Is communication a skill? Communication behaviors and being-in-relation

Zoppi, Kathleen A.; Epstein, Ron

doi:10.23938/assn.0421

Cited by 53 publications

(63 citation statements)

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“…41 Reviews of this kind have been important in questioning assumptions that shape communication research and guidance. 18,32,33,42 As our starting point, we drew on recent position statements in academic journals and health service guidance for practitioners drawn from the UK, Europe, the USA and Australia [6][7][8][9]12,13,43,44 to identify defining assumptions of the current paradigm. We compared these assumptions with research evidence of patients' own priorities for clinical communication and evidence of clinicians' views about how they meet patients' communication needs.…”

Section: Resultsmentioning

confidence: 99%

“…22 Moreover, clinicians, educationists and social scientists have warned over three decades that the concept of skills misrepresents communication. 18,84,85 For instance, when behaviours, such as making eye contact or talking empathically, are denoted as 'skills', the implication is that they are inherently and consistently beneficial. In reality, however, the meaning of communication behaviour usually depends on the context: eye contact can be threatening and patients can experience psychosocial talk as intrusive or inappropriate.…”

Section: Clinicians: Goal-directed Expertsmentioning

confidence: 99%

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A new paradigm for clinical communication: critical review of literature in cancer care

Salmon

Young

2016

Med Educ

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ObjectivesTo: (i) identify key assumptions of the scientific ‘paradigm’ that shapes clinical communication research and education in cancer care; (ii) show that, as general rules, these do not match patients’ own priorities for communication; and (iii) suggest how the paradigm might change to reflect evidence better and thereby serve patients better.MethodsA critical review, focusing on cancer care. We identified assumptions about patients’ and clinicians’ roles in recent position and policy statements. We examined these in light of research evidence, focusing on inductive research that has not itself been constrained by those assumptions, and considering the institutionalised interests that the assumptions might serve.ResultsThe current paradigm constructs patients simultaneously as needy (requiring clinicians’ explicit emotional support) and robust (seeking information and autonomy in decision making). Evidence indicates, however, that patients generally value clinicians who emphasise expert clinical care rather than counselling, and who lead decision making. In denoting communication as a technical skill, the paradigm constructs clinicians as technicians; however, communication cannot be reduced to technical skills, and teaching clinicians ‘communication skills’ has not clearly benefited patients. The current paradigm is therefore defined by assumptions that that have not arisen from evidence. A paradigm for clinical communication that makes its starting point the roles that mortal illness gives patients and clinicians would emphasise patients’ vulnerability and clinicians’ goal‐directed expertise. Attachment theory provides a knowledge base to inform both research and education.ConclusionsResearchers will need to be alert to political interests that seek to mould patients into ‘consumers’, and to professional interests that seek to add explicit psychological dimensions to clinicians’ roles. New approaches to education will be needed to support clinicians’ curiosity and goal‐directed judgement in applying this knowledge. The test for the new paradigm will be whether the research and education it promotes benefit patients.

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Section: Resultsmentioning

confidence: 99%

Section: Clinicians: Goal-directed Expertsmentioning

confidence: 99%

A new paradigm for clinical communication: critical review of literature in cancer care

Salmon

Young

2016

Med Educ

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“…Egener and Cole-Kelly 13 advocated training practitioners in flexibility in communication. Others propose approaches that are more explicitly holistic and creative, including mindfulness, 15,57 'deep acting' 58,59 or immersing learners in patient narratives or roles. 42,60,61 These approaches point to possible ways to implement the principles we propose.…”

Section: Implications For Teaching and Evaluating Communicationmentioning

confidence: 99%

Creativity in clinical communication: from communication skills to skilled communication

2011

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Medical Education 2011: 45: 217-226 Objectives The view that training in communication skills produces skilled communication is sometimes criticised by those who argue that communication is individual and intuitive. We therefore examine the validity of the concept of communication as a skill and identify alternative principles to underpin future development of this field. Methods We critically examine research evidence about the nature of clinical communication, and draw from theory and evidence concerning education and evaluation, particularly in creative disciplines. Results Skilled communication cannot be fully described using the concept of communication skills. Attempts to do so risk constraining and distorting pedagogical development in communication. Current education practice often masks the difficulties with the concept by introducing subjectivity into the definition and assessment of skills. As all clinical situations differ to some extent, clinical communication is inherently creative. Because it is rarely possible to attribute specific effects to specific elements of communication, communication needs to be taught and evaluated holistically. Conclusions For communication teaching to be pedagogically and clinically valid in supporting the inherent creativity of clinical communication, it will need to draw from education theory and practice that have been developed in explicitly creative disciplines.

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“…4 However, there is little evidence that communication skills teaching in oncology has improved clinical outcomes or patient experiences. 5,6 Moreover, critiques over three decades have challenged the validity of reducing communication to specific skills [7][8][9][10][11] and have warned that learning and performing skills might even be inimical to authentic caring. 10,12,13 Unsurprisingly, therefore, a significant minority of cancer doctors are sceptical of communication teaching in its current form.…”

Section: Introductionmentioning

confidence: 99%

How do surgeons think they learn about communication? A qualitative study

et al. 2015

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These surgeons' understanding of communication is consistent with recent suggestions that communication education: (i) should place practitioners' goals at its centre, and (ii) might be enhanced by approaches that support 'mindful' practice. By contrast, surgeons' understanding diverged markedly from the current emphasis on 'communication skills'. Research that explores practitioners' perspectives might help educators to design communication curricula that engage practitioners by seeking to enhance their own ways of learning about communication.

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Is communication a skill? Communication behaviors and being-in-relation

Abstract: ¿Es la comunicación una habilidad? Las habilidades comunicativas para mantener una buena relación Is communication a skill? Communication behaviors and being-inrelation

Cited by 53 publications

References 10 publications

A new paradigm for clinical communication: critical review of literature in cancer care

A new paradigm for clinical communication: critical review of literature in cancer care

Creativity in clinical communication: from communication skills to skilled communication

How do surgeons think they learn about communication? A qualitative study

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