Clinical Communication Skills

ISBN : 9780199550463

Peter Washer
174 Pages
189 x 245 mm
Pub date
Apr 2009
Oxford Core Texts
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  • Practical focus provides immediate benefit to readers.
  • This textbook on communication skills makes appropriately dynamic use of multi-media resources, consisting of 11 podcasts with real patients and doctors. This is the first such companion website in the clinical skills literature.
  • Discussion and theory is illustrated by extracts from podcast interviews, and by the inclusion of sample forms of written communication in medicine, including referral letters and case notes.
  • The book deals with communicating with colleagues as well as communicating with patients, including a particularly useful chapter on presenting patients, which some students find to be an intimidating experience.

Clinical communication has been formally taught to medical students in the first few years of their course for several years, but it is only in relatively recent times that clinical communication has become routinely assessed. Increasingly, students recognise the fact that their 'general' communication skills do not automatically translate into effective clinical communication. 

This textbook reflects the shifts described above and presents the medical student with a compelling resource in a field which has come of age. Clinical Communication Skills is designed to be the first textbook of choice for lecturers and students alike, for early use in the medical degree. The book recognises that this subject is often taught in parallel with Clinical Skills, and makes appropriate links. 

The book is unapologetically practical in its remit - it aims to equip students to deal with all kinds of clinical encounters, and to optimise the ways in which they communicate with patients and colleagues. Coverage features written communication, and also includes presenting patients to colleagues. Importantly, the book draws on patient and service-user involvement as well as a range of professional views. Readers can listen to these original interviews which are available as podcasts on the book's Online Resource Centre. Extracts from these interviews are woven into the text of the book, and are designed in a second colour for ease of reference. Similarly, sample conversational script is printed in colour so that students can easily scan for examples of positive communication. However, a pragmatic approach is taken; coverage of what to do when things go wrong is also provided. 

Clinical Communication Skills assumes no prior knowledge, but the communication challenges which the book addresses do advance throughout the chapters. The book starts with the basics of why clinical communication is taught, the process of the medical interview, and taking a medical history. The middle section of the book covers how to talk with other professionals, to a diverse range of patients, to children and young people, and to people with mental health problems. The final section of the book covers information-giving skills which have become more prominent across medicine, including managing uncertainty, explaining risk, patient safety, dealing with complaints and breaking bad news. The material is written to apply to a range of settings, not limiting itself to general practice. 

The advice provided in the book is informed by, and acknowledges key theories and frameworks. Indeed, the Editor completed a thorough literature review to underpin the writing of the book, and links to much of this research are provided on the book's online resource centre. In terms of comprehensiveness, this text spans the undergraduate clinical communication curriculum and is benchmarked against several international statements on doctor-patient communication, including the UK consensus statement on the content of communication curricula in undergraduate medical communication (von Fragstein et al, 2008). 
Online Resource Centrewww.oxfordtextbooks.co.uk/orc/washer/ 
· 11 podcasts of interviews relaying experiences of clinical communication, supported by full transcripts of the interviews. Each podcast is designed to be c. 5 minutes long, for ease of teaching and learning. All interviewees are real people (not simulated patients or actors). Interviewees include a variety of patients, including children, and an experienced General Practitioner. The audio content is reprised in the book, in the form of selected extracts which illustrate points within individual chapters. Full transcripts of each interview are also hosted on line to facilitate closer study of the material.
· Podcast introduction to the book from the Editor. 


IntroductionPeter Washer

Chapter 1: Why learn communication skills?Peter Washer
1.1: Why do we need to learn about clinical communication?
1.2: How good are doctors at talking with patients?
1.3: The benefits of good communication for doctors
1.4: The benefits of good communication for patients

Chapter 2 - The structure and process of the medical interviewPeter Washer
2.1: Introducing yourself and gaining consent
2.2: Questioning styles
2.3: Empathy and how to demonstrate it
2.4: Structuring, checking understanding and ending the interview

Chapter 3 - How to take a medical historyPeter Washer
3.1: The content of a medical history
3.2: Ways to phrase the questions in non-medical language
3.3: Recognising and responding to cues

Chapter 4 - Writing about patientsPeter Washer
4.1: Best practice in written medical communication
4.2: How to write up a medical history
4.3: Other forms of medical communication

Chapter 5 - Giving presentationsKatherine Woolf, Jayne Kavanagh and Melissa Gardner
5.1: General presentation tips
5.2: How to deal with presentation anxiety
5.3: Giving case presentations

Chapter 6: Talking with other health professionals & patients' familiesPeter Washer
6.1: Learning from the multidisciplinary team
6.2: Working as part of a multidisciplinary team
6.3: Giving and receiving feedback
6.4: Talking with patients' families

Chapter 7 - Talking with disabled peoplePeter Washer
7.1: Different models of disability
7.2: Talking with people with disorders of speech and language
7.3: Talking with people with sensory impairments
7.4: Talking with people with learning disabilities

Chapter 8: Talking with people from other culturesPeter Washer
8.1: Your own cultural background
8.2: The effects of culture on clinical communication
8.3: Strategies for dealing with prejudice and racism
8.4: Patients who have English as an additional language

Chapter 9 - Talking about sex and sexualityPeter Washer
9.1: When might we need to talk about sex and sexuality?
9.2: Doctors' attitudes to sex and sexuality
9.3: Talking with lesbian, gay, bisexual and transgender (LGBT) patients
9.4: When you might need to talk about sex in more detail

Chapter 10 - Talking with children and young peopleCaroline Fertleman & Peter Washer
10.1: Talking with parents
10.2: Talking with pre-school-age children
10.3: Talking with school-age children
10.4: Talking with young people

Chapter 11 - Talking with people with mental health problemsSimon Michaelson and Peter Washer
11.1: Talking with people with mental health problems
11.2: How to take a systematic psychiatric history
11.3: How to assess someone's mental state
11.4: Talking with alcohol and drug users

Chapter 12 - Giving information and managing uncertaintyPeter Washer
12.1: How to explain medical information
12.2: What to say when you don't know the answer
12.3: Different types of medical uncertainties
12.4: Complementary and alternative medicine (CAM)

Chapter 13: Talking about mistakes and dealing with complaintsPeter Washer
13.1: The prevalence of medical errors and accidents (adverse events)
13.2: Promoting patient safety
13.3: Why patients and relatives get angry
13.4: Complaints and litigation

Chapter 14 - Shared decision-making and communicating riskPeter Washer
14.1: Shared decision-making
14.2: Ethics and risk communication
14.3: Tools for facilitating shared decision-making

Chapter 15 - Breaking bad newsJudith Cave
15.1: How to tell patients bad news
15.2: Coping strategies to deal with the aftermath when another professional has broken bad news
15.3: Dealing with your own emotions

Appendix - How to do well in communication skills OSCEsPeter Washer

About the author: 

Edited by Peter Washer, Imperial College London

Judith Cave Consultant Medical Oncologist, Southampton General Hospital, and St Mary's Hospital, Isle of Wight. 

Caroline Fertleman Consultant Paediatrician, Whittington Hospital, London. 

Melissa Gardner Specialty Registrar (General Practice). 

Jayne Kavanagh Lecturer in Medical Education, University College London, and Associate Specialist in Sexual and Reproductive health. 

Simon Michaelson Consultant Psychiatrist, Northwick Park Hospital, London. 

Katharine Woolf Research Associate in Medical Education, University College London.

"Each chapter is well structured and is presented in an easy-to-read manner with extracts from podcasts used to provide an insight into patients and professional perspectives. This works very well and results in a balanced and credible resource for each chapter... All the chapters in this book use a clinical and functional approach to developing communication skills and this is done well." - Nurse Education in Practice

"This is an excellent book for medical students, providing a simple and basic introduction to the complex area of communication in medicine. It starts by clearly explaining the importance of good communication in medicine, and how this can be achieved. It has a wonderful overview on medical history taking, which I would recommend that all first years read before commencing clinical placements. The book then continues to elaborate on the history taking process in different professions and becomes a very useful tool for those taking speciality placements e.g. paediatrics, psychiatry. Caroline Rance, Medical Student, University of Southampton, School of Medicine"

"The strenghts of this book are: comprehensive; writing that is informative AND readable (too rare a combination); a layout that is appealing and navigable; very well-targeted at intended audience; and linked podcasts. It fills a gap and deserves to be immediately installed as the standard text for medical students." - BMA Book Awards Reviewers

"The author has produced a scholarly, readable and above-all useful text. It is very well argued, pitched perfectly for the intended audience and beautifully laid out. It is also very useful for more established practitioners." - Dr Malcolm Thomas, Medical Director, Effective Professional Interactions Ltd

"Skilfully integrates many aspects of communication that are required to become a safe and efficient doctor. This book is an absolute must for medical students to prepare them for the clinical environment and patient interactions." - Alison McEwing, student, Peninsula Medical School

"This invaluable text concisely demonstrates how imperative effective communications skills are and most importantly, manages to expertly outline how clinicians can best improve these skills for the benefit of their everyday practice " - Colin Neil , GP and part-time postgraduate MSc student, University of Warwick

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