AMEE Berlin 2002 Programme

dynamics, a term derived from family therapy, and
which focuses on relations, coalitions, behavioural
codes etc within the core family. Systemic dynamics
may have a strong impact on diagnosis and treatment.
In the first part of this double presentation, we will
show a video of a training, which involves the major
sources of information distortion, which might result
from history taking from a third party.
8I6 Training of the systemic approach
in doctor patient communication II:
history taking with a patient and a
third party
E M van Weel-Baumgarten* and K P M van Spaendonck
University of Nijmegen, Hermelynstraat 50, 6531 JZ Nijmegen,
NETHERLANDS
The next part of this double presentation focuses on a
training of a consultation with a patient and a third party.
In such cases the doctor is confronted with two people
who usually have a long history of intimate life in
common, which has resulted in a specific pattern of
interaction and behavioural codes. Any remark of the
doctor addressed to one of them, also has implications
for the other, and may disrupt the mentioned pattern of
interaction and behavioural codes. This type of
consultation involves a number of skills: to be in control
of the consultation, to negotiate, to give both parties
equal attention. Training also focuses on how to avoid
pitfalls, such as choosing sides, arbitrating, allowing
Session 8J Clinical teaching
8J1 Increasing student awareness of
strengths and weaknesses using a
standardized patient case
Devra Cohen*, Jerry Colliver, Mark Swartz and Randal Robbs
The Morchand Center, Mount Sinai School of Medicine, One
Gustave L. Levy Place, Box 1127, New York NY 10029, USA
Two classes of seond-year medical students (n=105,
class of 1999; n=107, class of 2000) rated awareness
of their strengths and weaknesses in performing a
physical examination, taking a history, and
communicating with a patient before and after an
interaction and feedback session with an SP. The ratings
were on a 5-point scale; 1-not at all; 2-a little; 3moderately;
4-very; 5-extremely. The results showed
that students were “moderately” aware of their strengths
and weaknesses before the encounter and “very” aware
following the encounter. The ratings increased from
pre to post on average 1.0 standard deviation (ranging
from .69 to 1.21 DSs) showing increased awareness of
strengths and weaknesses as a result of the whole
interactive session. Changes in awareness of strengths
and weaknesses for each of the three outcomes
separately as well as relationships between changes in
awareness and performance on the SP case will be
discussed.
Wednesday 5 September
- 4.97 -
the dominant party to overrule the other etc. A tripartite
consultation requires different communication skills
than a patient-centred interview. In our presentation
we will also show a video of how students can be trained
in this type of consultation.
8I7 Breaking bad news - evaluation of
courses run by students and young
doctors
H Ortwein*, E Herrmann, A Brunklaus, A Kreutz,
C Schwarz and J Schildmann
Department of Anaesthesiology, Charité, Humboldt University
of Berlin, Lychener Str 60, 10437 Berlin, GERMANY
Breaking bad news is one of the most challenging tasks
in medical communication. At German medical schools
communication skills training is usually not part of the
curriculum. A group of experienced students and young
doctors started a breaking bad news course for medical
students in their fourth year of medical training. During
a weekend course, participants receive excessive
training of the subject in role-plays in small groups.
Every student is able to play the role of the doctor as
well as the patient’s part in different situations which
are handed out as paper cases. We evaluated these
course with questionnaires, one before and one after
the course. The values of self-rating regarding the
capability to break bad news improved. Teaching
methods like peer group learning and role-plays were
judged positive for the subject.
8J2 Clinical dermatology: prospective
randomized comparison of a
traditional, a personal bed-side
teaching (PBST) and a problemoriented-practical
(POP) course
F R Ochsendorf*, H Boehncke, R Hovelmann, A Boer and
R Kaufmann
Zentrum Dermatologie und Venerologie, Klinikum der J W
Goethe-Universitat, Theodor-Stern-Kai 7, D-60590 Frankfurt/
M, GERMANY
To assess satisfaction, practicability and knowledge
gain, students were randomly allocated to a traditional
course (lectures and bed-side teaching; evaluable
n=137), bed-side teaching groups always with the same
teacher (PBST, n=37) and POP groups only using
“paper-cases” (n=36) over two terms. For evaluation,
a questionnaire and multiple-choice tests, written
anonymously at start and end of the course, were used.
The PBST-course (1.7 ± 0.7; mean ± SD) and the POPcourse
(1.6 ± 0.8) were rated significantly better
(p