Peer discussion on training physicians to be competent communicators: support for a multiple discourse approach.

To consider medical educators' views about training physicians to be competent communicators, a focus group was conducted at a large southeastern medical college with faculty responsible for training interns and residents to be competent communicators. The medical school was undergoing a curriculum review and instructional development process, including an examination of the methods being used to teach communication. A discussion of a teaching faculty committee revealed several themes, including the foundational assumption that communication is a natural ability that some have and others do not. Other notions likely to affect the educators' beliefs about the importance and effectiveness of communication education include the ideas that courtesy is synonymous with good communication and that although a few fundamentals might be transmitted, experience is the best teacher. Participants identified several audiences, in addition to patients, with whom they communicate as part of their profession, including other physicians, other health care providers (e.g., nurses and lab technicians), and hospital administrators, health care insurers, and others responsible for evaluating physicians' performance. The implications of this project for the development of medical communication courses within a multiple discourse approach are discussed.