Higher education: acquiring people skills

I sometimes wonder why senior medical practitioners are called ‘consultants’. Indeed you could ask why a visit to such an expert is described as a ‘consultation’. It certainly won’t involve the patient very much in expressing a view. From the consultant’s perspective the ‘consultation’ will consist of (usually) him telling you what is the matter with your health and then announcing ex cathedra what he is going to do about it. Your assessment of the merits of what he proposes is neither here nor there. Even your follow-up questions may be seen as something of an assault on the consultant’s professional integrity. So, however a medical consultant may approach his professional role, one suspects that his impact on the patient’s state of mind and mood is not often at or near the top of the agenda.

So are medical students not encouraged to think of their professional role in terms that involve the human dimension? Well, in one American college this is now being addressed. At the new Virginia Tech Carilion medical school student applicants have to show that they have ‘the social skills to navigate a health care system in which good communication has become critical.’ What the medical school is looking for is the potential for a ‘pleasant bedside manner and an attentive ear’, as well as good communication skills that would work between doctors.

This sounds like a good idea, and if others follow suit it may be that over time consultants will show greater people skills and sensitivity. But it is arguable that people skills and good communication would help in other subject areas also. Law would be an obvious example – a profession in which senior barristers can actually beat medical consultants in terms of arrogance and insensitivity. It is important that a university education does not prompt graduates to consider themselves to be socially superior. It is time to do something about the human dimension in the professions whose members we educate.

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17 Comments on “Higher education: acquiring people skills”

  1. Alan Fekete Says:

    I think people skills should be an outcome from any education that leads to a profession. For example, I teach in computing/IT. In Australia, any degree in this field needs to cover communication skills (writing reports, giving presentations, listening to clients), working effectively in teams, working respectfully with clients, etc. Covering these means giving students explicit instruction, plenty of practice, and there must be a substantial weight in assessment in some compulsory modules. The accreditation process checks this aspect of the curriculum very carefully.

  2. anna notaro Says:

    Wondering whether the term ‘consultant’ in this context is only used in the English-speaking world, in Italian for example one would refer to such doctors simply as ‘specialists’, given that they spend 3-4 years specializing in a certain field of medicine on top of the basic 6 years. The attitude you describe is of course common no matter the nationality/culture so there must be more to it than that, my take is that doctors’ training is exemplary of the Cartesian split (body/mind) so influential on our Western thought, in other words a doctor’s preoccupation is with the body and not with the patient’s state of mind, I doubt that empathy could ever be thought but certainly some communication skills can and maybe this connects with the previous post arguing the need for General Studies common to all university students. It would be another sign of civilization if real doctors would behave a bit more like fictional ones, take the ones in M*A*S*H for example (http://en.wikipedia.org/wiki/M*A*S*H_(TV_series)) and, since we are at it, would also be possible to teach them to hand-write in a decipherable manner?

  3. Eddie Says:

    “At the new Virginia Tech Carilion medical school student applicants have to show that they have ‘the social skills to navigate a health care system in which good communication has become critical.’ What the medical school is looking for is the potential for a ‘pleasant bedside manner and an attentive ear’, as well as good communication skills that would work between doctors”

    This is nothing new, as since the last 5 years or so, most Russell Group medical schools in England, and particularly in London, have rigorous interviews to look for these qualities in the applicants. If one reads the British Medical Journal, one will find these qualities have been articulated since the last few years. In medical conferences too these are highlighted.

  4. Eddie Says:

    Just an addition: “I sometimes wonder why senior medical practitioners are called ‘consultants’”

    This goes back to the history of the NHS and the history primary healthcare in Britain. The general practitioner is the port of first call for patients in Britain and the practitioner when confronted with a patient’s problem consults a specialist for that problem by referring the patient to him/her and hence the title consultant.

    The Britsih Medical Association (BMA) extracted the promise from Bevan the health secretary in postwar Atlee government, that they would agree to the establishment of the NHS, only if their members, the general practitioners become gate keepers between the patient and a medical specialist, and that the latter is only available to “consult” when requested by the general practitioner. In effect a general practitioner can veto a consultation even if the patient requests by not giving a referral letter.

  5. Don Says:

    Ferdinand’s penultimate line ‘It is important that a university education does not prompt graduates to consider themselves to be socially superior.’ is the giveaway. Having worked in a university (Irish) for over 30 years there is a palpable sense that university educators, that is, academics, particularly senior academics, do, in fact, consider themselves superior, socially, materially and morally to others. It is therefore inevitable that this sense of superiority will rub off on a good proportion of graduates, to the detriment of society, particularly those graduates in the historic professions of medicine, the law and the church – just look around….The apple doesn’t fall far from the tree…

  6. revd rob Says:

    It is the rare consultant that embraces all of the skill sets that are required when dealing with patients. As you have already outlined in your blog that good communication skills and people sensitivity is just not isolated to consultants,but I would also include academics, management, church hierarchy, etc. It all stems from the ego, that part of us that feels that we should be more and is superior to others. Those who have achieved to influential positions are even more ego driven than most and therefore their sense of self is reinforced by the position that they occupy. The reality is that they have identified with their role and have lost their true sense of who they really are. While the ego is important in the early stages of life it certainly causes huge problems when we come to the second half of life. Just imagine the transformational change on society if people could recognise where they are acting from!
    Might I add the writer of this blog is one of the rare individuals who has a strong sense of self.

  7. A consultant is someone you consult, not someone who consults you.

    It had been suggested recently that medical students be selected on the basis of aptitude with particular emphasis on “bedside manner” but to paraphrase one response to this, If I had to choose between a doctor with a good bedside manner or an intelligent informed one, I know which one I’d choose.

    The trouble with our points system in Ireland is that we get doctors who can remember lots of things but whose intelligence I doubt. Many still rely on their own opinions instead of practicing “evidence based medicine”.

  8. ObsessiveMathsFreak Says:

    I don’t require may doctors to be polite, well dressed, or well spoken; I require them to be well trained.

    • anna notaro Says:

      that was not the point, what is advocated here is a change of attitude on the part of the medical profession in particular, but not just, so that the patient is considered ‘holistically’, as a whole, mind and body, not least because the state of mind has an impact on the success of the therapy…

  9. Al Says:

    Tis a hard mould to replicate….
    What if the Leaving Cert had a 50% oral for all subjects, with presentation, dialogue and the ability to summarise the event.

    I have a project module at present, where there are serious marks for the project presentation at the end, and within that at the end of their presentation they are challenged and asked to take on board criticisms/ observations and try to restate their project thesis accomodating the external input.

  10. Wendymr Says:

    Medical schools in Canada, beginning with McMaster University, have started to pay attention to prospective students’ soft skills, including their ability to communicate with patients and understand cultural issues as part of their practice.

    The use of Multiple Mini Interviews is now becoming common as part of student selection. At McMaster, the MMI score forms 70% of the criteria to advance to full selection review.

    This Wikipedia page gives a fuller account of the development and spread of MMI as part of medical student selection in Canada, and indicates that the methodology is spreading to the selection processes in other health-related fields.

    • Al Says:

      There is a point to be made here in that Institutions are looking for these skills to be already present or in development…
      Is that an implicit admission that they cant be taught or are hard to teach???

      • Wendymr Says:

        My personal opinion – as someone working in career development, and who has been involved in hiring people for this field – is that the skills, if not already present, can’t be taught to the necessary extent. They’re more innate personal qualities than learned skills. Consider this: can you teach empathy, if someone doesn’t already possess it to any extent?

        Communication skills can be enhanced; students can learn about the difference between active and passive listening, and understand what demonstrates qualities of genuineness in the service provider to the patient or client. They can learn about different forms of questioning, and about body language; but without the underlying qualities of respect, empathy and compassion the student is unlikely to excel in these soft skills.

      • Wendymr Says:

        Sorry for the second post, but I had meant to add that something a hiring manager at another agency said to me once, and that I have never forgotten, is that he hires for these soft skills, not for the vocational qualifications. His exact words were ‘I can teach the skills for the job in six weeks. I can’t teach empathy.’

        • Al Says:

          I dont think that alot of skills can be taught, but they can be demonstrated, as long as those that teach or manage can demonstrate that which they preach and preach what they should preach then then this is the best case scenario.
          I would be wary of a rush to soft skills bias as such a meritocracy would attract socio/physco/ use your own derogative term….

          • Wendymr Says:

            I think the point is rather that these soft skills must exist along with the other criteria which were previously considered the only ones that mattered for selection. The link I gave from McMaster doesn’t say that the use of MMI determines entry into medical school, just that 70% of the score used to determine whether the candidate gets to the next stage of the entry process comes from the MMIs.

            And if you read more of the detail around the MMIs, you’ll see that it’s not only the soft skills that are being tested. It’s just that the innovation here is that these are now part of the equation.

            (Rather belatedly, I read the article Ferdinand linked to and saw that it refers to the MMI process, which has spread to US universities. However, it all started with McMaster University some years ago, which has now formed a consultancy company to market the MMI process around the world – so in Canada this approach to medical student selection is not new).

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