Schulung kommunikativer Fähigkeiten als integrativer Bestandteil der universitären Ausbildung von Medizinstudierenden. - Entwicklung, Implementierung und Evaluation eines neuen didaktischen Konzeptes am Beispiel eines Kurses zur ärztlichen Gesprächsführung

Good doctor-patient communication is a skill every physician should master as it plays a very important role in the day-to-day professional life of the doctor. Medical students also believe that when dealing with patients, social competence is a more important precondition of successful practice than practical medical skills. At the same time, this is an area that is badly neglected in medical studies. Social policy makers are demanding that doctors are trained in communication and in conducting patient-physician discussions. However, concepts on how to train communication skills to students are lacking in the curriculum of medical faculties throughout Germany. In particular, there are no such concepts that are based in educational theory and make use of scientific findings relating to adult teaching principles and adult learning. The aim of the present study was therefore to develop a didactically innovative course concept for training communication skills that could be implemented as a component of medical studies. The goal was that the new concept should describe standardized and well- substantiated basic training in conducting patient-physician discussions and taking a medical history. In addition, it should demonstrate how such a concept could be integrated into the curriculum for medical studies at Goethe University Frankfurt am Main. First of all conceptual fundamentals and the basics of learning theory with respect to communication skills training as part of medical education, as well as general fundamentals of higher education didactics, will be demonstrated. In the following, the procedure for developing and implementing a new modular-based course concept for conducting a patient-physician discussion will be described. Taking into account a needs analysis and the existing situation, the new course concept will be presented. In addition to the development of learning targets, content and special teaching materials, the qualification of the teachers will also be described as part of a training program for lecturers. A large part of the study deals with the evaluation and verification of the effectiveness of the new course concept. To do this, the overall concept, as well as the individual modules will be analyzed from the perspective of both students and lecturers. On the basis of the results of this analysis, the course concept will be fine tuned for the first time and presented. The whole process will reveal influencing factors and findings that can be summarized as follows: The innovative approach, both in terms of content and didactic method, as well as the integration of important research findings and conceptual ideas from the education of adults and university didactics into the field of medical education, has proved itself to be very successful. The approach can therefore be recommended for the development and implementation of new course concepts in the field of medicine. It is particularly valuable and important that a needs analysis was carried out at the beginning of the concept development phase. In order to ensure the course remains of high quality over the long-term, it is essential that it is organized centrally and constantly evaluated. The availability of uniform teaching materials also contributes greatly to raising the quality of the course and gaining widespread acceptance, and it is much appreciated by teachers. It has proven practical to combine the materials in the form of a toolbox. The adequate preparation of the course lecturers in the form of an obligatory, full-day training course plays a very important role in the success of the courses. Formative examinations, used to assess the communication skills of the students and to provide feedback on their performance, are considered extremely useful by both students and lecturers. It is recommended that students’ performance is measured by means of an objective evaluation instrument (e.g. FrOCK). The effectiveness with which the results of research relating to university didactics and adult education have been included in the development of the new course concept described in this study, suggests that a similar approach might be taken throughout the whole medical curriculum, or even in the curricula of other faculties. On the one hand, this would mean both examining and possibly improving existing courses from this perspective, and developing new courses in a manner corresponding with the new approach. The need to teach communication skills has been clearly demonstrated using medical studies as an example, and implemented in practice though the development of a new conceptual approach to teaching physician-patient communication. As communication skills play an important role in almost all professions, they should play a fundamental role in education generally. The results of this study can contribute significantly to the development of qualified training courses in these skills for use in other faculties as well.