Will any of us admit that our communication skills are below par? Could we take a better history? Could we help patients to better understand and participate in their treatment? Will this book, now in its second edition, help practising surgeons to improve their communication skills and hopefully help to avoid complaints and litigation, so many of which stem from misunderstanding?
In the first chapter, ‘Defining what to teach and learn: an overview of the communication skills curriculum’, the style is such that I was not sure if this book was going to be a manual for teachers and organisers of courses or an instruction book for students. Helpfully, in the introduction the authors ask: ‘Who is the intended audience?’ The reply they give includes learners at all levels of education, facilitators and programme directors, medical educators, medical education administrators, funding agencies and medical politicians. In fact, just about everybody and, having read the remaining seven chapters, I agree with them and suggest that there are very few of us who could not benefit from a diligent reading of this book.
A stylistic irritation stems from its joint Canadian and English authorship. The authors try to fend off any criticism in this area with another useful question in the introduction: ‘How have we addressed style issues in a book intended for the European, North American and wider international market?’ Indeed, there is a little glossary to explain, for example, that they use the term ‘specialist’ rather than ‘consultant’ and ‘resident’ rather than ‘registrar’. Nevertheless, in a book concerned with clarity of communication, this is somewhat irksome.
Chapter 1 is about defining what to teach and learn and describes the important Calgary–Cambridge Guide, for which these authors are well known. The next six chapters provide a detailed exposition of the skills of this framework: ‘Initiating the session’, ‘Gathering information’, ‘Providing structure to the interview’, ‘Building a relationship’, ‘Explaining and planning’ and, finally, ‘Closing the session’. There is a final chapter dealing with specific issues, such as breaking bad news and age-related issues. The layout of the chapters is good and clear, and there are useful shaded boxes to summarise some aspects together with boxes which include snippets of patient–doctor dialogue to emphasise particular points.
The authors make much of the fact that this volume is research-based and provide references for many of the points that they make. Chapter 6, ‘Explanation and planning’, is particularly well referenced. In some places, however, they have the slightly irritating habit of saying ‘we know from research…’ and then fail to provide a reference to the relevant work. There is a further reading section and a reference section which includes around 450 entries.
The main effect this book had on me is that now, when I speak to patients, I find myself checking that I have given them enough time to respond and check that they have understood what I have said. In short, I believe that use of the advice in this book cannot help but make you a better doctor.