Communication skills learnt through skills based training methods


Celia Tan Ia Choo
Jiang Bo
Angeline Ng
Goh Soo Cheng
Karen Koh
Leila Ilmami Bte Nasron
Shirley Toh
Madhavi D/O Perianan Suppiah


9AA Teaching and assessing communication skills


SingHealth, Group Allied Health, Singapore
Singapore General Hospital, Institute of Medical Simulation and Education, Singapore
Singapore General Hospital, Postgraduate Allied Health Institute, Singapore


For many healthcare professionals (Doctors, Nurses, Allied Health Professionals and other frontline staff), effective and good communication is essential for quality patient care and safety. Effective communication requires the ability to understand and to be understood. Role plays have often been used to teach communication skills (1). Not surprising as it consists of a number of practical skills that are not easy to teach using the usual didactic or practical class demonstration method and even harder to assess for competency. To address this issue, a team of healthcare professionals and administrators met to develop a short 2-day workshop that focussed on teaching key communication skills and the use of role plays with standardised patients to enhance learning and feedback to participants. Teaching communication skills over a short duration has not been reported previously. These communication competencies are also found but not adapted from the Kalamazoo communication checklist (2).

Summary of Work

Participants attended a 2-day communication skills training workshop and were required to demonstrate their current skills level in a role play with a standardised patient using a standardised case scenario commonly encountered in the healthcare environment with patients, supervisors and colleagues. The role plays were conducted before and after the communication teaching sessions. Communication tools were taught in the 3 categories and each category included expected tasks as follows:

1. Introductory and non-verbal skills

  • Greets interviewee, introduces self, body posture (leaning forward, relaxed), sitting position, eye contact, tone, etc. Those aspects of skills were summarized as "Attending Behaviours".

2. Listening skills

  • Appropriate use of open-ended questions
  • Appropriate use of close-ended questions
  • Appropriate use of clarifying questions
  • Questions are well-paced
  • Appropriate use of encouragers
  • Appropriate use of paraphrasing
  • Appropriate use of summarizing
  • Appropriate reflection of feelings

3. Goal-setting and closure

  • Includes patient/relative in setting goals – determines appropriate commitment and motivation
  • Identifies additional resources as appropriate
  • Summarizes session
  • Acknowledges patient and closes interview

The competency level of each of the expected tasks above was assessed and graded with a score before and after the workshop. The scores range from 0 (low competency level) to 2 (high competency level) with increment of 1. The following picture is the screenshot of the video taken during the workshop.


Summary of Results

84 participants participated over 5 workshops, which was first conducted in January 2013. Pre- and Post-workshop scores for each skill were compared using Wilcoxon Signed Ranks Tests. Results demonstrated that all 13 skills were significantly inproved at the end of the workshop (Figure 1). The total score for each participant, of 13 the skills were also calculated and compared before and after the workshop. Analysis showed that 89.3% (75 out 84) of the participants have higher total scores after the workshop representing improved overall skills (Figure 2).





Results show that there is improved learning of communication skills using role plays before and after the 2-day teaching sessions (1, 3). It was interesting that some participants did not improve, instead, had worse results post training. They felt that thinking too much to use the new skills affected their ability to flow naturally in the role play. In addition, most of the trainees found the workshop useful to improve the practical aspect and use of communication skills taught during the workshop.

In conclusion, role plays before and after a workshop was found to be useful in teaching communication skills to :

  1. Build positive relationships during patient or staff encounters.
  2. Be aware of personal biases and attitudes that affect positive communications
  3. Manage challenging patient encounters.


Take-home Messages

Communication requires complexed skills that are not easily acquired unless taught in a skills based method such as role plays.



(1) Deepa Rao. Skills development using role-play in a first-year pharmacy practice course. Am J Pharm Educ. 2011 Jun 10; 75(5): 84.

(2) Eleanor B. Peterson, Aaron W. Calhoun, Elizabeth A. Rider. The reliability of a modified Kalamazoo Consensus Statement Checklist for assessing the communication skills of multidisciplinary clinicians in the simulated environment. Patient Educ Couns. 2014 Sep; 96(3): 411-8.

(3) Walter F. Baile, Adam Blatner. Teaching communication skills: using action methods to enhance role-play in problem-based learning. Simul Healthc. 2014 Aug; 9(4): 220-7.

Summary of Work
Summary of Results
Take-home Messages
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