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I teach communication skills to clinical students and find that it is
useful to have a selection of approaches from which to choose. When the
students first start clinical medicine many have little confidence in
adopting the role of the doctor and the gentleness of Pendleton's rules is
required. This approach also teaches them about the importance of being
supportive to each other, and gives the session a feeling of safety which
is sometimes missing otherwise.
As students become more used to giving and receiving feedback, and
certainly with postgraduates, Pendleton can seem cumbersome, artificial
and longwinded, and I find that the ALOB (agenda-led, outcome-based)
approach to feedback works well. Interestingly, when I introduced this
method to other tutors, Pendleton's rules were so etched into their brains
that they found it impossible not to open with something positive.
Choosing which method to use depends on the group or individual you
are teaching and to a certain extent on the topic. To demand slavish
adherence to one method of feedback makes no more sense than having only
one model of the consultation.
No competing interests
12 September 2005
Helen R Salisbury
GP and tutor in communication skills
Department of Primary Care, Oxford University, Old Road Campus, Headington, OX3 7LF