Communication skills and undergraduate medical education

This paper reports some aspects of teaching communication skills based on experience with over 100 pre-clinical students in each of two years. Students interviewed patients selected by general practitioner tutors from their practices and 214 interviews, recorded on videotape, were subsequently analysed. Without having been given detailed instruction, approximately two-thirds of each class of second year students (mean age 19 1/2 years) sustained a consultation for 5 minutes or more. Over one half of the students elicited the salient features of the patients' problems within this short time. Anxiety exhibited by the majority of students could be seen to influence the interviews in several ways. These manifestations and the ways in which the interview was affected are briefly described. When some of the patients were subsequently interviewed by postgraduate trainees in general practice, the consultations differed in a number of respects. These differences are described, and the possible significance of the observations is discussed in relation to medical education.