["The consultation lab"--training clinical communication]

Discourse is the doctor's most essential tool. Since 1992, 500 Danish GPs have participated in "The consultation process I" and videosupervision in Greece. Participants are divided into groups of six. Each group works in a virtual consultation lab in which doctor-patient role plays are videotaped and supervised according to a specific matrix. In this experimental setting we have further sophisticated the nine phases (the P-R-A-C-T-I-C-A-L model) of the consultation process and improved our matrix for group supervision of video sessions. Typical individual pitfalls in doctor-patient communication have been demonstrated. Participant doctors were allowed to freely explore individual styles, and then establish how they were perceived by their "patients'"; they have learned how patient experience of a consultation varies. Furthermore, the courses helped to create networks: several groups met later, and a great many of these GPs have joined medical student tutoring. This way, the courses have contributed to more efficient work practices and job satisfaction, to professional advances, and to a lasting of the quality of upgrading in general practice.