How do I improve my communication skills?BMJ 2017; 357 doi: https://doi.org/10.1136/bmj.j2587 (Published 05 June 2017) Cite this as: BMJ 2017;357:j2587
Clarity, feedback, and reflective practice are key, finds Abi Rimmer
“Communication failures can lead to complaints”
—Emily Shepherd, medical adviser, Medical and Dental Defence Union of Scotland (MDDUS)
“Effective communication is a key part of the doctor-patient relationship and has a direct impact on patient safety. At MDDUS we have dealt with many examples of patient complaints as a result of communication failures. Many of these could have been avoided by taking some simple steps.
“One common scenario we encounter is when a doctor issues unclear instructions. Doctors have a duty to discuss their patient’s condition and treatment options in a way that’s easily understandable—this lets the patient make informed decisions. Use clear, simple, and consistent language and avoid complex explanations or jargon.
“Many complaints can be prevented by listening to the patient’s worries and adopting an open and constructive approach. It is important to avoid acting defensively and instead show empathy and foster an atmosphere that encourages questions. The GMC’s Good Medical Practice guidance states that doctors must “give patients the information they want or need in a way they can understand.
“Ask for feedback to gauge how you’re doing”
—Sarah Coope, GP and communication skills trainer and coach
“Firstly, what feedback have you had about your communication skills? It could be formal or informal, from patients or colleagues. Reflect on the feedback and clarify the impression you would like to be making. For example, if you’ve been told you seem rushed and disinterested, then set your intention as being more empathetic and calm.
“Secondly, “observe” yourself during interactions with others to gain insight into what you are doing. Notice the other person’s verbal and non-verbal responses to what you’re saying and doing—do they appear to feel understood, reassured, and respected by you? If not, what, specifically, are you doing or not doing that is getting in the way?
“Thirdly, decide what you are going to do differently, one step at a time. For example, to be more empathetic and a better listener, start by allowing the other person to fully finish what they are saying without interrupting and show that you have heard by recapping what they’ve told you and reflecting back any emotion that you pick up on.
“Finally, ask for feedback to gauge how you’re doing and keep practising until the new skills become automatic.
“Reflective practice is required to improve communication skills”
—Angela Rowlands, senior lecturer in clinical communication, Queen Mary University of London
“Extensive reflective practice is required to develop clinical skills,1 and improving communication skills is no different. Evidence shows that doctors who attend workshops to improve their skills and then have the opportunity to get feedback about how they communicate in real consultations will learn the most.2
“Learning to communicate effectively means making the most of every interaction. Simulated patients are often used in communication skills training, giving students and clinicians the chance to immerse themselves within a protected and controlled environment.3 Although their use has been criticised for the occasional lack of authenticity, simulated patients can give valuable practice opportunities and feedback.45
“Annie Cushing, Vivien Cook, and I have written about a project aimed at supporting students in communicating with patients in clinical settings during their undergraduate years.6 Students learnt about communication within the consultation process and got immediate, focused, one-to-one feedback. Moreover, they were able to maximise the feedback by immediately applying it to further consultations.
“Doctors can continue their learning over time by self and peer assessment, and attending further courses or workshops.”