Patient-centredness from education to practice: The 'lived' impact of communication skills training

Background: Although communication skills training (CST) enhances patient-centred skills and attitudes, the literature indicates a problematic transfer of these from education into practice. Aim: We explored 'lived' experiences of medical students and doctors to gain a better understanding of the impact of CST on patient-centredness in the transition to real practice. Methods: From a phenomenological perspective, we conducted 15 interviews and 11 focus groups with 4-9 participants/group (n=67) at two universities and carried out constant comparative analysis. Results: The gap between education and practice is the central phenomenon. Although CST raises students' communication awareness and self-efficacy in an 'ideal' context, this paradoxically seems to jeopardize their ability to bridge the gulf. In addition, CST does not come to grips with students' attitudes. However, CST appears to be successful in equipping students with long-lasting 'handles'. Yet students need more support to mould the provided 'ideal' models into their own unique style of context-specific patient-centred behaviour. This implies: raising students' awareness of own attitudes and communication styles, offering a more realistic training ground, integrating CST with clinical experience and translating the primary-care-rooted concept of patient-centredness into various specialization contexts. Conclusion: CST could raise its impact by supporting students' recycling processes towards a personal style of context-sensitive patient-centredness.