Communication: "Communication is the process by which information and feelings are shared by people through an exchange of verbal and non-verbal messages".

The idea that doctors routinely learn communication through experience or that doctors are inherently either good or bad communicators is being largely abandoned. It is now widely believed that such skills can be taught to both students and doctors

The Importance & Benefits of Effective Communication Skills in Medical Practice: 1. Effective communication skills (ECS) is an integral part of diagnosis. 2. (ECS) enhances patient compliance to treatment plan. 3. (ECS) contributes to patient satisfaction. 4. (ECS) contributes to physician’s satisfaction, clinical competence and self assurance. 5. (ECS) may contribute to cost and resource effectiveness. 6. (ECS) contributes to a better health outcomes. 7. (ECS) training can give rise to institutional gains. 8. (ECS) contributes to the decrease of medical malpractice claims.

The rationale for investment in communication skills training: 1. Communication skills training is a small investment with great potential gain:. 2. The feasibility of CST has been widely demonstrated: 3. Communication skills training has been shown to improve doctor’s CS: 4. Good communication is good for patients, good for doctors and good for the health service.

The most useful varieties of learning methods in CS: 1. Interactive lectures: 2. Written materials: 3. Videotapes: 4. Experiential learning (practical) :Which includes: - Modeling: such as -Tutor models: -Clinician models: -Video film models: - Role play: - Simulated patients:

LEVELS OF MEDICAL COMMUNICATION I- COMMUNICATION ON AN EMOTIONAL PLANE. II- COMMUNICATION ON A CULTURAL PLANE. III- COMMUNICATION ON AN INTELLECTUAL PLANE.

ASSUMPTIONS AND EVIDENCE BASE -Effective clinician-patient communication results in numerous significant benefits. -Communication is one of the core clinical skills, and developing it to a professional level of competence is as important as developing competence regarding cognitive knowledge, physical examination, and problem solving. -Communication is a series of learned skills which can be taught; it is not just a personality trait or a single global ability.

ASSUMPTIONS AND EVIDENCE BASE -Experience alone can be a poor teacher of CS. That is, without guidance and assessment, experience tends to reinforce communication styles and habits regardless of whether they are good or bad. -Changes resulting from communication training can be retained. - the most important factors patients look for when selecting a doctor is whether their physician "communicates well" and demonstrates a "caring attitude." Where a doctor is trained and how long they have been in practice are far less important, according to the survey respondents (AAMC,1999).

CURRICULUM CONTENT I- CORE COMMUNICATION SKILLS: These are mostly derived from the Comprehensive Clinical Method (CCM) which is used at Dalhousie University 1. Doctor-Patient Interpersonal skills. 2. Information Gathering Skills. 3. Information Giving Skills.

CURRICULUM CONTENT II- ADVANCED (SPECIFIC) COMMUNICATION SKILLS. 1. Skills for Motivating Patient Adherence to Treatment Plans. 2. Protocol for Breaking Bad News. 3. Dealing with Angry Patient. 4. The Very Short Contact. 5. Disclosing Medical errors and side effect of treatment. 6. Special Medical Situation: such as A- Special groups of population. B- Special groups of disorders. C. Special personality problems. D. Special clinical situations.