Advanced communication skills: conflict management and persuasion

There is an increasing need in the medical school curriculum to adequately prepare students for professionalism in the workplace. This senior seminar is a four-week course designed to develop fluency in handling conflict and negotiation as well as understanding the elements of persuasive communication. Students used the Meyers-Brigg Personality Inventory as a paradigm for understanding different communication styles.

The class was piloted in October and November 2001 and consisted of four modules. In module one, each student was given the Meyers-Brigg Personality Inventory to take. Discussions and exercises provided insight into the student's own communication style as well as styles the individual student might find more problematic. The second module consisted of four sessions focusing on conflict management and negotiating skills. Students were given strategies for dealing with conflict as well as specific approaches for communicating with "difficult" patients. In the subsequent sessions, students had a chance to further incorporate these strategies by (1) discussing in a small-group setting a conflict situation that they had either witnessed or experienced in order to systematically evaluate how to incorporate conflict-management approaches into their particular communication style. (2) Role-playing four conflict situations students' were likely to encounter in their professional lives. Role-plays were videotaped and individual feedback was given immediately after the role-play by the observing students, the patient-actor, and the evaluator, who had been trained to give specific feedback on the conflict strategies. (3) Watching specific videotaped role-plays as a class allowed students to see and give feedback on particularly effective strategies that their colleagues used. The third module was devoted to giving bad news and ways that different people prefer to receive bad news, using the MBTI personality types as examples. The final module outlined the principles used in persuasion. Each student had the opportunity to make a five-to-ten-minute persuasive speech, the topic to be applicable to the student's specialty, which was reviewed by his peers. Feedback was tailored specifically to the different principles of persuasion.

The curriculum was judged to be effective in changing confidence and attitudes as evidenced by pre- and post-course evaluations that students filled out during the last session of the class. Six things contributed to its success: (1) the class was offered as a fourth-year seminar; students could see its relevance and therefore were motivated to learn. (2) Activities were designed to build on learning in ways that graduated from passive to active. In such a way the theoretical was made practical. (3) Feedback was immediate and congruent. For example, the evaluators and patient-actors were all trained in the conflict management principles taught. (4) Feedback done by peer review allowed students to internalize strategies. (5) Concrete steps were given for behavioral change. (6) Small-group sessions invited camaraderie and allowed for individualized attention. Future activities include integrating this curriculum into residency teaching; the course is a continuation of a first-year course on interviewing skills taken by every student.