Loving communication

[摘要] We have reflected in detail on the articles on communication in January's BJGP,1-3 and have indulged in various emotive responses, mostly mildly despairing — ‘so if we don't do that, what are we meant to do?’, ‘try playing a difficult bass riff without practising the parts’, and ‘helpful — not’. Some reasons for our ‘gut’ reactions were that, as Skelton4 implies, consultation skills teaching and research has a history that leaves its mark — the skill set most espoused, researched, and championed by primary care, which has taken years of marginalised effort (evangelism?) to see its effective penetration into undergraduate and postgraduate programmes. We are also critical of educational naivety in all four contributions: the point of learning microskills in a systematic and reproducible way5 is to unpick the building blocks of expert practice for the purpose of helping novices (think of being taught to put in your first chest drain). Edwards'3 generalised plea for wider patient involvement goes against the skilled use of time when congruence is close and decisions simple. Skelton's examples of poor performance will still need training in the fluid use of multiple microskills, even though the diagnosis and needs of the doctors go broader than that.

[学科分类] 卫生学