Maximizing Student Clinical Communication Skills in Dental Education-A Narrative Review

Abstract

Dental student training in clinical communication skills and behavioral aspects of treatment are lauded as clinically meaningful in the dental education literature. However, many dental school curricula still only provide didactic, one-time coursework with multiple choice examination assessment and little or no student skill-activating activities. This article aims to review literature relevant to optimizing clinical communication and behavioral skills in dental education. The review summarizes findings of several relevant reviews and usable models to focus on four themes: (1) special characteristics of dentistry relevant to communication skill needs, (2) essential components of dental student learning of communications skills, (3) clinical consultation guides or styles and (4) optimal curricular structure for communication learning effectiveness. Contexts of communications in the dental chair differ from medical and other allied health professions, given the current mostly dentist-dominant and patient-passive relationships. Patient-centered communication should be trained. Dental students need more practical learning in active listening and patient-centered skills including using role-play, videotaping and ultimately, real patient training. Medical consultation guides are often unwieldy and impractical in many dental contexts, so a shortened guide is proposed. Communication skills need to be learned and taught with the same rigor as other core dental skills over the entire course of the dental curriculum.

Keywords: active listening; communication skills; dental education; empathy; health consultations; longitudinal learning; motivational interviewing; patient-centered communication; role-play feedback; video feedback.

Figure 1

Twenty-six communication skills in four categories adapted from Khalifah and Celenza [8]. Generic skills are those to be used at any dental visit and must become natural habits of the dentist. Case-specific skills regard individual cases and situations and vary according to patient and case. Time-specific skills are appropriate at certain times in a consultation. Emerging skills are skills to be applied in distinctive cases with special considerations.

Figure 2

Calgary–Cambridge Guide Domains (adapted from Silverman et al. [35] and Kurtz et al. [34].

Figure 3

Dental Consultation Communications Checklist (DCCC) from Sangappa, 2013.

Figure 4

Miller’s pyramid model of clinical assessment [49].