Abstract
Aim of the study:The communication skills of students of the Dutch medical schools of Maastricht and Leiden were compared, to assess the effectiveness of these schools' different approaches to communication skills training. Both schools have a six-year undergraduate medical curriculum, divided into four preclinical years and two years of clinical clerkships. The Maastricht problem-based curriculum offers an integrated clinical skills training programme, including communication skills, which runs throughout the first four years. Communication skills training in Leiden is concentrated in courses in the preclinical phase, at the beginning of the clinical phase and preceding two clerkships.
Method:Communication skills of fourth-year and sixth-year students (N = 161) of both universities were assessed using four OSCE stations in which students did entire consultations with standardised patients. Trained observers rated these consultations, using a checklist.
Results:Maastricht students of both year groups obtained significantly higher checklist scores for their communication skills than their Leiden colleagues. The Leiden students' scores increase between years 4 and 6, whereas those of the Maastricht students showed no significant change.
Discussion:The higher scores obtained by the Maastricht students indicate a greater overall effectiveness of a longitudinal, integrated approach compared with concentrated courses. Absence of formal training in the clinical phase in Maastricht leads to stabilisation of communication skills, whereas the increase in the Leiden students' scores between years 4 and 6 offers evidence that formal communication skills training during the clinical phase does pay off. These findings suggest that the preferred approach to communication skills training would be an integrated, longitudinal programme, which continues during the clinical years.
Similar content being viewed by others
References
AAMC (1999). Report III. Contemporary Issues in Medicine: Communication in Medicine. Medical Schools Objectives Project. Washington: Association of American Medical Colleges.
Aspregren, K. (1999). BEME guide no. 2: Teaching and learning communication skills in medicine - a review with quality grading of articles. Med Teach 21: 563–570.
Bishop, J.M., Fleetwood-Walker, P., Wishart, E., Swire, H., Wright, A.D. & Green, I.D. (1981). Competence of medical students in history taking during the clinical course. Med Educ 15: 368–372.
Bowman, F.M., Goldberg, D.P., Millar, T., Gask, L. & McGrath, G. (1992). Improving the skills of established General Practitioners: The long term benefits of group teaching. Med Educ 26: 63–68.
Caroll, J.G. & Monroe, J. (1984). Teaching clinical interviewing in the health professions. A review of empirical research. Ev Health Prof 3: 21–45.
Flaherty, J.A. (1985). Education and evaluation of interpersonal skills. In A.G. Rezler & A. Flaherty (eds.), The Interpersonal Dimension in Medical Education, pp. 101–145. New York: Springer Verlag.
General Medical Council, Educational Committee (1993). Tomorrow's Doctors. London: General Medical Council.
Helfer, R.E. (1970). An objective comparison of the paediatric interviewing skills of freshman and senior students. Pediatrics 45: 623–627.
Holm, U. & Aspregren, K. (1999). Pedagogical methods and affect tolerance in medical students. Med Educ 33: 14–18.
Hoppe, R.B., Farquhar, L.J., Henry, R.C., Stoffelmayr, B.E. & Helfer, M.E. (1988). A course component to teach interviewing skills in informing and motivating patients. J Med Educ 63: 176–180.
Jongbloets, M.W.M., Dolmans, D.H.J.M., Hoogenboom, R.J.I. & Wolfhagen, H.A.P. (2000). Het ritme van de tijdbesteding van de PGO-student [How do PBL-students divide their time between regular coursework and self-directed learning]. Dutch Journal of Medical Education 19: 49–56.
Kraan, H.F. & Crijnen, A. (1987). The Maastricht History Taking and Advice Checklist: Studies of Instrumental Utility [dissertation]. Maastricht: University Press.
Kurtz, S., Silverman, J. & Draper, J. (1998). Teaching and Learning Communication Skills in Medicine. Oxon: Radcliffe Medical Press.
Maguire, P., Fairbairn, S. & Fletcher, C. (1986). Benefits of feedback training in interviewing as students persist. BMJ 292: 1573–1578.
Ong, L.M.L., de Haes, C.J.M., Hoos, A.M. & Lammes, F.B. Doctor patient communication: A review of the literature. Soc Sc in Med 40: 903–918.
Ram, P., van der Vleuten, C.P.M., Rethans, J-J., Grol, R. & Aretz, K. (1999). Assessment of practising family physicians: Comparison of observation in a multiple station examination using standardised patients with observation of consultations in daily practice. Acad Med 74: 62–69.
Riccardi, V.M. & Kurtz, S.M. (1983). Communication and Counselling in Health Care. Springfield, IL: Charles C. Thomas.
Roter, D.L. & Hall, J.A. (1992). Doctors Talking with Patients: Improving Communication in Medicine. London: Auburn House.
Rutter, D.R. & Maguire, P. (1976). History taking for medical students II: Evaluation of a training programme. Lancet 2: 556–560.
Sanson-Fisher, R., Fairbairn, S. & Maguire, P. (1981). Teaching skills in communication to medical students - a critical review of the methodology. Med Educ 15: 33–37.
Silverman, J., Kurtz, S. & Draper, J. (1998). Skills for Communicating with Patients. Oxon: Radcliffe Medical Press.
Studiegids Geneeskunde. Curriculum 1999–2000. Dienst onderwijs-en studentenzaken, Faculteit der Geneeskunde. Rijksuniversiteit Leiden [Study Guide, Faculty of Medicine. University of Leiden].
van Dalen, J., Zuidweg, J. & Collet, J. (1989). The curriculum of communication skills at Maastricht medical school. Med Educ 23: 55–61.
van Dalen, J. & Bartholomeus, P. (1990). Training clinical competence in a Skillslaboratory. In W. Bender, R.J. Hiemstra, A.J.J.A. Scherpbier & R.P. Zwierstra (eds.), Teaching and Assessing Clinical Competence, pp. 135–140. Groningen: BoekWerk Publications.
van Dalen, J. (ed.) (2000). Skillslab, Centre for Training of Skills. Maastricht: University Press.
van Dalen, J., Prince, C.J.A.H., Scherpbier, A.J.J.A. & van der Vleuten, C.P.M. (1998). Evaluating communication skills. Adv Health Sc Educ 3: 187–195.
van der Hurk, M.M., Wolfhagen, H.A.P., Dolmans, D.H.J.M. & van der Vleuten, C.P.M. (1996). Een inventarisatie van de studielast in het preklinische curriculum geneeskunde [Detailing the time students spend in a pre-clinical medical curriculum]. In Th.J. ten Cate, J.H. Dikkers, E. Houtkoop, M.C. Pollemans, J. Pols & J.A. Smal (eds.), Gezond Onderwijs-5 [Proceedings of the 5th Conference of the Dutch Society of Medical Education], pp. 183–189. Houten: Bohn Stafleu Van Loghum.
van der Vleuten, C.P.M., Scherpbier, A.J.J.A., Wijnen, W.H.F.W. & Snellen, H.A.M. (1996). Flexibility in learning: A case-report on problem based learning. Int Higher Educ 2: 17–24.
van Thiel, J., Kraan, H.F. & van der Vleuten, C.P.M. (1991). Reliability and feasibility of measuring medical interviewing skills: The revised Maastricht history taking and advice checklist. Med Educ 2: 224–229.
van Thiel, J., van der Vleuten, C.P.M. & Kraan, H.F. (1992). Assessment of medical interviewing skills: generalisability of scores using successive MAAS-versions. In R. Harden, I. Hart & H. Mulholland (eds.), Approaches to the Assessment of Clinical Competence. Proceedings of the Fifth Ottawa Conference, Centre for medical Education. University of Dundee, Scotland.
Verhoeven, B.H., Verwijnen, G.M., Scherpbier, A.J.J.A., Holdrinet, R.S.G., Oeseburg, B., Bulte, J.A. & van der Vleuten, C.P.M. (1998). An analysis of progress test results of PBL and non-PBL students. Med Teach 20: 310–316.
Wouda, J. & van de Wiel, H.B.M. (1992). Communicatieve vaardigheden: een diagnose en een advies. [Communication skills: A diagnosis and an advice]. Bulletin Medisch Onderwijs 11: 116–118.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
van Dalen, J., Kerkhofs, E., van Knippenberg-van den Berg, B. et al. Longitudinal and Concentrated Communication Skills Programmes: Two Dutch Medical Schools Compared. Adv Health Sci Educ Theory Pract 7, 29–40 (2002). https://doi.org/10.1023/A:1014576900127
Issue Date:
DOI: https://doi.org/10.1023/A:1014576900127