Disentangling communication challenges in trainees' learning journeys: A longitudinal study in the general practice...

Learning skilled communication implies adapting and monitoring to the needs of the clinical encounter. Research suggests communication challenges can trigger learning; however, their nature remains unclear. This study explores what challenges act as triggers, improving understanding of developing skilled communication and guiding educators in targeted coaching.

This longitudinal qualitative study used a phenomenological approach to collect data from first- and third-year general practitioner trainees through clinical observations, interviews, and audio-diaries. Using a twofold approach, a thematic content analysis was performed, triangulating data sources and next, findings were used to craft stories illustrating the communication challenges learners encountered during training.

Per year-group a story was crafted, illustrating communication challenges driving trainees' learning. First-year trainees focused on the effectiveness of patient-centred communication skills. Third-year trainees adopted a meta-perspective, using self-monitoring skills to develop a personalised style, adapt communication to patients' needs, and work collaboratively, driven by curiosity to understand each patient's context.

We identified communication challenges in workplace learning that trigger the development of skilled communication. To help learners recognise and share these challenges, a safe learning environment is crucial, along with scaffolded guidance from educators to support learners in identifying challenges and fostering self-monitoring skills throughout their learning journey.