ABSTRACT
To explore the ways in which biomedical culture responds to the new curricular addition of communication skills training, we observed activities related to the communication skills training of a class of 70 first-year medical students in an Israeli medical school during 2002–3. In addition, focus groups were conducted with medical students (n = 210) during 1998–2001. A gap was found between the rhetoric of “patient-centered communication” and “empathy” and the traditional concerns of medical authority, efficiency, and scientism. Communication skills and empathy training were appropriated into medical socialization by being reconstructed as clinical competence. Findings are further discussed in the context of medical professionalism, Israeli culture, service acting and service roles, and organizational learning.
Similar content being viewed by others
References
Albrecht Karl, Ron Zemke 1985 Service America! NY: Warner Books
Argyris Chris, Donald Schon 1978 Organizational Learning. NY: Addison-Wesley
Association of American Medical Colleges 1999 Contemporary Issues in Medicine: Communication in Medicine (Report III of the Medical School Objectives Project). Washington, DC: Association of American Medical Colleges
Barrett Robert J. 1988 Clinical Writing and the Documentary Construction of Schizophrenia. Culture, Medicine and Psychiatry 12(3):265–299
Barry Christine, Colin Bradley, Nicky Britten, Fiona Stevenson, Nick Barber 2000 Patients’ Unvoiced Agendas in General Practice Consultations: Qualitative Study. British Medical Journal 320(7244):1246–51.
Benbassat Jochanan, Reuben Baumal 2001 Teaching Doctor-Patient Interviewing Skills Using an Integrated Learner and Teacher-Centered Approach. The American Journal of the Medical Sciences 322(6):349–357
Berg M. 1995 Turning a Practice into a Science: Reconceptualizing Post-war Medical Practice. Social Studies of Science 25:437–76
Chinitz, David, ed. 2000 The Changing Face of Health Systems. The Israel National Institute for Health Policy and Health Services Research. Jerusalem: Gefen
Conrad Peter 1988 Learning to Doctor: Reflections on Recent Accounts of the Medical School Years. Journal of Health and Social Behavior 29:323–333
Denzin Norman 1978 The Research Act. NY: Aldine
Duffy Daniel, Geoffrey H. Gordon, Gerald Whelan, Kathy Cole-Kelly, Richard Frankel, all participants in the American Academy on Physician and Patient’s Conference on Education and Evaluation of Competence in Communication and Interpersonal Skills 2004 Assessing Competence in Communication and Interpersonal Skills: The Kalamazoo II Report. Academic Medicine 79:495–507
Foucault Michel 1967 Madness and Civilization. New York: Random House
Glaser Barney, Strauss Anselm L. 1967 The Discovery of Grounded Theory: Strategies for Qualitative Research. Chicago: Aldine
Glick, Shimon 1985 Symposium on “Patients’ Rights.” Ben-Gurion University Medical School (in Hebrew)
Good Byron J. 1994 Medicine, Rationality, and Experience: An Anthropological Perspective. Cambridge: Cambridge University Press
Hafferty F. 1988 Cavader Stories and the Emotional Socialization of Medical Students. Journal of Health and Social Behavior 29: 344–356
Hafferty F., Franks R. 1994 The Hidden Curriculum, Ethics Teaching, and the Structure of Medical Education. Academic Medicine 69(11):861–71
Hajek Peter, Najberg Eva, Cushing Annie 2003 Medical Students’ Concerns about Communicating with Patients. Medical Education 34(8):656–8
Halpern Jodi 2003 What is Clinical Empathy?. Journal of General Internal Medicine 18(8): 670–678
Hargie O., Dickson D., Boohan M., Hughes K. 1998 A Survey of Communication Skills Training in U.K. Schools of Medicine: Present Practices and Prospective Proposals. Medical Education 32:25–34
Hochschild Arlie 1983 The Managed Heart: Commercialization of Human Feeling in Late Capitalism. Berekely, CA: University of California Press
Katriel Tamar 1986 Talking Straight: Dugri Speech in Israeli Sabra Culture. Cambridge: Cambridge University Press
Lavie J., Wenger E. 1991 Situated Learning: Legitimate Peripheral Participation. Cambridge: Cambridge University Press
Makoul G. 2003 Communication Skills Education in Medical School and Beyond. Journal of the American Medical Association 289(1):93–94
Markakis, Kathryn, Richard Frankel, Howard Beckman, and Anthony Suchman 1999 Teaching Empathy: It Can Be Done. Working paper presented at the Annual Meeting of the Society of General Internal Medicine, San Francisco, CA, April 29–May 1
Markakis Kathryn, Beckman Howard, Suchman Anthony, Frankel Richard 2000 The Path to Professionalism: Cultivating Humanistic Values and Attitudes in Residency Training. Academic Medicine 75:141–150
Moss F., McManus I. 1992 The Anxieties of New Clinical Students. Medical Education 26:17–20
Schein Edgar 1990 Organizational Culture. American Psychologist, February: 109–119
Schein Edgar 1985 Organizational Culture and Leadership. San Francisco: Jossey-Bass
Shuval Judith 1992 Social Dimensions of Health: The Israel Experience. NY: Praeger
Shuval Judith, Anson Ofra 2000 Social Structure and Health in Israel. Jerusalem: The Hebrew University, Magnes Press
Silverman J., Kurtz S., Draper J. 1988 Skills for Communicating with Patients. Oxford: Radcliffe Medical Press
Spencer John, Silverman Jonathan 2001 Education for Communication: Much Already Known, So Much More to Understand. Medical Education 35(3):188–190
Stewart M.A. 1995 Effective Physician-Patient Communication and Health Outcomes: A Review. Canadian Medical Association Journal 152:1423–33
Strauss Anselm, Corbin Juliet 1990 Basics of Qualitative Research: Grounded Theory Procedures and Techniques. Newbury Park, CA: Sage
Suchman Anthony L. 2001 Control and Relation: Two Foundational Values and their Consequences. Issues in Interdisciplinary Care 3(2): 145–150
Suchman Anthony L. 2003 Research on Patient-Clinician Relationships: Celebrating Success and Identifying the Next Scope of Work. Journal of General Internal Medicine 18(8): 677–81
Suchman Anthony, Kathryn Markakis, Howard Beckman, Richard Frankel, 1997 A Model of Empathic Communication in the Medical Interview. Journal of the American Medical Association 277(8): 678–683
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
RAZ, A.E., FADLON, J. “WE CAME TO TALK WITH THE PEOPLE BEHIND THE DISEASE:” COMMUNICATION AND CONTROL IN MEDICAL EDUCATION. Cult Med Psychiatry 30, 55–75 (2006). https://doi.org/10.1007/s11013-006-9008-0
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11013-006-9008-0