunks. This sense of shock isn’t unreasonable- after all most medical students studied Science or Maths for the majority of the time at A-Level so having classes dedicated to a social skill seems alien. If I’m being completely honest, I too was a little sceptical by the concept of having to study Comms- surely I didn’t need to be taught how to communicate?
I got my answer to that question during our first simulated patient encounter during first term. In these sessions we are put into groups of three and take it in turns to have a conversation with an actor- or simulated patient- as if a GP has asked us to find out more about why they have come to see the doctor. We usually get around 5-10 minutes to uncover as much information we can about the nature of their ailment as well as a bit more about their medical and social background. During my first conversation I remember spending most of the time floundering- desperately trying to think of my next question whilst the actor rebutted most of my former ones with yes or no answers. Yes, I really did need to be taught how to communicate in a medical setting.
Luckily, I had this revelation early in the year and still had plenty of Comms teaching yet to come. With a new sense of purpose, I made sure to pay attention during Comms lectures so that I went into my next simulated patient session with far more confidence. As well as our peers and the actor, a clinical tutor is also present during these interactions as a sort of mediator. At the start of each session, we are asked to list up to three aspects of our communication which we would like to improve upon. These could be the way we introduce ourselves (another feature which takes more practice than you feel it should), whether we use questions effectively, or our body language. This enables the tutor and our peers to take extra note of these aspects of our communication to feedback to us at the end. Each time we take away new skills to apply the next time so by the end of the year we feel much more comfortable communicating with patients.
I had taken for granted the essential role communication plays within medicine. I mean, I always knew it was important (I’m pretty sure I said so in my personal statement) but I don’t think I really appreciated why. Until one day I did. As part of our GP placement last year we went on home visits to patients with chronic illnesses to see how they’re coping and to just generally chat to them. During one of these encounters, a patient recounted to me an incident which took place more than two years prior in which he didn’t like the way a doctor spoke to him. He had no issues with their medical judgement or subsequent treatment, and it wasn’t that the doctor spoke inappropriately or unkindly, but their word choice was slightly off. Yet so far into the future, this patient could still tell me what the doctor said and how it made him feel. This moment made me realise how much of an impact our communication can have upon patients. A lasting impact. That is what makes Comms so important.
