Designing a curriculum for communication skills training from a theory and evidence-based perspective

OBJECTIVE: Because quality health care delivery requires effective clinician-patient communication, successful training of health professionals requires communication skill curricula of the highest quality. Two approaches for developing medical communication curricula are a consensus approach and a theory driven approach. We propose a theory-driven, communication function framework for identifying important communication skills, one that is focused on the key goals and outcomes that need to be accomplished in clinical encounters. We discuss 7 communication functions important to medical encounters and the types of skills needed to accomplish each. DISCUSSION: The functional approach has important pedagogical implications including the importance of distinguishing the performance of a behavior (capacity) from the outcome of that behavior in context (effectiveness) and the recognition that what counts as effective communication depends on perspective (e.g., observer, patient). CONCLUSION: Consensus and theory-driven approaches to medical communication curricula are not necessarily contradictory and can be integrated to further enhance ongoing development and improvements in medical communication education. PRACTICE IMPLICATIONS: A functional approach should resonate with practicing clinicians and continuing education initiatives in that it is embraces the notion that competent communication is situation-specific as clinicians creatively use communicative skills to accomplish the key goals of the encounter.