Communication skills teaching in Brazilian medical schools: What lessons can be learned?

Communication Apprehension Among Health Professions Students in Brazil

Objective. To determine the levels of communication apprehension experienced by health professions students in Brazil.Method. A cross-sectional study of dentistry, pharmacy, medicine, and nursing students at a Brazilian university was conducted from December 2019 to May 2020. The students were invited to complete the Personal Report of Communication Apprehension (PRCA-24) and provide demographic data. Univariate and bivariate analyses were conducted.Results. A total of 644 health students answered the survey, and 25.5% were classified as having high communication apprehension. Male participants had significantly lower PRCA-24 scores than female participants. No significant differences were found between PRCA-24 scores by age category or academic year. Medical students had significantly lower mean PRCA-24 scores than pharmacy students.Conclusion. The prevalence of communication apprehension was high among health professions students. Women and pharmacy students had the highest communication apprehension scores. Health educators should consider the effects of communication apprehension on students and use adequate interventions during communication skills training to alleviate this apprehension.

Evidence of validity for a Health Teaching Skills Scale

Abstract There are few studies found in the literature that analyze the university professor duties, specifically in the area of health. The purpose of this article was to describe the construction of a scale to evaluate the importance of health teaching skills and to seek evidence of validity using factorial (exploratory and confirmatory) analyzes based on the internal structure. The sample was composed by university students of Nursing and Medical courses (n = 315). The results indicated the presence of 4 factors that remained in the model after performing the confirmatory factorial analysis, which are: use of information and communication technologies in teaching (13 items, α = 0,87); Teaching in practical health scenarios (10 items, α = 0,81); Interpersonal relationship (6 items, α = 0,89); and Didactics (5 items; α = 0,63). We concluded that the instrument has initial evidence of validity and may be applicable in studies to diagnose the learning needs of university professors.

Habilidades de comunicação clínica dos preceptores de medicina de família e comunidade em Florianópolis, Santa Catarina, Brasil

Objetivo: Este estudo investigou a autoavaliação dos preceptores (versão resumida do Guia Observacional Calgary-Cambridge) sobre quanto aplicam e ensinam HCC, bem como sobre oportunidades de ensino e qualidade do feedback. Métodos: Realizou-se um estudo transversal com 44 preceptores ativos do internato e da residência de medicina de família e comunidade de Florianópolis, Santa Catarina, Brasil. Resultados: Os preceptores se autoavaliaram positivamente em relação à aplicação e ao ensino de HCC, mas as oportunidades de ensino de HCC são escassas e a qualidade do feedback é mediana. Conclusão: É preciso melhorar a estrutura física e a educação permanente sobre feedback e métodos de ensino, incluindo videogravação de consulta, para ampliar as oportunidades de ensino de HCC.

Importância das habilidades de ensino em saúde atribuída por estudantes e professores universitários

Resumo O artigo teve como objetivo analisar a importância atribuída às habilidades de ensino em saúde por estudantes e docentes universitários dos cursos de Enfermagem e Medicina. Os dados foram coletados em 2017 com base na aplicação de duas escalas de habilidades de ensino em saúde a 315 estudantes e 80 docentes. Foram analisadas, por meio de testes não paramétricos, diferenças entre grupos de estudantes (tipo de curso, de instituição e faixa etária) e de professores (tipo de curso, de instituição, tempo de atuação e tipo de prática docente). Os resultados indicaram elevada importância das habilidades de ensino em saúde tanto para professores quanto para estudantes universitários. Foram observadas, também, diferenças significativas entre estudantes dos cursos de Enfermagem e Medicina, de instituições públicas e privadas, assim como de professores com tempos de atuação e práticas docentes distintas. Esse resultado incentiva a realização de pesquisas que avaliem as habilidades de ensino em saúde adotadas em cursos universitários, pois contribuem diretamente para o desenvolvimento de ações de formação docente.

Cross-cultural adaptation of the Four Habits Coding Scheme (4HCS) for teaching and assessing patient-centered communication skills in Brazil

Brazilian educational guidelines reinforce patient-centered care communication skills as an important competence for medical students. The Four Habits Coding Scheme (4HCS) is an instrument used for teaching and assessing clinicians' communication skills in a person-centered care approach. We aimed to translate and culturally adapt the 4HCS into Brazilian Portuguese. The translation process was accomplished in seven stages: initial translation, reconciliation, back translation, review by the author, independent review, consensus version through Delphi technique, review by a language coordinator, and pretest. During pretest, three independent observers assessed four medical consultations, which were performed by medical students and residents, that had been recorded in a real healthcare scenario. Reviewers had difficulty in reaching consensus on expressions referring to understanding the person as a whole, such as "Engage in small talk", "Expansion of concerns", "Elicit full agenda", "Use patient's frame of reference", and "Explore plan acceptability". They also had difficulty in reaching consensus on the translation of the word "clinician", which was first translated as "physician". Historical and cultural issues in the physician-patient relationship may have influenced this result. The Brazilian 4HCS is a culturally, conceptually, semantically and operationally sound instrument. It may represent an important advance for strengthening the person-centered care model in Brazil.