Academic journal article American Journal of Pharmaceutical Education

Teaching Communication Skills to Medical and Pharmacy Students through a Blended Learning Course

Academic journal article American Journal of Pharmaceutical Education

Teaching Communication Skills to Medical and Pharmacy Students through a Blended Learning Course

Article excerpt


Effective communication is paramount to practicing patient-centered care, and cultivating this skill is a vital component in the training of all health care students. Medical and pharmacy school accreditation bodies recognize the importance of this competency in the training of future clinicians as programmatic curricula incorporating the formalized instruction of interpersonal communication skills are mandatory. (1,2) From a physician's perspective, patient-centered care "seeks to focus medical attention on the individual patient's needs and concerns, rather than the doctor's." (3)

This general definition could easily apply to pharmacists and other health professionals as well. The concept of delivering patient-centered care is at the heart of health care reform, and cultivating a clinician-patient relationship is a foundation for its successful deployment. Exemplary communication skills are the ultimate in patient-centeredness, and the emphasis of the course is to truly help students of all disciplines begin to focus on the issues of the patient primarily. Yet, learning to balance clinician-centered aspects (ie, diagnosis, medications) of communication with patient-centered aspects (ie, fears, concerns, expectations) and performing them at a competent level requires instruction and regular practice for the student learner.

Suggested pedagogical methods to teach communication skills are varied and can involve observation (real time or recorded), self-assessment, role-playing, and role modeling. (4) Experiential-based instruction with feedback improves student communication competencies over traditional or instructional-based formats. (5) Yet, few studies have been conducted comparing two or more experiential methods in communication training. One study evaluating standardized patients (SP) and peer role-playing concluded both methods improved self-efficacy and objective structured clinical examination (OSCE) scores, however the role-play technique led to higher empathic responses. (6)

Many training institutions have employed SP interactions for experiential learning. (7-10) This type of interaction is preferred over actual patients because a SP can be a helpful ally in teaching and assessment. (11) However, early learners also need exposure to traditional instructional methods to introduce desirable and effective core communication concepts. One approach to delivery is using a blended learning format whereby students first learn and observe basic communication skills on their own time and follow that with an experiential component. With this approach, students come prepared to practice learned patient-centered communication techniques and receive feedback, which uses the training time more efficiently.

Blended learning, a form of e-learning using electronic media, is defined as "the thoughtful integration of classroom face-to-face learning experiences with online learning experiences." (12) The online component may be classified as either synchronous (eg, videoconferencing, instant messaging, chat) or asynchronous (eg, web-based presentations, lectures ormodules, e-mail, blogs). Advantages of blended learning formats compared to traditional learning formats are that they are valued by self-directed adult learners, help overcome the limitations of meeting time and space, reach a larger number of students, support instructional methods hard to achieve using textbooks, save training costs, produce high student ratings, increase student perceptions of achieving course objectives, and achieve academic results equivalent to strict face-to-face teaching. (13-16)

Blended learning is used in health education to teach a broad scope of subject matter such as acute care, pediatrics, otolaryngology, cardiovascular pharmacotherapy, oral radiology, orthodontics, respiratory care, research ethics, and interprofessional team development. (14, 16-23) There is also "rudimentary" evidence that blended learning strategies can help students improve their clinical competencies. …

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