Developing an effective and comprehensive communication curriculum for undergraduate medical education in Poland – the review and recommendations

doi:10.21203/rs.3.rs-1892499/v1

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Research Article

Developing an effective and comprehensive communication curriculum for undergraduate medical education in Poland – the review and recommendations

https://doi.org/10.21203/rs.3.rs-1892499/v1

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published 07 Sep, 2023

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Background

The recognition of the importance of effective communication in the healthcare system has been growing. Given that communication courses have to be adjusted to the specificity of a particular culture, language, and other contextual issues, many countries and communities sharing a common language have proposed their recommendations for communication curriculum for undergraduate medical education. Thus far, no such recommendations have been developed, for either any Central and Eastern Europe countries, or for regions where Slavic languages are spoken. This study aims to describe the current state of the art and offer recommendations for medical communication training for undergraduate medical students in Poland.

Methods

The recommendations were developed through an iterative consultation process with lecturers, faculty members of medical schools, and education coordinators. PubMed and Google Scholar databases were searched to identify full text English and Polish language articles on communication curriculum for undergraduate medical education. Additionally, the new Ordinance of the Polish Minister of Science and Higher Education, defining educational standards for undergraduate medical education was analysed in search of learning outcomes that could be applied in communication skills teaching. The authors extracted the most relevant communication skill competencies, as determined by the process participants, discussed current challenges, including those of the COVID-19 pandemic era, and indicated best practices.

Results

A state of the art review was conducted, and a set of recommendations was developed pertaining to the scope and methodology of teaching communication skills. The study included: (1) definition, (2) education content, (3) learning outcomes, (4) the recommended teaching methods. The recommendations are in concord with the graduate profile, as well as the current structure of medical studies. The authors listed and discussed the basic communication competencies expected of medical graduates, as well as medical communication course content viewed from different perspectives, including clinical, psychological, sociological, legal, and linguistic.

Conclusions

Detailed recommendations aimed at integrating best practices into a comprehensive communication curriculum may promote successful teaching, learning, and assessment of medical communication.

assessment

clinical communication

curriculum

medical communication

medical education

The communication skills of healthcare workers are part of basic clinical skills [1]. Communication is a necessary tool for physicians that is of fundamental value during all stages of the treatment process [2]: from establishing the correct diagnosis [3] to the effective use of therapy available for a given patient [4].

Multiple studies confirm that the manner in which a physician communicates with his or her patient directly impacts patient satisfaction [5, 6] and measurable treatment outcomes [7]. Quality communication also counteracts the effects of professional burnout among medical personnel [8, 9] additionally, the recognition of the importance of team communication is also growing [10]. It exerts influence on the effectiveness of the provision of health care [11]. Paradoxically, technical progress and the introduction of modern digital solutions have not diminished the role of interpersonal communication skills in the practice of medicine but have made them even more crucial. New challenges, such as the COVID-19 pandemic, have demonstrated that effective communication matters more than ever [12, 13].

The importance of communication in clinical practice has also been recognized in Poland [14–16], as attested to by changes in the medical education curriculum, especially at medical and medical-dental faculties. Medical universities and faculties are making efforts to incorporate communication studies more thoroughly and effectively into their curricula, in order to equip future healthcare professionals with the necessary occupational competencies.

For this process to be successful, best practices need to be identified and be implemented in a culturally sensitive fashion. With the growing demand for communication skills training to be incorporated into undergraduate medical education, there is a need for the standardization of teaching practices, and the continued assessment of communication skills.

With the increasing recognition of the importance of medical communication, its teaching has been incorporated into the core curriculum of undergraduate medical education. Medical faculties worldwide started to introduce appropriate courses to their curricula at the end of the 20th century. One of the first experiences came from the University of Lagos in 1984 [13]. More recent examples include Leipzig University Medical School (COMSKIL Communication Skills Training [17]) and (Longitudinal Communication Curriculum [18]), Charité - Universitätsmedizin Berlin [19], Ghent University [19], and Harvard Medical School [20].

The need for standardized teaching practices lead to several countries developing their own consensus statements. One of the first consensuses on the teaching and assessment of communication skills in medical schools came from Canada in 1992 [21] and 1993 [22]. One of the most influential was the UK consensus statement on the content of communication curricula in undergraduate medical education, first published in 2008 [23], and updated 10 years later [24]. Other notable national recommendations have come from India [25], Brazil [26], Korea [27], Germany [28], the Netherlands [29], and Switzerland [30].

Attempts have been made to offer international recommendations or consensuses based on the languages spoken, such as the Latin American, Portuguese and Spanish consensus on a core communication curriculum for undergraduate medical education [31] and the Basel consensus statement for German-speaking students [32].

One hundred twenty-one communication experts from fifteen professional fields and sixteen European countries have previously prepared a European consensus on learning objectives for a core communication curriculum devoted to health care professionals [33], as outlined by the goals of the Bologna Process.

Objective - Why is a Polish consensus on teaching communication needed?

Some medical educators believe that communication skills are constant across different cultures and languages. Also, UK communication skills curricula suggested that they can be implemented worldwide. However, other researchers question this assumption; Mirza argued that such skills cannot plausibly be considered universal [34]. She suggested several adaptations to the ‘communication curriculum wheel’ were needed before it could be utilized in a local context. She also pointed out that the core tasks of clinical communication must be learned and practiced in every context. However, applying those universal skills should be adapted to fit into a local context. Local culture, religion, structure of society, legal and ethical issues should be taken into account, as these profoundly affect all aspects of communication.

Also, the context of local language significantly impacts medical communication, which was reflected in the attempts to write consensuses based not on the language spoken. Therefore, it became vital to prepare recommendations that were specific to the system of undergraduate medical education in Poland, including present day challenges.

Unlike the countries of Western Europe and North America [35], in Poland the introduction of the study of communication in the field of medicine was not implemented by faculties of medicine into the curriculum until the second decade of the 21st century. Its importance was demonstrated much earlier, also by the Polish Society of Medical Communication [14].

Until recently, communication classes were optional for medical students. However, it does not mean that the topic of communication was totally absent from the curriculum. For example, interviewing skills were incorporated in a non-standardized (and undocumented) fashion into clinical and humanities subjects. Early on, compulsory communication classes were conducted as part of other classes, e.g., internal propaedeutics, which were first organized in 2008 at the Medical University of Warsaw

However, it was not until 2015 that obligatory communication classes were introduced into the curriculum of the Collegium Medicum of the Jagiellonian University [36]. The following years saw compulsory communication courses introduced by other universities in Poland, including Warsaw, Bydgoszcz, Olsztyn, Poznań, and Lublin. However, due to a lack of general guidance, these communication courses varied in design, number of hours taught, organization, and course content. The only point of reference regarding course content is the Regulation of the Minister of Science and Higher Education, which indicates the learning outcomes that a student of medicine must attain. Some of these outcomes relate to knowledge and communication skills. However, these effects are described in general terms, allowing for great freedom in interpreting the scope of topics and teaching methodology. The number of learning outcomes and their formula are limited. What is lacking is a better description of the way of teaching communication, its methodology, and the competencies of communication skills educators. This leads to a situation where communication becomes an obligatory part of education but remains completely unstructured. The various curricula differ not only in the number of hours devoted to the topic of effective communication, but also in the type of classes (lectures, seminars, simulations), in the number of years of study, and in the staff tasked with developing the communication skills of the students. Due to the general nature of the learning outcomes set out in the regulation, there are also differences in the educational content. The Polish Society of Medical Communication's recommendations are a proposal related to the organization of both the method of instruction and the subject matter, in order to help build a uniform communication curriculum at all medical universities.

As early as 1986, researchers advocated for the teaching and assessment of communication skills to be a continuous process throughout undergraduate and postgraduate medical education for clinical practice [37].

“What youth is used to, age remembers” – the earlier doctors start studying medical communication, the better effect it may give. Because of that the organization of medical communication curriculum of Poland has been started at the undergraduate level.

The aim of the study was to review medical communication curriculum research and present recommendations for communication skills training for undergraduate medical students in Poland.

The recommendations for the undergraduate medical communication curriculum were developed through an iterative consultation process with 8 teachers, members of medical faculties, and the education coordinators representing the five Polish medical schools (Bydgoszcz, Kraków, Olsztyn, Poznań, Warszawa), all of whom are members of the Polish Society of Medical Communication.

The study included: (1) definition, (2) education content, (3) learning outcomes, (4) the recommended teaching methods.

For the study, a literature review was performed using Google Scholar and PubMed databases to identify full text articles published in English and Polish concerning communication curriculum for undergraduate medical education.

The authors identified common communication skill competencies by comparing the Calgary Cambridge Observation Guides, Kalamazoo Consensus Statement, framework communication skills, the Four Habits Model, The SEGUEG Framework, and previous communication skills lists that the authors have used.

The new Ordinance of the Minister of Science and Higher Education on educational standards for undergraduate medical education also underwent a content analysis in order to select learning outcomes including communications skills. Additionally, the authors discussed present day challenges posed by the COVID-19 pandemic.

To develop the communication curriculum recommendations for undergraduate medical education in Poland and to achieve a consensus, a systematic academic approach and the Delphi technique were used. The process of the curriculum development was split in 6 phases within the process: (1) development of a list of learning outcomes concerning communication skills on basis of literature, existing consensus statements, frameworks and guidelines, (2) in person expert meeting to discuss: (a) general communication competencies, (b) education content based on various aspects of communication, (c) educational content concerning medical consultations, (d) the recommended teaching methods, (3) development of a first draft of recommendations, (4) online meetings and electronic discussion process to revise the first draft; (5) second Delphi round to test the revised draft and make suggestions for improvement (6) a final Delphi round for the recommendations.

The objectives and learning outcomes needed to be most comprehensive in inclusion and detailed. They were defined according to Bloom’s taxonomy using a skills-based approach. Ambiguous aspects among experts were reworded and new aspects incorporated.

The study includes: (1) definition of medical communication, (2) education content, (3) learning outcomes, (4) the recommended teaching methods.

Definition

Medical communication is an interaction between healthcare professionals (doctors, nurses, midwives, etc.) and patients (and their relatives) [38], as well as the interaction between healthcare professionals themselves (in medical teams) [39], taking place as part of a healthcare relationship [40] within a treatment or a prophylaxis. Most often, it takes the form of a face to face encounter [41], but various means of remote communication are also possible. The overall goal of such communication is to provide the best healthcare.

Medical communication has also become a research discipline, which has been developing dynamically (including in Poland) for over a dozen years, as evidenced by the growing number of studies and publications. Research and medical education need to go hand in hand for best practices to be gradually institutionalized [42].

Education content

A proposed content list to be included as a part of the communication curriculum in medicine and dentistry may ensure consistency and a high and similar level of education.

The listed issues relate to general problems (introducing the subject of medical communication and exploring it from different perspectives) and detailed (related to specific situations in doctor's work). All the topics listed are directly related to the practice of medicine.

Table 1

Education content (general)
MEDICAL COMMUNICATION AND ITS SIGNIFICANCE IN HEALTHCARE
The definition and scope of medical communication
The goals of medical communication
The importance of communication in medical practice
The impact of medical communication on patient safety
Health literacy as a communication challenge

Although general interpersonal communication competencies remain a basis for medical communication, various aspects of communication should be considered, such as: psychological, sociological, legal, ethical, and linguistic.

Table 2

Education content based on various aspects of communication
Aspect of communication	Education content
Psychological	Recognition of student's communication style
Psychological	Individualization of contact with the patient (the ability to talk to patients concerning their perspective and personality)
Sociological	Mechanisms influencing communication behavior in interpersonal relationships
	Social roles of the doctor and the patient and their influence on communication
	The authority of the doctor
	The image of a doctor in the society
	Linguistic and cultural differences
Legal	Legal aspects of informing the patient (informed consent)
	Legal aspects of communication with the patient's relatives
	Communication errors resulting in lawsuits
Ethical	The importance of communication in building relationships and trust between doctor and patient
	Communication as the basis for obeying patient rights
	Communication in shared decision making
Linguistic	Functions of utterances and the therapeutic function of the word (good dialogue)
	Getting to know the patient's experience based on their statements (narrative)
	Translating specialized language (and medical jargon) into general language
	Basic principles of Polish language etiquette (including address forms, rules of linguistic politeness in various situations, e.g during a visit, medical, physical examination, etc.)

Medical consultation may be considered as a core situation in medicine. Table 3 describes educational content concerning it.

Table 3

Educational content concerning medical consultations
COMMUNICATION DURING THE MEDICAL CONSULTATION
Establishing contact and starting consultations
Proxemics in doctor-patient contact
Communication with relatives of the patient
Providing consultation structure and signposts
MEDICAL INTERVIEW
The structure of the interview
Interview and elements of clinical reasoning (identification of a clinical picture, verification of a hypothesis)
Communication skills support the effectiveness of gathering information
Communication aspects of the physical examination
PATIENT’S PERSPECTIVE
Recognition of the patient's perspective (ideas, concerns, and expectations (ICE) and emotions)
Patient's socioeconomic conditions
Taking into account the patient's perspective in planning the diagnostic and therapeutic procedure
EXPLANATION AND PLANNING
Methods to aid in the transfer of information and its accurate recall
Methods of involving the patient in medical decisions
The use of tools (applications) and models, facilitating diagrams patient understanding of medical issues
MOTIVATING THE PATIENT
Recognizing the sources of patient motivation and readiness to implement the recommendations
The use of methods to strengthen the patient's motivation
Involving the patient in the therapeutic process and pro-health behaviors
Maintaining the patient's motivation in chronic diseases
CLOSING THE CONSULTATION
Create a safety net explaining possible unexpected outcomes, what to do if the plan is not working, when and how to seek help
Summary of the visit and joint approval of the action plan
COMMUNICATION IN SPECIFIC SITUATIONS
Coping with the patient's expectations
Communication related to intimate (personal) topics
Communication of uncertainty and risk
Breaking bad news (EMPATHY protocol) [53] (Emotions, Meeting place, Patient's perspective, Adequate language, Truth, Hope, Yes! (Patient’s empowerment)
Communication in aggressive situations
Medical error communication
Communication in emergencies and life-threatening situations Communication in chronic diseases
Communication in terminal care
Communication in pediatrics
Communication in geriatrics
Communication in psychiatry
Communication in caring for people with disabilities
COMMUNICATION IN MEDICAL TEAMS
Principles of communication in a medical team
Communication in conflict situations in the team

Learning outcomes

Communication competencies are necessary to make medical communication effective. Those competencies comprise knowledge (appropriate background), skills [43], and attitudes [44] that lead to an understanding between medical staff and the patient (and their relatives) [45, 46] and between the medical team members themselves. This understanding considers the full context.

The process of medical communication remains strictly linked with general communication competencies. Those competencies used at different stages of the consultation contain:

communication skills required to build a relationship with the patient
verbal and non-verbal communication in the relationship between the doctor and the patient
communication skills in telemedicine
active and careful listening - methods to improve communication
empathy and cognitive empathy (including clinical empathy) and their importance in medical communication
overcoming communication barriers
assertiveness in communication.

With the proper training every graduate should be able to:

recognize the patient's perspective (their beliefs about disease, their expectations and fears), effectively connect it with the biomedical perspective during the information gathering stage, and provide information in an understandable manner;
easily interact with the patient and his relatives using various channels and forms of communication, during both the diagnostic stage and throughout the therapeutic process;
build a trusted relationship with the patient based on the mutual understanding of the role and course of action (i.e., caring for the maintenance and development of the patient's well-being and health in collaboration with doctor);
make medical decisions together with the patient while respecting their autonomy;
serve as the patient's advisor and guide throughout the diagnostic and therapeutic processes;
skillfully and consciously shape a relationship with the patient, even during periods of increased stress and emotional tension;
behave in a mature and empathetic way; knowledge and skills allow him to flexibly interact with various patients (and in different situations);
have comprehensive medical knowledge, extended with elements other fields (including psychology and sociology), he gives patients multidimensional help in the context of therapy as well as prevention and strengthening health or improving functioning, including environmental interventions;
demonstrate the ability to absorb new knowledge and skills and adjusting them to changing working conditions and requirements;
care about the personal well-being (sets the realistic goals and has requirements to each other, adequate to their possibilities), because the students know that the smooth functioning of them as doctors and the whole team they are a part of depends on it;
communicate efficiently with members of the medical team and manages conflict situations.

Teaching methodology

The recommended teaching methods are grouped into types as presented in Table 4.

Table 4

The recommended teaching methods
Examples of techniques	TYPE OF TEACHING METHOD
	PROBLEM	FEEDING	VALORISATION	PRACTICAL
	Case study	Lecture	Roleplaying	Simulation - conversation with a simulated patient, overview and feedback
	Problem-based learning	Presentation	Visualization	Writing scenarios of interaction with the patient
	Movie	Anecdote	Careful reading (of literary texts and narratives about the disease and disability)	Conversations with patient avatars (using artificial intelligence)
	Didactic games	Story	Reflective discussion	Conversations with real patients
	Discussion		Reflective writing
	Brainstorm
	Correcting conversation scenarios

The learning outcomes of these proposals provide guidance to the universal introduction, support, and development of a communication curricula as a part of undergraduate medical studies in Poland.

The following set of recommendations is the first of its kind in Central and Eastern Europe. Country and language-orientated list of content, learning outcomes and teaching methods may inspire experts from other countries in this region and encourage them to prepare recommendations on the development of communication skills in medicine that correspond to Slavic countries' linguistic and cultural contexts.

Definition

The reference for the definition of communication in medicine is the one formulated by Jan Doroszewski in 2007 [38]. Its basic assumptions have been maintained and the essential determinants of medical communication from the perspective of the current state of knowledge and practical experience have been updated.

General communication competencies

The perception of communication should be interdisciplinary. Communication as a field of study and competence draws from various sciences. Integrating this knowledge and skills together is essential. As a result, this leads to the acquisition of competencies that the graduate can use in clinical practice. Therefore, the first part of the educational content (Tables 1 and 2) is related to students' understanding and acquiring knowledge and skills in various fields. Later in education, these elements are integrated with the clinical context.

Psychological, sociological, legal, ethical, and linguistic aspects of communication have been detailed (Table 2).

The basic skills associated with the consultation stages are based on the Calgary Cambridge model [48, 52], which accurately describes them. This list has been expanded with motivation, as it is vital in numerous diseases of affluence and as it should counteract the very poor health literacy of Polish society. Also, patient's perspective should be emphasized due to the still strong paternalism in Polish healthcare.

Teaching methods should be selected according to the aims and means of instruction. Using practical methods is highly recommended.

Graduate profile as a result of modern education

The process of educating doctors depends on the medical culture [47] and evolves with a changing world [48]. Successive technological and digital revolutions (new diagnostic tools, incremental changes and developments, specialization of knowledge, computerization, telemedicine) and social and cultural changes (increased autonomy of patients, a growing number of chronically ill people) have influenced medical education [49]. Still, it affects the practice of medicine [42].

The practice of medicine requires current and future doctors to develop new clinical skills, demonstrate broadly defined competencies (including communication skills), and emotional maturity. One thing does not change: medicine must maintain its primary goal of providing support to others in need, and to help facilitate their return to good health in life-threatening situations.

Being a doctor is not only about providing medical services. It is most importantly having – the privilege of building a special relationship with another person based on trust, respect, and an openness that no machine can replace.

A model utilized to train doctors should meet various requirements and expectations [20]. When designing this model, various factors and trends should be considered. They will shape the future working conditions of doctors. Medical education should be a response to these challenges. To be responsible enough, the priorities of education at the stage of undergraduate education should be already change and include key competencies in teaching (especially communication) that will allow doctors to practice their profession effectively. They will also support the smooth operation of the entire healthcare system.

Medical universities should follow modern standards of instruction with a view toward the future practice of medicine.

The organization of education

The development of highly competent communication skills should be initiated as early as possible, and optimally should be made a permanent part of the curriculum throughout all the years of a student’s medical studies. During education, the student should initially develop knowledge and appropriate attitudes. They will transpose into simple skills, and over time into more complex ones.

The introduction of communication skills training should also be integrated as an educational tool into inpatient and outpatient settings, as well as in medical simulation centers. The curriculum should be structured in such a way as to enable students to acquire practical communication skills that are essential in the practice of medicine. For the best education of practical communication skills, the number of students included in the study groups should not exceed the number of students in the clinical training groups.

Some studies suggest that communication skills can diminish during the four years of medical school [20]. Medical communication is allotted a limited amount of space in the curriculum. This curricular time must be expanded in order to enhance the important role of effective communication [50]. It is also important to continue communication skills training during the clinical years of undergraduate medical studies. To avoid the erosion of skills over time, clinical skills training should be continuous and supported by the institutional authorities [51].

The medical communication curriculum and classes should be designed, coordinated, and implemented (at least partially) by an internal unit responsible for the enhancement of communication competencies at a given university. Entrusting these tasks to a unit specialized in medical communication ensures that the consistency of the content taught in various classes will be maintained. Moreover, the appropriate preparation of those teaching communication subjects, and the employment of the appropriate didactic methods will ensure proper outcomes. The team responsible for teaching communication should employ specialists in medical communication who have certificates confirming their qualifications in this field. These factors should guarantee a high quality of education.

Assessment methodology

Assessment of practical skills is crucial in the learning process and should be an integral part of the curriculum. Formative assessment and summative assessment [54] are recommended. The first is to verify and monitor the direction of development of current students' knowledge and skills, and the second is to give a final grade for a given course, a task, or a block of tasks.

Both classic oral examinations (the so-called bedside examinations) and some written forms examinations (such as SJT - Situational Judgement Tests) assess communication skills. However, they do so in a selective and unstructured manner. Objective Structured Clinical Examination (OSCE) [55] or Mini-CEX (mini-Clinical Evaluation Exercise) carried out in a hospital setting and / or outpatient clinic as the methods of communication competency assessment are recommended. These two methods make a multi-faceted assessment of students' communication skills possible, and at the same time, they are characterized as highly reliable and valid.

Future directions and challenges

Poland faces challenges and pitfalls regarding the teaching of effective medical communication. The most critical barriers today in this field include (1) incomplete understanding (also in the medical community) of separateness and interdisciplinary foundations of medical communication, (2) misidentification of communication with persuasive (or even manipulative) techniques, and (3) perception of communication competencies separately from clinical practice.

In order to optimize communication skills teaching in practice, Junnod Perron cited the special need to: (1) modify the climate and structure of the working environment so that training and teaching of good communication skills in clinical practice become valued, supported, and rewarded; (2) extend communication skills training to all fields of medicine; (3) regularly provide structured training and adapt it to trainees' needs [56].

There is a need for developing a communication skills training program as the communication skills of many students turned out to be inadequate [57].

However, the quality of delivering the course should be high. Researchers in India found a high prevalence of unfavorable attitudes toward communication skills classes based on a poor quality of the subject [58].

The passage of time and the added experience gained by teachers may promote change. Students’ attitudes toward the learning clinical communication skills at the end of medical school have greatly improved over twelve years in two Norwegian medical schools from 2003 to 2015 [59].

Of course, competent communication includes an essential range of skills, and in order to maintain these skills beyond the undergraduate stage, continuing education will be needed [60].

Training in communication skills requires approaches which are different from the instruction related to other clinical subjects. It is also a challenge to ensure that students not only absorb the nuances of communication and interpersonal skills but adhere to them throughout their careers [25].

Based on the experience of Polish and foreign medical universities, detailed recommendations for the organization and training of communication competencies on medical courses are offered to integrate views on teaching, learning, and assessment of clinical communication. It should be extended to and adapted to other medical faculties in the long term and adjusted to their specific needs and conditions.

It is hoped that this paper may be of assistance to those involved in the planning, development, application, and evaluation of medical communication curricula. Although designed for undergraduate education, the consensus statement provides a starting point for further professional development.

Changes in the practice of medicine should lead rapidly to adjustments in the curricula content.

The responsible and wise implementation of the teaching of medical communication at Polish universities is of great importance to the future of the health care system, the performance and efficiency of doctors and medical teams, and in the level of the quality of care that patients receive.

However, appropriate care should also cover teachers' needs and prevention of their burnout. Medical faculty stress/burnout links directly to a willingness to implement medical school curriculum change [61]. Occupational burnout directly reduces the readiness to change. Therefore, to have successful academic reform in medical schools, it would be beneficial to assess and manage occupational burnout among clinical faculty members.

The necessary curriculum and organizational changes should be evolutionary, not revolutionary. It is essential that training in effective communication be coherent to the rest of the medical curriculum. Gradual integration of new techniques into the existing teaching model promises best chances of success. What is desired is also an approach change of the faculty members, who need to share the belief about the importance of medical communication teaching.

COVID-19 – Coronavirus disease

EMPATHY - Emotions, Meeting place, Patient's perspective, Adequate language, Truth, Hope, Yes! (Patient’s empowerment)

Mini-CEX - mini-Clinical Evaluation Exercise

OSCE - The Objective Structured Clinical Examination

SEGUE - Set the stage, Elicit information, Give information, Understand the patient's perspective, and End the encounter

SJT - Situational Judgement Tests

UK – United Kingdom

Ethics approval and consent to participate

The study was performed in accordance with relevant guidelines and regulations. The recommendations were developed through an iterative consultation process with lecturers, faculty members of medical schools, and education coordinators. The informed consent was obtained from all study participants. Due to the fact that the activities described in the article were carried out by experts in the field of communication (lecturers, trainers, researchers), the consent of the bioethics committee was not required according to the Polish law:

- The Act from December 5, 1996 on the professions of doctor and dentist (last version from February 28, 2020, (Journal of Laws of 2020, item 514) as amended);

- Act from September 6, 2001 Pharmaceutical Law (last version from May 15, 2020 (Journal of Laws of 2020, item 944) as amended);

- Act from 7 April 2022 on medical devices (Journal of Laws of 2022, item 974);

- The Act from March 18, 2011 on the Office for Registration of Medicinal Products, Medical Devices and Biocidal Products (last version from May 4, 2020, Journal of Laws of 2020, item 836) as amended).

These legal acts refer to the Bioethics Committee's opinion on medical experiments, therapeutic experiments, clinical trials of medicinal products, and clinical trials of medical devices. Review of publications and consultations with authors are not medical experiments. The Bioethical Committee from Poznan University of Medical Sciences waived the study approval as they decided there is no way to expose the research participant to possible danger, as participants were medical experts, not patients and as part of the study is based on the review.

Consent for publication

Not applicable.

Availability of data and materials

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

Competing interests

The authors declare that they have no competing interests.

Funding

Not applicable.

Authors' contributions

MB conceptualization, methodology, writing the main manuscript; ASP conceptualization, investigation, writing and editing the main manuscript; AD conceptualization, methodology, writing and editing the main manuscript; ML contributed to the conception, design of the work; M.Ch.-K. linguistic component, review and editing the main manuscript; LM contributed to the conception, design of the work; ZK conceptualization, visualization; A.K. J. conceived the idea for the study. All authors reviewed the manuscript. version of the manuscript. All authors edited and approved the final version of the manuscript.

Acknowledgements

The authors would like to thank you Joseph F. O’Malley and Piotr Sadowski for their support and writing editing.

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No competing interests reported.

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Developing an effective and comprehensive communication curriculum for undergraduate medical education in Poland – the review and recommendations

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Abstract

Background

Methods

Results

Conclusions

Background

Objective - Why is a Polish consensus on teaching communication needed?

Methods

Results

Definition

Education content

Learning outcomes

Teaching methodology

Discussion

Definition

General communication competencies

Graduate profile as a result of modern education

The organization of education

Assessment methodology

Future directions and challenges

Abbreviations

Declarations

References

Additional Declarations

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Journal Publication

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