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Project Overview

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.

Background: 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 important ways.

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.

Major leadership 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.

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Macy Initiative on Health Communication
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