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Can you teach bedside manner?

4 November 09 05:53 GMT

VIEWPOINT
Ros Levenson
Lay member of the General Medical Council

One of the most vital skills a doctor can learn is how to deliver difficult or bad news in a clear and sympathetic way.

Ros Levenson, a lay member of the General Medical Council, explains how their training is changing to make sure that all doctors have a good bedside manner.

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Doctors are often there at the most crucial times in our lives such as births, deaths and occasions when close family members or friends may be ill.

We trust they know how to help us and put our faith in their skills, knowledge and abilities.

Yet can their crucial 'bedside manner' help doctors to deliver us with vital information in a way that we can understand and is sympathetic to our needs?

Future doctors

Basic medical knowledge and clinical skills, while fundamentally important, will not be enough on their own.

Medical students must be inspired to learn about medicine in all its aspects to work with patients and become the doctors of the future.

We're all familiar with the idea that a doctor's 'bedside manner' may be as important to the patient as his or her technical competence, possibly even affecting the recovery process.

But perhaps in the past, it was all a bit more hit-and-miss.

We assumed and hoped that young doctors were either inherently good communicators, or they would automatically learn how to communicate (and how not to) from their more experienced colleagues.

While I wouldn't assume that all medical students and junior doctors have the same innate communication skills or compassionate personalities on which to build, I certainly do believe that we can and should provide them with the tools and training to be effective communicators.

Sensitive issues

That is why the new edition of Tomorrow's Doctors, published by the General Medical Council (GMC) is so important.

Tomorrow's Doctors requires medical schools to ensure that their students can communicate effectively - including demonstrating how to break bad news, discuss sensitive issues or plan treatment with vulnerable patients.

Students also need to be taught to work effectively with others, passing on information and handing over care, as well as giving feedback to colleagues.

Tomorrow's doctors will also see students expected to master specific clinical procedures like administering a local anaesthetic before they graduate.

'Hard lessons'

These procedures ensure that students are able to take advantage of advances in medical technology that allows increasingly lifelike training mannequins to be used for clinical procedures, as well as developing skills on real patients with consent and under supervision.

It is important that students are able to communicate effectively with patients in these situations and put them at ease.

Some students may find these hard lessons to learn.

We should certainly expect support to be provided for students who are struggling in these areas.

In rare instances, it may even be necessary to advise students to pursue other courses more suited to their abilities.

We also need to help students to develop their confidence and their communication skills.

Student assistantships, in which students act as assistants to a junior doctor, with defined duties under appropriate supervision, can be very helpful.

And, of course, it is hoped that tomorrow's doctors will continue to improve their bedside manner throughout their careers as they gain experience and listen to what their patients tell them.

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