Med school grant will expand training in doctor-patient communication skills The Department of Family and Community Medicine at the UND School of Medicine and Health Sciences will receive $445,000 over three years from the U.S. Department of Health and Human Services, Health Resources and Services Administration, Bureau of Health Professions, Division of Primary Care, to strengthen the communication skills of medical students. Rosanne McBride, a clinical psychologist in the department and co-director of Clinical Sciences Education for the first-year curriculum, is the principal investigator of this project. This grant will help students understand the behavioral, emotional and social factors that affect health as well as how to manage these factors by strengthening students’ ability to communicate effectively with their patients. “This training fits well with the direction of national health care reform,” said McBride. “To a great extent, our health care system has been problem-focused—addressing health issues only after they have become problematic. Growing trends for the future are placing a greater emphasis on preventing disease and promoting wellness and the things people can do to stay healthy.” Medical advances now allow people with serious illnesses like heart disease and cancer to live longer, so physicians also need to be better trained to help patients adopt lifestyles that result in better disease management, improved quality of life, and decreased mortality. This can range from helping patients decrease tobacco use to identifying and treating depression, a factor that can often interfere with maintaining a healthy lifestyle. “To be effective in these activities, doctors need to improve their face-to-face communication with patients, so doctor and patient can work as partners to manage each patient’s unique health concerns and ways of staying healthy,” said McBride. The grant will extend and strengthen the medical school’s existing communication skills training program. “Learning to communicate effectively with patients is a skill, much like driving a car,” said McBride. “You can’t learn it from just hearing a lecture or reading a book—you actually have to practice the skill to become good at it.” For communication skills, this means being able to practice interacting with patients—actual “hands-on” practice. Students in training frequently practice using “standardized patients” or actors trained to behave as patients with specific health concerns such as diabetes or depression. This state-of-the-art communication skills training requires considerable investment of resources up front to recruit, train, and compensate standardized patients and expand faculty supervision of student experiences. This up-front investment is well worth it because it can significantly lower health care costs down the road. Namely, better doctor–patient communication plays a large role in improving health outcomes and chronic disease management, improving patient satisfaction and quality of life, maintaining wellness and preventing health problems, decreasing medical errors, and decreasing malpractice liability. The UND medical school is consistently among the top medical schools in the country for producing family practice physicians, according to rankings released by the American Academy of Family Physicians, and 40 percent to 45 percent of our graduates enter primary care specialties. Good communication is important for doctors in primary care specialties like family medicine, general internal medicine and pediatrics because they manage a broad range of patient concerns over time, including mental health concerns like depression or anxiety as well as prevention and management of chronic disease. In North Dakota, 81 percent of the state is designated by the federal government as a primary care health professions shortage area, and 90 percent of the state is designated as a mental health professions shortage area. The UND medical school places a high degree of importance on preparing students for entry into primary care to encourage future practice in North Dakota’s health care shortage areas. As the focus of healthcare changes, arming students with good communication skills is a crucial aspect of preparation for both primary care and all medical specialties. -- Denis F. MacLeod, Communications Coordinator, Center for Rural Health, dmacleod@medicine.nodak.edu, 777-3300