Supporting healthcare conversations with people with communication difficulties: a mixed-methods evaluation of a teaching programme for student doctors

Introduction: Communication difficulties can be experienced by up to one in five people across their lifespan, and future doctors must feel empowered to support these patients in their healthcare conversations. Evidence suggests that teaching healthcare professionals how to support PwCD can be effective, yet current UK medical curricula do not routinely include such teaching. This study investigated whether teaching delivered to third-year medical students improved knowledge, skills, and confidence in communicating with patients with communication difficulties (PwCD).
Methods: This mixed-methods study utilised semi-structured interviews to identify PwCD priorities in healthcare conversations, which were analysed using Content Analysis and then incorporated into a teaching package delivered to medical students. The teaching package comprised two sessions delivered to third-year medical students, covering communication difficulties, the impact on healthcare of CD, and introducing students to strategies to support PwCD understanding and expression. The teaching was evaluated using a repeated-measures, within- and between-group design. Student participants provided self-ratings of knowledge and confidence, and PwCD and Expert Assessors provided ratings of student skill in conversation.
Results: Interviews identified a range of positive and negative experiences, demonstrating the importance of good communication for patient experience. Student participant data showed statistically significant increases on all measures of knowledge and confidence. PwCD data suggested a significant increase in students’ communication skills overall, but no increase in specific skills. Expert Assessor results did not suggest any objectively-measured significant increase in skills.
Conclusions: The study demonstrated that teaching may lead to increased student knowledge and confidence in working with PwCD. No objective increase in specific skills was found; a longer timescale and more experiential opportunities are recommended. The study potentially supports existing literature and calls for such teaching to be included in pre-qualification clinical training, across a longer period of time, with on-going support for healthcare professionals’ skills in practice.