Teaching Communication in Clinical Clerkships: Models from the Macy Initiative in Health Communications

Kalet, Adina MD, MPH; Pugnaire, Michele P. MD; Cole-Kelly, Kathy MS, MSW; Janicik, Regina MD; Ferrara, Emily MA; Schwartz, Mark D. MD; Lipkin, Mack Jr. MD; Lazare, Aaron MD

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Medical educators have a responsibility to teach students to communicate effectively, yet ways to accomplish this are not well-defined. Sixty-five percent of medical schools teach communication skills, usually in the preclinical years; however, communication skills learned in the preclinical years may decline by graduation. To address these problems the New York University School of Medicine, Case Western Reserve University School of Medicine, and the University of Massachusetts Medical School collaborated to develop, establish, and evaluate a comprehensive communication skills curriculum. This work was funded by the Josiah P. Macy, Jr. Foundation and is therefore referred to as the Macy Initiative in Health Communication. The three schools use a variety of methods to teach third-year students in each school a set of effective clinical communication skills. In a controlled trial this cross-institutional curriculum project proved effective in improving communication skills of third-year students as measured by a comprehensive, multistation, objective structured clinical examination.

In this paper the authors describe the development of this unique, collaborative initiative. Grounded in a three-school consensus on the core skills and critical components of a communication skills curriculum, this article illustrates how each school tailored the curriculum to its own needs. In addition, the authors discuss the lessons learned from conducting this collaborative project, which may provide guidance to others seeking to establish effective cross-disciplinary skills curricula.

Dr. Kalet is associate professor of medicine and master, Walter Reed Society for Health Policy and Public Health; Dr. Janicik is instructor of clinical medicine; Dr. Schwartz is associate professor of medicine, director, General Internal Fellowship Program, and master, Walter Reed Society for Health Policy and Public Health; and Dr. Lipkin is professor of medicine. All are in the Division of Primary Care, Department of Medicine, New York University School of Medicine, New York, New York. Dr. Pugnaire is associate professor and vice dean for undergraduate medical education and Ms. Ferrara is director, Division of Grants and Special Projects and assistant professor of family medicine and community health, both in the Office of Medical Education, University of Massachusetts Medical School, Worcester, Massachusetts. Ms. Cole-Kelly is professor of family medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio. Dr. Lazare is chancellor and dean, University of Massachusetts Medical School. Versions of this paper were presented at the Program in Medical Communications Annual Meeting, Barcelona, Spain, September 2000; the meeting of the Group on Education Affairs of the AAMC, Chicago, Illinois, October 2000; and the Society of General Internal Medicine, Annual Meeting, Boston, Massachusetts, May 2001.

Correspondence and requests for reprints should be addressed to Dr. Kalet, New York University School of Medicine, 550 First Avenue, Old Bellevue, D401B, New York, NY 10016: telephone: (212) 263-1137; fax: (212) 263-8234; e-mail: 〈ak41@nyu.edu〉. For information about the authors, see the end of the article.

For articles on related topics, see pp. 495–507 and 508–510.

© 2004 Association of American Medical Colleges