[Clinical communication--a structured teaching model]

A 16-hour course of patient-centered consultation skills, aimed at senior medical students and clinicians, is presented. The goal is to train participants in communication skills which at the same time stimulate the development of a good therapeutic relationship and allow effective gathering of relevant clinical information. The article describes a consultation model in five consecutive steps--opening, exploration, hypothesis testing, negotiations over management, and closure. Each phase confronts the doctor with typical tasks to be solved through adequate dialogue with the patient. The course is based on active student participation through role play, dialogue, reciprocal observation and group analysis of videotaped consultations between the participants and real patients. The article gives a detailed presentation of structures and techniques applied in the course, and describes how this training in consultation skills was developed.