The “how”: principles of how to teach and learn communication skills

Introduction

We explore four important questions:1. Why take a skills-based approach to

communication teaching and learning?2. Why is it necessary to learn communication

skills experientially? 3. Why take a problem-based approach to

communication skills teaching?4. Why complement experiential learning with

didactic methods and cognitive material?

Hashem Yaseen 2016

Hashem Yaseen 2016

The importance of both skills and attitudinal approaches to communication teaching.

Why take a skills-based approach to communication teaching and learning?

Hashem Yaseen 2016

The skills approach

The attitude approac

h

Hashem Yaseen 2016

The skills approach Communication is a skill It is a series of learned skills and not simply a

matter of personality. Individual skills can be delineated and

learned. Knowledge of appropriate skills does not

translate directly to performance. Practice with observation and feedback is

required to achieve acquisition of new skills and change in learners behaviour.

communication training requires formal instruction that is intentional, systematic, specific and experiential.

Hashem Yaseen 2016

The attitude approach Block in communication → deeper level of

attitudes and emotions. ??

Exploration of the doctor’s thoughts, feelings, and emotions towards patient. ??

Hashem Yaseen 2016

Why both skills and attitudes?

The concept of outcome

What you want to achieve?

The capacity !

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Why take a predominantly skills –based approach?

1. Skills acquisition is the one essential component of communication teaching and learning.

2. Skills acquisition is important even where are no attitudinal blocks.

3. The skills approach is less threatening to the defensive learner.

4. Skills acquisition can lead to changes in attitudes.

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Skills vs. Issues Issues-based approach Coursework is organized around

issues such as ethics , culture , age , death and dying and addiction.

Not preferred The well-rounded communication

curriculum deals with skills , attitudes and specific communication issues.

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Which teaching and learning methods work in practice ?

1 - experiential learning methods

2 - problem-based learning methods

3 - Didactic methods

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The evidence that specific experiential methods are necessary

Why use experiential learning methods?

I hear and I forget I see and I remember I do and I understand

Confucius (551-479 BC)

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handouts lecturesTraining

workshopVideo / audio

recording

Real patients

Simulated patients

Roleplay feedback

Teaching methods used to bring about changes in learners communication skills

Hashem Yaseen 2016

The evidence that specific experiential methods are necessary

Rutter and Maguire 1976

Roe 1980

Evanset al 1989

Madan et al 1998

Suggest the following key steps: • The provision of detailed written guidelines on the areas to

cover and the skills to use .• The opportunity to practice interviewing under controlled

conditions .• Observation by self and facilitator• The provision of feedback by an experienced facilitator with

the aid of audio or video tape

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What makes the mentor so good ?…. “He is gifted with patients.” !

Modelling

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The essential ingredients of experiential communication skills learning

Systematic delineation and definition of essential skills.

Observation of learners. Well-intentioned , detailed and

descriptive feedback . Video or audio recording and

review. Repeated practice and rehearsal of

skills. Active small group or one-to-one

learning.

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Feedback without observation is like treatment without diagnosis

Observation

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Video or audio recording advantages

Learners who can observe or listen to themselves understand their own strengths and weaknesses much more readily than if they rely on reflection alone.

Recordings encourage a learner – centered approach with the learner being more centrally and actively involved in the analysis

Recordings help to prevent misconceptions and disagreements Recordings allow feedback to be much more specific as there is always an

exact referent for any particular item of discussion Recordings help feedback to focus on description rather than on

evaluation Recordings allow areas to be reviewed on several occasions and enable

the learner to revisit feedback and learning at later date

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Repeated practice and rehearsal of skills.

1. Practising skills in safety.

2. Enabling ongoing feedback and rehearsal

3. Developing an individual approach.

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Active small group or one-to-one learning .

Requires learners to take a more active role – to learn by doing rather than by just listening or reading

Experiential study shifts the primary focus away from the lecture and the book to one's own behaviour

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Where do we start?

What de we observe and why?

Why use a problem – based approach to communication skills teaching?

Hashem Yaseen 2016

Why use a problem – based approach to communication skills teaching?

Adults are motivated by learning that is:1. Relevant to learners present situations.2. Practical rather than just theoretical3. Problem centered rather than subject centered4. Built on learners previous experience.5. Directed towards learners perceived needs6. Planned in terms of negotiated and emergent objectives7. Participatory, actively involving learners8. Geared to learner’s own pace9. Primarily self – directed10. Designed to promote amore equal relationship with

teachers11. Evaluated through self – and peer assessment

Hashem Yaseen 2016

Why use a problem – based approach to communication skills teaching?

Constructivism characterizes learners and learning as follows:

1. Knowledge is constructed by learner

2. Knowledge is based on learner’s understanding – scientifically collected or academic knowledge is important but it is the only truth.

3. The learner builds cognitive structures through interaction, reflection and inquiry.

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Discovering learners perceived needs

Using a problem – based approach in practice

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Creating a supportive climate

Using a problem – based approach in practice

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Developing appropriate experiential material

Using a problem – based approach in practice

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Taking a problem – based approach to analyzing the consultation

Using a problem – based approach in practice

Hashem Yaseen 2016

Hashem Yaseen 2016

The balance between self – directed and facilitator – directed learning

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Why include didactic teaching in the communication skills programme?

What place is there for more didactic ؟teaching methods

The “how”: principles of how to teach and learn communication skills