Uexküll, Psychosomatische Medizin: Theoretische Modelle und klinische Praxis - mit Zugang zum Elsevier-Portal (German) Paperback – 20 Jun by There is a newer edition of this item: Uexküll, Psychosomatische Medizin.
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Organisation of teaching and assessment entails another hours.
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All in all, the effort for running the SOKO curriculum can be estimated to require hours per year. The financial budget includes the fees for student tutors and simulated patients, producing videos and other material that is needed for teaching and assessment. Video cameras are provided by the learning centre of the medical faculty in Basel.
From the student perspective, the SOKO curriculum consists of 57 teaching hours including lectures and seminars that are integrated in organ-based modules and deal with communication and related issues. All in all, students attend 22 hours of lectures and 35 hours of seminars and small groups.
Assuming that an undergraduate medical programme in Europe includes 5. The modules and courses of the medical curriculum in Basel are evaluated on a cyclic basis [ 26 ]. The SOKO curriculum has not been evaluated in the last years or since implementation of the Bologna-process. However, individual communication skills courses in the second and third Bachelor year have been evaluated by the course organisers themselves.
The session with the expert supervisor was also evaluated very positively. Identifying communication skills more effectively was considered the most positive aspect with the expert supervisor. Students were asked to judge how secure they were in managing specific medical encounters. Items of the questionnaire were related to communication techniques which were trained during the course structuring an interview, dealing with emotions, gathering and sharing information.
Students felt more confident in all seven aspects after the course see table 2 Tab.
Due to data protection, it was not possible to correlate the data with OSCE results. Students were also able to comment on the course. They were asked to name personal goals for the communication skills course. Most frequent goals were to conduct an interview with a patient e. These goals are thus consistent with the educational objectives of the communication skills course. Over the last few years, different educational activities related to communicative and social competencies were integrated into four consecutive years of the medical programme in Basel. Thereby, a longitudinal curriculum was implemented that allows cumulative learning.
Course contents build on each other, are related to other competencies and contents of the medical programme, and are assessed continuously with OSCEs [ 9 ]. Special emphasis was placed on a limited number of specific communication techniques which are trained in simulated and real situations time and time again with a growing level of difficulty.
The selection of the communication techniques is based on two criteria. Within the overall objective of patient-centred communication, the techniques aim to give the patient room and a voice in the conversation. In addition, they aim at helping students gather complete and correct data and share information with the patients. This enables patients to become well-informed partners in the decision-making process. The second criterion is related to the scientific foundation and validation of communication techniques with empirical studies.
For some of the communication techniques, effectiveness has been shown [ 19 ], [ 27 ], [ 28 ], [ 29 ], [ 30 ], [ 31 ]. For other techniques, no evidence has been provided yet. It is the explicit aim for the next years to conduct research studies to evaluate the effectiveness of these communication techniques. To decide which contents and conversational challenges a longitudinal curriculum should address, it is important to consider what kind of competencies and encounters students can train during their undergraduate medical studies.
Some communication challenges may occur for the first time during postgraduate training. Others may only be important for some clinical disciplines so that students might focus on them during their special study modules. A number of consensus statements and catalogues of learning objectives give details and recommendations to answer this question [ 10 ], [ 32 ], [ 33 ], [ 34 ], [ 35 ].
Balint groups have been offered to students in the third Bachelor year and in the first and second Master year on a voluntary basis. However, students showed little interest and scarcely used the voluntary offer. The selection of course content and the amount of hours a longitudinal communication skills curriculum should include are related.
In Basel, approximately one per cent of the total amount of teaching hours during the undergraduate programme seems to be quite low.
However, at the moment, there are no recommendations or data on how many teaching hours a communication skills curriculum should include. Dedicating time to a specific element of medical education will also always be a political question that has to be negotiated in teaching committees or similar bodies.
New competencies, contents or disciplines will always struggle to receive time in an existing educational programme. Even if they are integrated additively with extra hours, logistical issues e. The amount of teaching time for a course therefore results from a combination of content-related considerations and the impact of the negotiation skills of the course leader and his or her fellow campaigners. Who are the significantly involved supporters and fellow campaigners of the SOKO curriculum in Basel?
The major effort of teaching, assessing, and organising the educational activities is borne by the psychosomatic staff which is part of the department of internal medicine. Other engaged clinicians come from very different clinical disciplines including general practitioners and specialised physicians in their own practice, as well as psychotherapists. It remains to be seen, whether this organisational structure is sufficient to sustainably maintain the high quality of the SOKO curriculum.
At the moment, quality is very much dependent on the commitment of individuals, who score OSVE stations, offer Balint groups, and train teachers in their spare time. The future challenge will be to establish and anchor sustainable structures in the faculty and in the university hospital to provide a longitudinal communication skills curriculum not only by a small group of enthusiasts but by the majority of clinical teachers. We would like to thank Dr. Daniel Bauer, researcher at the chair of Medical education at the university hospital in Munich for critically reviewing the manuscript and Claudia Steiner, MA, Psychosomatic Medicine Basel, for her great help in translating the manuscript into English.
The authors declare that they have no competing interests. National Center for Biotechnology Information , U. Published online Aug You are free to copy, distribute and transmit the work, provided the original author and source are credited. This article has been cited by other articles in PMC. Communication skills, longitudinal curriculum, undergraduate medical education, Bologna process.
Background Bologna process in Switzerland Switzerland was one of the first countries to consequently implement the regulations of the Bologna process for all degree programmes of higher education including medical education [ 1 ], [ 2 ]. Bologna-compatible medical education in Basel The Bachelor and Master programme in Basel consists of both a core curriculum and special study modules.
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Organ-based modules of the Basel undergraduate medical programme. Communicative and social competencies in medical education Consensus statements and recent publications call for integrating communication skills training into the clinical context [ 7 ], [ 8 ], [ 9 ], [ 10 ]. Bachelor year 1 In the first year of studies, students are introduced into the basics of clinical communication and into the biopsychosocial model as a complement to the biomedical model.
Bachelor year 2 The second year of studies is dedicated to the training of the above mentioned communication techniques. Bachelor year 3 In the third year of studies, students attend a communication skills course for medical interviewing skills as well as lectures and seminars dealing with sharing information, risk communication, and decision making. Master year 1 Communication skills lectures and seminars in the first master year are dedicated to breaking bad news.
Assessment of communication skills Communication skills are assessed at the summative end-of-year OSCEs together with other clinical skills. Teaching effort and teaching hours per student Teaching effort for all teachers of the SOKO curriculum consists of approximately hours. Evaluation The modules and courses of the medical curriculum in Basel are evaluated on a cyclic basis [ 26 ]. Evaluation of the communication skills course in the Bachelor year 3: Discussion Over the last few years, different educational activities related to communicative and social competencies were integrated into four consecutive years of the medical programme in Basel.
Considerations for the future Who are the significantly involved supporters and fellow campaigners of the SOKO curriculum in Basel? Acknowledgement We would like to thank Dr. Competing interests The authors declare that they have no competing interests. Reforms of the pre-graduate curriculum for medical students: Kaiser HJ, Kiessling C.
Two-cycle curriculum - bachelor-master structure according to the Bologna agreement: Contemporary Issues in Medicine: Medical School Objectives Project. Association of American Medical Colleges; Makoul G, Schofield T. Communication teaching and assessment in medical education: A mainstream activity or just a minority sport? Longitudinales, bologna-kompatibles Modell-Curriculum "Kommunikative und soziale Kompetenzen": Longitudinal and Concentrated Communication Skills Programmes: Two Dutch Medical Schools Compared.
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