Interpersonal skills.

Introduction

Interpersonal skills are becoming more and more a necessity in the medical profession. The expectation from health care professionals is beyond just knowledge of the medical facts. To practice medicine effectively, doctors need to develop interpersonal skills in communication, leadership, management, teaching and time management. All of these are vital tools and are becoming increasingly essential subjects in teaching both undergraduate students and postgraduate doctors. However, a degree of self- motivation and personal initiative is needed to develop these skills. In this article, I will give an overview on interpersonal skills and will be follow this by a series of articles, in future issues, dealing with these skills.

Definition

Interpersonal skills are those essential skills involved in dealing with and relating to other people, largely on a one- to-one basis [1].

The Importance of Interpersonal Skills

The General Medical Council in the United Kingdom has set up standards for good medical practice emphasizing that doctors must make the care of their patients their first concern [2]. Keeping up to date, maintaining and improving performance and good clinical care are very important in achieving this goal. However, investing in developing doctors’ interpersonal skills is essential in maintaining good clinical standards and can be rewarding in the long term. Failing to do so may put patients and doctors at risk.

To have a chance of being successful doctor, every interpersonal contact must have an objective and every effort must be made to avoid creating win-lose transactions whenever possible [1].

Good interpersonal skills can lead to:

Less litigation

Creating a friendly environment for patients and staff

Increased productivity of the staff

Effective time management

Improvement in patient care

Development of good reputation for the institute or hospital

High quality of training for employees and trainees

Methods of Assessing Interpersonal Skills

There are many models to assess interpersonal skills either by direct observation, feedback from patients, 360° reviews and videotaped consultation [3].

Direct Observation

Direct observation can be useful to assess patient care, medical knowledge, practice-based learning, interpersonal and communication skills, professionalism, and systems-based practice [4]. The following methods are used:

Mini Clinical Evaluation Exercise (Mini CEX) which is designed to assess the clinical skills, attitudes and behaviors of trainees [5].

Direct Observed Practical Skills (DOPS), which is designed to provide feedback on procedural skills [5].

Objective Structured Clinical Examination (OSCE), which is a performance-based test to measure candidates’ clinical competence.

Feedback

Feedback from patients is essential in providing doctors with better understanding of their interaction with patients as well as highlighting areas where they can improve, which leads to strengthening the patient-doctor relationship. This could be done in outpatient or inpatient settings by using Doctors’ Interpersonal Skills Questionnaire, which could be used immediately after the patient's consultation with a doctor [6]. Asking patients to complete a questionnaire is a good way of finding out what they think of the doctor and his/her practice. Many doctors are often reluctant to choose this kind of review not realizing that it can help to identify their weak areas as patients see it. Patient questionnaires alone or with the peer review can be used to give a 360-degree feedback. On the other hand, verbal feedback from patients is usually difficult, unpredictable and sometimes counterproductive.

360° Review

This method is important in getting feedback from work colleagues [7]. A minimum of seven people are needed to make this exercise a valid and reliable tool. A mixture of colleagues, such as junior and senior doctors, nurses, ward clerks and peers from other organizations, should be involved. It is best to minimize the number of people who are familiar to the reviewer. The wider the range of people, the more useful feedback you will get. This method gives an excellent insight into the work behaviors. It is mostly anonymous feedback; therefore the results are more valid and representative of the experiences of the interaction of doctor with different work colleagues. The majority of doctors will find the 360° review a positive experience although some may have difficulty with the concept of this assessment. However, It is a good method to identify some of the learning needs [8]. It is generally a valid, reliable, fair and feasible tool for assessment.

Videotaped Consultation

Videotaped consultation is a method adopted by the Royal College of General Practitioners in the United Kingdom for direct assessment of general practitioner trainees and doctors [9]. It is a method in which the doctor has to demonstrate and provide evidence of competence. This method is intended to encourage the learning and teaching of communication skills by making it part of a postgraduate exam and clearly defining the competencies required to pass. Reliability has been demonstrated to be satisfactory.

Methods to Develop Interpersonal Skills

As with any human skill, interpersonal skills can be improved through conscious effort [1]. Therefore, the following steps could be adapted to develop interpersonal skills:

The inclusion of these skills in the curriculum of all undergraduate medical schools;

Inclusion in the assessment of an entry to specialty training;

Be part of annual appraisal of doctors in training;

Be used as a part of exit assessment for postgraduate doctors;

Including these skills in the senior doctors appraisal and revalidation process;

Teaching these skills through courses and workshops as part of continuous medical education.

Conclusion

Interpersonal skills are important tools and the medical profession should aim to acquire and develop them. Teaching these skills to undergraduate students and postgraduate doctors is vital. The setting of standards by regulatory bodies must include interpersonal skills and a robust system should be in place to assess these skills for health care professionals. Regular training courses are essential in developing and improving interpersonal skills for all members of the medical profession. If all is in place then greater patient satisfaction will be achieved.