Can doctors really improve communication skills?

Doctor thinking 2Have you ever attended a communication skills course as part of your training? Did you focus on the methods, tools and techniques to use to improve interactions with patients and colleagues?

This week, I’ve been exploring some training ideas with an associate. Cally Hooks has a great deal of experience in both working as and training others for the role of a standardised patient. We were discussing how that approach is often utilised to assess a doctor’s communication skills. Along the way we got into a question which is rather fundamental.

How possible is it for a doctor to improve communication?

You probably know colleagues who take the approach that you either can or you can’t. They may even point to studies which indicate that doctors trained to use communication tools may even perform less well than their untrained peers. Their conclusion is that “the over-use of tools actually stifles natural interaction”. They may well be correct in making that observation.

Now you may well be thinking, “That’s a surprising thing for someone who spends a lot of time training doctors to use communication tools to say.” So let me explain my approach.

Tools are essential for any profession.

A hammer and chisel enabled Michelangelo to create the statue of David. Yet in the hands of the unskilled they may be able to do little more than knock a hole in the wall.  The master sculptor developed exceptional dexterity through understanding both his tools and the stone which he worked with. In the same way, the expert surgeon understands both tools and anatomy; the expert physician both the medications and physiology. We all want the best quality, most appropriate tools at our disposal. When it comes to communication, the same principle applies. We need the best tools for the job plus an understanding of the individuals we want to interact with. Why they are reacting as they are? Why are they may be struggling to follow recommendations? Why they angry/upset/argumentative, and so on. This applies interactions with patients and colleagues alike.

Some healthcare communication tools appear simple, even basic. The WHO surgical checklist contains several examples of this type. Others, including models for breaking bad news, are more obviously complex.  In the hands of the expert, all can have surprisingly beneficial results.  In the hands of the unskilled, the careless, or those who are using them without awareness of the supporting theory they can be, at best, ineffective or a waste of time. At worst, like any other sharp or powerful tool, they have potential to inflict great harm.

OK, so how do you learn and improve?

Expertise results from dedicated practice and stretching experience. To repeat an Oscar Wilde quote from a previous blog, “Experience is simply the name we give to our mistakes“.

The expert communicators we know were not simply born that way. If you ask them – and they are honest with you – they will be able to tell you of the horrible mistakes they have made in their past. Their expertise has developed through identifying the most appropriate tools for the job and learning how to use them. They may have discovered some techniques by themselves and been introduced to others by colleagues, books, online learning or on courses. Just like Michelangelo, they will have developed more than just knowledge of their tools. They have also developed comprehension of ‘what’ they are working with. In communication this is who, rather than what – team members and their patients.

This is why we concentrate on exploring both tools/techniques of communication and the human condition applied to world of healthcare.

Some of the changes we discuss may appear minor, leading to only small improvements. To quote Tom Peters, author of In Search of Excellence, “There’s no such thing as an insignificant improvement”. The proficiency of that expert communicators we know is the culmination of numerous minor improvements. Their proficiency can only be maintained through regular reflection and adjustment.

Your patients and colleagues want you to be the best you can be.

What steps are you taking to unlock your potential and to improve your communication?

By Stephen McGuire – Head of Development