Listening to patients and responding with care: a model for teaching communication skills.

BACKGROUND: Listening to patients and responding with care requires answering two simple but not so obvious questions: Does the clinician know how to listen? and Does the clinician know how to show patients that he or she cares? The initial task for the clinican is to learn to use listening skills to identify the way in which a patient is most comfortable interacting. Once this is accomplished, the clinician uses this information to move closer to where the pateint is comfortable communicating. MODEL FRAMEWORK: The framework for this model is the continuum of two intersecting axes. The horizontal axis poles are inquisitive and assertive. The vertical axis poles are objective and subjective. People who are most comfortable communicating in an inquisitive way and tend to be objective are called investigators. Those who are most comfortable communicating in an inquisitive way but are subjective in nature are called unifiers. People who are most comfortable communicating in an assertive way and favor subjectivity are called energizers. Those who are most comfortable communicating in an assertive way and tend to be objective are called enterprisers. PUTTING THE MODEL TO WORK: The progression of the typical medical interview, which involves gathering information, making decisions, addressing patient concerns, and discussing long-term outcomes requires the clinician to communicate in all four communication modes. Learning to identify how he or she is most comfortable communicating may help the clinician make a smooth transition from one mode to another.

Do learning style and learning environment affect learning outcome?

This study compared learning outcomes of students with different learning styles, as identified by the Kolb Learning Style Inventory indicators, in a traditional in-class environment with those taking the same course via distance education. The above-average scores were evenly distributed, 47% of the in-class group and 43% of the distance group. For three of the four learning styles, there was no relationship to learning outcome or environment. The Diverger group did show a relationship with above-average scores in the distance group (83%). The findings support that the classroom or distance environment did not influence learning outcome. Learning style did not appear to affect learning outcome in either group, except that the Diverger learning style may have a positive relationship to learning in the distance environment.

The Managed Care Education Clearinghouse.

The authors surveyed all 125 allopathic medical schools to determine the number of schools that had implemented a formal curriculum in managed care and how many had a substantial interest in a Web-based clearinghouse for managed care curricular resources. They describe the results of their survey and the Web site they developed, the Managed Care Education Clearinghouse.