Communicative competence is an integral part of the Düsseldorf Curriculum Medicine as one of eight competence areas. In order to systematically teach this competence in medical education and training, we have therefore developed a longitudinal communication curriculum with CoMeD (Communication in Medical Education Duesseldorf) and implemented it in stages in our model course of study:
- In the 1st year of study, the basics of communication are taught.
- In the 2nd and 3rd year of study, communication focuses on patient interaction during anamnesis and consultation interviews.
- In the 4th and 5th years of study, the focus is on communication in challenging clinical contexts.
The central element of the longitudinal communication curriculum is learner-centered, skills-oriented, interdisciplinary teaching units in small groups. Physician conversation forms and communication skills are practiced here in standardized conversation simulations with trained simulation patients (currently 60 simulation patients are involved in teaching) or in student role-plays. These include:
- Participative decision making
- Communication with relatives
- Breaking bad news
- Team communication
- Dealing with difficult emotions
The conversation simulations are led either by lecturers or by student tutors. The physician conversation techniques and their subsequent reflection are always taught in a clinical context involving as many subjects as possible. Physicians teach in their specific clinical settings or subject contexts and support role modeling. All lecturers are qualified accordingly in special training courses.
Each interaction (conversation simulation, role play or exercise with real patients from the clinic) is followed by structured 360° feedback. The (peer) feedback is also an important part of the curriculum and runs according to evidence-based design. By comparing self-assessment and peer assessment during feedback, self-reflection is promoted, which is also one of the eight competencies of the Düsseldorf Curriculum Medicine.
In addition to regular feedback by peers, simulation patients, and instructors, the learning process is guided by formative examinations. The following examination formats are currently used:
- Clinical Practical Part of the Intermediate Medical Examination (OSCE) after the 3rd year of study.
- CoMeD-OSCE (Objective Structured Clinical Examination) in which only communicative competence is tested in the 4th year of study
- Mini-Clinical Examination (Mini-CEX) in the 4th and 5th year of study.
In total, we offer about 1700 practical teaching units per year with simulations or role plays on communication for all semesters. In addition, there are about 600 teaching units per year for communication stations in the OSCE exams. Each student is able to conduct approximately 15 simulation conversations with a simulation patient in a variety of clinical settings and with increasing levels of difficulty over a five-year course of study.
CoMeD is continuously evaluated and further developed. For example, a fourth stage is currently in preparation, in which a transfer to everyday clinical practice will take place during the practical year (6th year of study).
Due to the cross-sectional and longitudinal implementation of the communicative teaching units in the core curriculum of all five years of study, a total of 18 CoMeD seminars have been mapped in 10 out of 20 subject or study blocks in different subject areas in each case so far, in addition to 2 OSCE formats with communication stations.