Table 4.
Content of curriculum by specialties
| Communication skill | Specialty | ||||
|---|---|---|---|---|---|
| Internal Medicine | Family Medicine | Surgery | Oncology | Others (including Radiology, Obstetrics & Gynaecology, Paediatrics, Anaesthesia, Accident & Emergency, Trauma) | |
| 1. Create and sustain a therapeutic relationship with patients and families | |||||
| a. Structuring the consultation | |||||
| Opening the discussion by setting the agenda and expectations | [126] | [22] | [16, 160–162] | ||
| Utilising simple, clear language and effective questioning skills to gather information | [37, 126] | [119] | [114] | [17, 102, 131, 161, 163, 164] | |
| Sharing information effectively | [165] | [131, 161] | |||
| Checking patient understanding | [165, 166] | ||||
| Shared decision making | [103, 126] | [165, 167] | [129, 149] | [160, 162] | |
| Providing closure to consult | [126] | [161, 162] | |||
| Summarising | [22] | ||||
| b. Building the physician-patient relationship | |||||
| Making patient/patient’s family feel at ease | [153, 168, 169] | ||||
| Showing empathy | [37] | [166, 167] | [36, 111] | [114, 152] | [102, 138, 153, 164, 170, 171] |
| Showing respect | [103] | [102, 104] | |||
| Convey understanding of concerns | [153] | ||||
| Understanding the patient’s perspective | [126, 172] | [134, 165, 166] | [102, 153, 162, 164, 169, 171] | ||
| Eliciting patient’s wishes, needs, concerns and expectations | [172] | [173] | [16, 163, 170] | ||
| Identifying patient’s health literacy levels | [174] | ||||
| Motivational interviewing and counselling | [37] | [140, 165, 174, 175] | [116] | [176] | |
| Employing verbal and non-verbal skills | [22, 134] | [173] | [138, 163, 164] | ||
| Listening skills | [17, 102, 138, 147, 163, 164, 171] | ||||
| Non-judgmental communication | [147] | ||||
| Managing patients’ emotions | [11, 177] | [22] | [3, 118, 129, 173] | [17, 138, 160] | |
| Culturally and linguistically appropriate communication | [99] | [140] | [152] | [102, 147, 163, 171] | |
| How to interact when patient’s relatives are present | [118] | ||||
| How to communicate with patient indirectly through interpreters or over telephone consultations | [175] | [36] | [34] | ||
| Communication with adolescents | [34] | ||||
| Communicating with 'difficult' patients or family members or emotional patients | [146, 151] | [175] | [111, 146] | [114] | [34, 146, 162, 163] |
| Handling family conflict | [153] | ||||
| Dealing with mismatched expectations | [16] | ||||
| Conducting family discussions | [178] | [178] | [149] | ||
| Communication clarity | [163] | ||||
| c. Context-specific skills | |||||
| i. End-of-life communication | |||||
| Using the word ‘dying’ | [125] | ||||
| Conducting goals of care and advance care planning conversations | [177, 179, 180] | [181] | [16, 92, 124, 171] | ||
| Discussing pain management | [180] | ||||
| Eliciting Do Not Resuscitate orders | [182] | [109] | |||
| Responding to euthanasia requests | [16] | ||||
| Sharing prognostic information with patients | [107] | [114, 129] | [16, 105] | ||
| Preparing for death | [129] | [16] | |||
| Managing patient’s reactions | [177] | [139] | [183] | ||
| Maintaining patient's welfare | [183] | ||||
| Supporting patient’s decision | [179] | ||||
| Offering organ donation | [92] | ||||
| Pronouncing death | [5] | ||||
| ii. Difficult conversations with seriously ill patients | |||||
| Explaining a patient’s worsening condition | [153] | ||||
| Explaining that treatments are not indicated | [36] | [153] | |||
| Discussing whether to forego life-sustaining treatment | [124] | ||||
| Transitioning to palliative care | [36] | [3, 114, 149] | [133, 153] | ||
| iii. Other contexts | |||||
| Breaking bad news | [11, 146, 151, 178] | [130, 175, 178] | [12, 32, 36, 119, 127, 146, 186] | [3, 114, 115, 118, 129, 139, 149, 152, 173, 187] | [6, 7, 108, 113, 124, 131, 133, 141, 146, 153, 162, 163, 170, 185, 188] |
| Disclosure of medical complications | [32, 137] | [6] | |||
| Navigating situations with ethical issues | [131] | ||||
| Disclosure of medical errors and apology | [99, 151, 189] | [36, 127] | [92] | ||
| Discussing risks/benefits of procedures and obtaining informed consent | [146, 151] | [165] | [119, 146, 186] | [6, 146, 170] | |
| New medication and discharge counselling | [99] | ||||
| 2. Work effectively as a member or leader of a health care team | |||||
| Managing disagreements between colleagues | [111] | ||||
| Working with ‘difficult’ colleagues | [163] | ||||
| Oral presentations and giving feedback | [191] | [7, 190] | |||
| Leadership skills | [36] | [153] | |||
| Interprofessional communication | [99, 192, 193] | [111] | [191] | [7, 190] | |
| Writing skills, especially for documentation | [194] | ||||
| Persuasive communication | [176] | ||||
| Reporting findings in a letter to the general practitioner | [169] | ||||