Undergraduate teaching of consultation skills – examples from the teaching of pharmacy and medicine Tracey Coppins Teaching Fellow, School of Pharmacy, Keele University

Content Why do we teach Communication Skills? How do we teach Communication Skills? What do we teach in Communication Skills classes? How do we assess Communication Skills?

Consultation Skills v. Communication Skills Is there a difference? We start by teaching communication skills

Why do we teach communication skills? Standards set by the General Pharmaceutical Council (GPhC) for the initial education and training of pharmacists state that pharmacy students should be able to instruct patients in the safe and effective use of their medicines and devices communicate with patients about their prescribed treatment Future Pharmacists - Standards for the initial education and training of pharmacists (GPhC May 2011)

Why do we teach communication skills?

How do we teach communication skills? 5.1 Curricula must be integrated. Component parts of education and training must be linked in a coherent way.

How do we teach communication skills? 5.2 Curricula must be progressive, dealing with issues in an increasingly more complex way until the right level of understanding is reached:

How do we teach communication skills? Level 1 – Knows. Knowledge that may be applied in the future to demonstrate competence. Level 2 – Knows how. Context-based tests – knows how to use knowledge and skills. Level 3 – Shows how. A student or trainee is able to demonstrate that they can perform in a simulated environment or in real life. Level 4 – Does. Acting independently and consistently in the complex situation of an everyday or familiar context. Evidence for this level is showing in this context that one is able to demonstrate the outcomes in a complex everyday situation repeatedly and reliably. Note that these levels do not equate to years of study.

How do we teach communication skills? 5.3 An MPharm degree must be delivered in an environment which places study in a professional and academic context and requires students to conduct themselves professionally. Clinical Skills Suite

How do we teach communication skills? Teaching methods include Lectures (theoretical concepts) Workshops (role play and reflective tasks) Virtual Patient (safe and replicable) Simulated Patients (safe and replicable) Real Patients (higher risk and unpredictable) Learning through Practice (LtP placements) Professional Development Portfolio (reflective)

How do we teach communication skills? Virtual patient demonstration

How do we teach communication skills? Other opportunities to improve communication skills Inter-professional Education Synoptic Assessment Group tasks and presentations University life – mentor, interviewer, ambassador

What do we teach? Stage 1 Basic framework to communicating with a patient using Calgary Cambridge model with a focus on opening a consultation, building rapport, questioning, listening and explaining, closing a consultation and non-verbal communication.

What do we teach? Stage 1 Written communication skills Negotiation (role play with prescriber to amend prescriptions) Information gathering (WWHAM) Advice giving (handing out prescriptions)

What do we teach? Stage 2 Advice giving (using formulations) Interactions (being able to identify and explain the interaction to a health care professional) Explaining (accuracy checking for dispensing errors)

What do we teach? Stage 3 Interactions (being able to identify and explain the interaction to a health care professional and recommend a course of action to rectify the problem) Explaining (admitting to an error and apologising to the patient) Responding to symptoms (WWHAM with recommendation for OTC product)

What do we teach? Stage 4 Explaining (Angry patient - dealing with a dispensing error) Complex communication (Ethical dilemma – standing by decision and giving reasons for it) Explaining (Clinical procedures – history taking, blood pressure, using a stethoscope, patella reflex testing)

How do we assess communication skills? 5.10 Marking criteria must be used for all assessments and all pass criteria must reflect safe and effective practice. 5.11 Patient safety must be paramount in assessments: any evidence of an assessment demonstrating unsafe practice must result in failure.

How do we assess communication skills? Multiple choice questions (MCQ’s) Competency based assessments (CBA’s) Reflections in workbook and portfolio Learning through Practice placements

How do we assess communication skills?

How do we assess communication skills?

Further developments Augmented and Virtual Reality in teaching