Learner-Centered Interactive Methods for Improving Communication Skills

  • Jonathan SilvermanEmail author
  • Michela Rimondini


In the Outcomes Project, the Accreditation Council for Graduate Medical Education (ACGME) mandated that all medical specialties ensure that its residents develop competency in different areas, including “interpersonal and communication skills.” The Psychiatry Residency Review Committee of the ACGME fixed additional requirements for psychiatrists, who also need to demonstrate competency in CBT and four other different kinds of psychotherapy (ACGME 2000). This implies that communication and CBT are considered core skills in the curriculum of mental health providers (see Chapter 1).


Communication Skill Teaching Session Simulated Patient Real Patient Communication Training 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. ACGME: ACGME: Outcome project. ACGME General Competencies Version 1.3, 2000, 28 September 1999.Google Scholar
  2. Anderson, M. B., Stillman, P. L., & Wang, Y. (1994). Growing use of standardised patients in teaching and evaluation in clinical medicine. Teaching and Learning in Medicine, 6, 15–22.CrossRefGoogle Scholar
  3. Aspergren, K. (1999). Teaching and learning communication skills in medicine: A review with quality grading of articles. Medical Teacher, 21(6), 563–570.CrossRefGoogle Scholar
  4. Association of American Medical Colleges Panel on the General Professional Education of the Physician and College Preparation for Medicine. (1984). Physicians for the Twenty-First Century: The GPEP report. Washington, DC: Association of American Medical Colleges.Google Scholar
  5. Association of American Medical Colleges. (1999). Report 3: Contemporary issues in medicine: Communication in medicine. Washington, DC: AAMC. Intro, 8.3: overview and assess.Google Scholar
  6. Bandura, A. (1988). Principles of Behavior Modification. New York: Holt, Rinehart and Winston.Google Scholar
  7. Barrows, H. S., & Abrahamson, S. (1964). The programmed patient: A technique for appraising clinical performance in clinical neurology. Journal of Medical Education, 39, 802–805.PubMedGoogle Scholar
  8. Beckman, H. B., & Frankel, R. M. (1994). The use of videotape in internal medicine training. Journal of General Internal Medicine, 9, 517–521.CrossRefPubMedGoogle Scholar
  9. Beckman, H. B., Markakis, K. M., Suchman, A. L., & Frankel, R. M. (1994). The doctor–patient relationship and malpractice. Archives of Internal Medicine, 154, 1365–1370.CrossRefPubMedGoogle Scholar
  10. Bennett-Levy, J., McManus, F., Westling, B. E., & Fennell, M. (2009). Acquiring and refining CBT skills and competencies: Which training methods are perceived to be most effective? Behavioral and Cognitive Psychotherapy, 37, 571–583.CrossRefGoogle Scholar
  11. Bingham, L., Burrows, P., Caird, R., Holsgrove, G., & Jackson, N. (1996). Simulated surgery – Using standardized patients to assess clinical competence of GP registrars – A potential clinical component of the MRCGP examination. Education for General Practice, 7, 102–111.Google Scholar
  12. Bradley, C. P. (1992). Turning anecdotes into data. The critical incident technique. Family Practice, 9, 98–103.CrossRefPubMedGoogle Scholar
  13. Brenner, A. M. (2009). Uses and limitations of simulated patients in psychiatric education. Academic Psychiatry, 33, 112–119.CrossRefPubMedGoogle Scholar
  14. Byrne, P. S., & Long, B. E. L. (1976). Doctors talking to patients. London: Her Majesty’s Stationery Office.Google Scholar
  15. Cegala, D. J., & Lenzmeier Broz, S. (2002). Physician communication skills training: A review of theoretical backgrounds, objectives and skills. Medical Education, 36(11), 1004–1016.CrossRefPubMedGoogle Scholar
  16. Cohen-Cole, S. A., Bird, J., & Mance, R. (1995). Teaching with roleplay – a structured approach. In M. Lipkin Jr., S. M. Putnam, & A. Lazare (Eds.), The medical interview. New York: Springer.Google Scholar
  17. Duffy, F. D. (1998). Dialogue: The core clinical skill. Annals of Internal Medicine, 128(2), 139–141.PubMedGoogle Scholar
  18. Dunn, W. R., & Hamilton, D. D. (1986). The critical incident technique – A brief guide. Medical Teacher, 8, 207–215.CrossRefPubMedGoogle Scholar
  19. Fallowfield, L., Jenkins, V., Farewell, V., Saul, J., Duffy, A., & Eves, R. (2002). Efficacy of a Cancer Research UK communication skills training model for oncologists: A randomised controlled trial. Lancet, 359(9307), 650–656.CrossRefPubMedGoogle Scholar
  20. Fallowfield, L., Jenkins, V., Farewell, V., & Solis-Trapala, I. (2003). Enduring impact of communication skills training: Results of a 12-month follow-up. British Journal of Cancer, 89(8), 1445–1449.CrossRefPubMedGoogle Scholar
  21. Ficklin, F. L. (1988). Faculty and house staff members as role models. Journal of Medical Education, 63, 392–396.PubMedGoogle Scholar
  22. Flanagan, J. C. (1954). The critical incident technique. Psychological Bulletin, 51, 327–358.CrossRefPubMedGoogle Scholar
  23. Fleming, J. (1967). Teaching the basic skills of psychotherapy. Archives of General Psychiatry, 16, 416–426.PubMedGoogle Scholar
  24. Hargie, O. D. W., & Morrow, N. C. (1986). Using videotape in communication skills training: A critical review of the process of self-viewing. Medical Teacher, 8, 359–365.CrossRefPubMedGoogle Scholar
  25. Hoppe, R. B. (1995). Standardized (simulated) patients and the medical interview. In M. Lipkin Jr., S. M. Putnam, & A. Lazare (Eds.), The medical interview. New York: Springer.Google Scholar
  26. Kaufman, D. M., Laidlaw, T. A., & Macleod, H. (2000). Communication skills in medical school: Exposure, confidence, and performance. Academic Medicine, 75(Suppl 10), S90–S92.CrossRefPubMedGoogle Scholar
  27. King, A. M., Prkowski-Rogers, L. C., & Pohl, H. S. (1994). Planning standardised patient programmes: Case development, patient training, and costs. Teaching and Learning in Medicine, 6, 6–14.CrossRefGoogle Scholar
  28. Knowles, M. S. (1984). The adult learner – A neglected species. Houston, TX: Gulf.Google Scholar
  29. Kurtz, S. M. (1990). Attending rounds: A format and techniques for improving teaching and learning. Paper presented at the 3rd International Conference on Teaching and Assessing Clinical Competence, Groningen, the Netherlands.Google Scholar
  30. Kurtz, S. M. & Heaton, C. J. (1995). Teaching and assessing information giving skills in the communication curriculum. Paper presented at the 6th Ottawa Conference on Medical Education, University of Toronto.Google Scholar
  31. Kurtz, S. M., Laidlaw, T., Makoul, G., & Schnabl, G. (1999). Medical education initiatives in communication skills. Cancer Prevention and Control, 3(1), 37–45.PubMedGoogle Scholar
  32. Kurtz, S., Silverman, J., Benson, J., & Draper, J. (2003). Marrying content and process in clinical method teaching: enhancing the Calgary-Cambridge guides. Academic Medicine, 78(8), 802–809.CrossRefPubMedGoogle Scholar
  33. Kurtz, S. M., Silverman, J., & Draper, J. (2005). Teaching and learning communication skills in medicine (2nd ed.). Oxford: Radcliffe Medical.Google Scholar
  34. Laidlaw, T., Kaufman, D. M., MacLeod, H., Wrixon, W., van Zanten, S., & Simpson, D. (2004). Relationship of communication skills assessment by experts, standardized patients and self-raters. Paper presented at the Association of Canadian Medical Colleges Annual Meeting, Halifax.Google Scholar
  35. Maguire, P., Fairbairn, S., & Fletcher, C. (1986). Consultation skills of young doctors: 1 – Benefits of feedback training in interviewing as students persists. BMJ, 292, 1573–1576.CrossRefPubMedGoogle Scholar
  36. Maguire, G. P., Goldberg, D. P., Hobson, R. F., Margison, F., Moss, S., & O’Dowd, T. (1984). Evaluating the teaching of a method of psychotherapy. British Journal of Psychiatry, 144, 575–580.CrossRefPubMedGoogle Scholar
  37. McNaughton, N., Ravitz, P., Wadell, A., & Hodges, B. D. (2008). Psychiatric education and simulation: A review of the literature. Canadian Journal of Psychiatry, 53, 85–93.Google Scholar
  38. Oh, J., Segal, R., Gordon, J., Boal, J., & Jotkowitz, A. (2001). Retention and use of patient-centered interviewing skills after intensive training. Academic Medicine, 76(6), 647–650.CrossRefPubMedGoogle Scholar
  39. Participants in the Bayer-Fetzer Conference on Physician–Patient Communication in Medical Education. (2001). Essential elements of communication in medical encounters: The Kalamazoo consensus statement. Academic Medicine, 76(4), 390–393.CrossRefGoogle Scholar
  40. Pololi, L. H. (1995). Standardised patients: As we evaluate so shall we reap. Lancet, 345, 966–968.CrossRefPubMedGoogle Scholar
  41. Razavi, D., Merckaert, I., Marchal, S., Libert, Y., Conradt, S., Boniver, J., et al. (2003). How to optimize physicians’ communication skills in cancer care: Results of a randomized study assessing the usefulness of posttraining consolidation workshops. Journal of Clinical Oncology, 21(16), 3141–3149.CrossRefPubMedGoogle Scholar
  42. Ridsdale, L., Morgan, M., & Morris, R. (1992). Doctors’ interviewing technique and its response to different booking time. Family Practice, 9, 57–60.CrossRefPubMedGoogle Scholar
  43. Rimondini, M., Del Piccolo, L., Goss, C., Mazzi, M., Paccaloni, M., & Zimmermann, C. (2006). Communication skills in psychiatry residents – How do they handle patient concerns? An application of sequence analysis to interviews with simulated patients. Psychotherapy and Psychosomatics, 75, 161–169.CrossRefPubMedGoogle Scholar
  44. Rimondini, M., Del Piccolo, L., Goss, C., Mazzi, M., Paccaloni, M., & Zimmermann, C. (2010). The evaluation of training in patient-centred interviewing skills for psychiatric residents. Psychological Medicine, 40, 467–476.CrossRefPubMedGoogle Scholar
  45. Sanson-Fisher, R. W., & Poole, A. D. (1980). Simulated patients and the assessment of medical students’ interpersonal skills. Medical Education, 14, 249–253.CrossRefPubMedGoogle Scholar
  46. Sholomskas, D. E., Syracuse-Siewert, G., Rounsaville, B. J., Ball, S. A., Nuro, K. F., & Carroll, K. M. (2005). We don’t train in vain: A dissemination trial of three strategies of training clinicians in cognitive-behavioral therapy. Journal of Consulting and Clinical Psychology, 73, 106–115.CrossRefPubMedGoogle Scholar
  47. Silverman, J. (2009). Teaching clinical communication: A mainstream activity or just a minority sport? Patient Education and Counseling, 76(3), 361–367.CrossRefPubMedGoogle Scholar
  48. Silverman, J. D., Draper, J., & Kurtz, S. M. (1997). The Calgary-Cambridge approach to communication skills teaching 2: The Set–Go method of descriptive feedback. Education for General Practice, 8, 16–23.Google Scholar
  49. Silverman, J. D., Kurtz, S. M., & Draper, J. (1996). The Calgary-Cambridge approach to communication skills teaching 1: Agenda led outcome based analysis of the consultation. Education for General Practice, 7, 288–299.Google Scholar
  50. Silverman, J., Kurtz, S. M., & Draper, J. (2005). Skills for communicating with patients (2nd ed.). Oxford: Radcliffe.Google Scholar
  51. Simpson, M., Buckman, R., Stewart, M., Maguire, P., Lipkin, M., Novack, D., et al. (1991). Doctor–patient communication: The Toronto consensus statement. BMJ, 303, 1385–1387.CrossRefPubMedGoogle Scholar
  52. Smith, S., Hanson, J. L., Tewksbury, L., et al. (2007). Teaching patient communication skills to medical students: A review of randomised controlled trials. Evaluation and the Health Professions, 30(1), 3–21.CrossRefGoogle Scholar
  53. Southgate, L. (1993). Statement on the use of video-recording of general practice consultations for teaching, learning and assessment: The importance of ethical considerations. London: RCGP.Google Scholar
  54. Stillman, P. L., Sabars, D. L., & Redfield, D. L. (1977). Use of trained mothers to teach interviewing skills to first year medical students: A follow up study. Pediatrics, 60, 165–169.PubMedGoogle Scholar
  55. van Dalen, J., Kerkhofs, E., van Knippenberg-Van Den Berg, B. W., van Den Hout, H. A., Scherpbier, A. J., & van der Vleuten, C. P. (2002). Longitudinal and concentrated communication skills programmes: Two Dutch medical schools compared. Advances in Health Sciences Education Theory and Practice, 7(1), 29–40.CrossRefPubMedGoogle Scholar
  56. Vu, N. V., & Barrows, H. (1994). Use of standardised patients in clinical assessments: Recent developments and measurement findings. Educational Researcher, 23, 23–30.Google Scholar
  57. Weerasekera, P., Manring, J., & Lynn, D. J. (2010). Psychotherapy training for residents: Reconciling requirements with evidence-based, competency-focused practice. Academic Psychiatry, 34, 5–12.CrossRefPubMedGoogle Scholar
  58. Westberg, J., & Jason, H. (1993). Collaborative clinical education: The foundation of effective health care. New York: Springer.Google Scholar
  59. Westberg, J., & Jason, H. (1994). Teaching creatively with video – Fostering reflection, communication and other clinical skills. New York: Springer.Google Scholar
  60. Wilkinson, S., Perry, R., Blanchard, K., & Linsell, L. (2008). Effectiveness of a three-day communication skills course in changing nurses’ communication skills with cancer/palliative care patients: A randomised controlled trial. Palliative Medicine, 22(4), 365–375.CrossRefPubMedGoogle Scholar
  61. Wündrich, M., Peters, J., Philipsen, A., Kopasz, M., Berger, M., & Voderholzer, U. (2008). Clinical teaching with simulated patients in psychiatry and psychotherapy. A controlled pilot study. Nervenarzt, 79, 1273–1274.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.School of Clinical MedicineAddenbrooke’s HospitalCambridgeUK

Personalised recommendations