Biomedical Engineering Reference
In-Depth Information
As almost all doctors run on tight time schedules it has become important
to develop more or less specifi c communicative skills and strategies that
make it possible for doctors to routinize their medical interviews. It must be
possible to perform the medical interview in almost the same way irrespective
of the actual patient, the type of medical problem, the specifi c situation or
context - but also irrespective of the specifi c medical doctor. The medical
interview still has to be performed in a way that lives up to the basic norms
of communication and good doctoring. In other words, the communicative
technology has to be independent of actual persons and their problems and
conditions, and rather be a part of the health care organization.
Communication programme
During the past decade or so we have seen the emergence of more or less
institutionalized educational measures in, for instance, the training of
medical doctors in communicating with patients. Becoming a medical doctor
not only involves learning the traditional biomedical knowledge, but also
learning how to talk and interact with patients, how to evaluate this talk
and how to talk about talk. That is, becoming a doctor also means learning
how to observe, analyse and discuss one's own ways with patients as well
as those of colleagues and students; i.e. learning to implement and use a
communicative ideology. It is a self-refl ective mode that has at least to some
extent become part of the modern medical identity and competence.
This is not a trivial task for students, at least not in an academic setting,
as most medical subjects are embedded in a system of academic medical
specialities that can be mastered mainly by mere cognitive learning. Courses
in medical communication therefore often contain practical elements
that lead to an increased effect on communication skills. Yet, most efforts
to optimize courses in doctor-patient communication focus on creating
effective training modes, e.g. longitudinal versus concentrated instruction
(van Dalen
et al.
2002) and evaluation formats (Humphris and Kaney 2000;
Humphris 2001). The assessment of students' acquired communication skills
is regarded as a powerful motivational learning source.
As the acquisition of
professional
communication competence involves
processes that differ from most traditional academic subjects, the special
diffi culties and requirements of such courses need to be highlighted and
understood. Few studies of this process focus on the wider social context, and
address the wider functions and meanings of doctor-patient communication.
Most studies of communication in medical settings have focused on the ways
doctors and patients talk together, and generally on the social and verbal
interactive patterns and how these are structured by the institutional context.
This is especially true of most studies in the conversation analytic tradition
(see for instance Erickson 1999). Most of these studies do not discuss the
communication processes in terms of technologies and communicative
ideologies.
