Biomedical Engineering Reference
In-Depth Information
The Faculty of Health Sciences at Linköping University (Sweden) has
given a course in communications skills training since 1986. It gives medical
students from the fi rst to the fourth academic term the opportunity to meet
patients at a primary health care centre and to practise diagnostic interviews
that focus on both the medical and the psychosocial aspects of the patient's
illness. These interviews are recorded on videotapes and discussed in
small groups together with a general practitioner and a group supervisor.
Supervision groups usually consist of seven students, one general practitioner
who is employed at the respective primary health care centre, and one group
supervisor, often a therapist trained in group or family therapy. The student
belongs to the same group throughout the course.
We followed two groups in Terms 1, 2 and 3 of the medical programme.
The fi rst group consisted of four female and three male students, and a male
group supervisor; as the general practitioners changed during the course,
two male and one female physician were in this group. The second group
consisted of fi ve female and two male students, one group supervisor and
one general practitioner, both females.
The groups held their sessions at two different primary health care centres
in two different Swedish towns. The sessions took place during the course of
an afternoon and started with two students meeting one patient, one student
talking and one videoing the interview. After the student-patient interview,
both students sat in on the patient's regular visit to the general practitioner.
The following group discussions included the collective watching of the
fi lmed student-patient interviews accompanied by comments. Discussions
were videoed.
Ideology and refl exivity
The medical communication taught at the Faculty of Health Sciences at
Linköping University employs a communicative
ideology
that is based on
a biopsychosocial perspective on health and illness and uses the physician's
emotional perceptions of the patient as a diagnostic source. The course plan
formulates educational objectives for each academic term. This involves
confronting the student with increasingly diffi cult interview situations
concerning disease severity and the patient's social background (age, ethnic
group, foreign language). As a theoretical introduction, a topic on the
communication model is read, and there are guidelines for the skills to be
acquired during the course. These guidelines are based on the biopsychosocial
model and ideology and operationalize its assumptions in the doctor-patient
relationship.
A
holistic
perspective on the communication model takes the patient's life
situation as well as his/her psychosocial background and current relationships
into account. The model is viewed in the training programme as presenting a
patient-centred
point of view in contrast to a
disease-centred
or
doctor-centred
one. Physicians using a patient-centred approach to history-taking in the
