Three medical schools:
NYU, University of Massachusetts, and Case Western Reserve, are participating
in an initiative to develop a state of the art, innovative, comprehensive
communication skills curriculum grounded in a set of core competencies
that should be mastered by every graduated physician. This four-year project
(January 1999 - December 2002) is funded by the Josiah Macy, Jr., Foundation.
The project began with a collaborative effort to identify and define the
critical communication skills needed by physicians in the practice of
medicine. These skills are outlined in Our Competency Document that encompass
three domains: communicating with the patient, communicating about the
patient, and communicating about medicine and science. Each school is
encorporating these competencies into a communications curriculum. Other
key elements of the Macy initiative include: faculty development, curriculum
implementation, and evaluation of the education and training intervention.
A Macy Scholars Program in Health Communication will also be initiated.
The Need Identified
Beginning in the late
1960's, a growing body of research and conceptual analysis of physician-patient
ineractions documented the paramount importance of communication in health
care. Improved communication skills in practitioners increases the health
of patients by increasing the effectiveness, efficiency, and cost-effectiveness
of acute, chronic, and preventive health care and enhances the satisfaction
of patients and practitioners.
Because our ability
to communicate is the major medium of practice and advancement of our
field, as well as the basis by which the public judges our profession,
improved communications will advance the field itself in fundamentally
Medical school began
to teach communication skills, typically a six-week course given during
the first or second year. Although in 1988, 35% of schools had such teaching,
and by 1993, 65% had, communication skills during the clinical years were
not addressed and student skills were documented to decline markedly in
the clinical years.
organizations in academic medicine, such as the American Association of
Medical Colleges, and the LCME (the medical school accrediting agency)
have called recently for curriculum development in the area of enhanced
communication. The Macy Initiative will help medical educators at all
levels respond to this need.