Disentangling communication challenges in trainees’ learning journeys: A longitudinal study in the general practice specialty training programme

Background:

Learning skilled communication implies adapting and monitoring to the needs of the clinical encounter. Research suggests communication challenges can trigger learning; however, their nature remains unclear. This study explores what challenges act as triggers, improving understanding of developing skilled communication and guiding educators in targeted coaching. 

Material and methods: 

This longitudinal qualitative study used a phenomenological approach to collect data from first- and third-year general practitioner trainees through clinical observations, interviews, and audio-diaries. Using a twofold approach, a thematic content analysis was performed, triangulating data sources and next, findings were used to craft stories illustrating the communication challenges learners encountered during training. 

Results: 

Per year-group a story was crafted, illustrating communication challenges driving trainees’ learning. First-year trainees focused on the effectiveness of patient-centred communication skills. Third-year trainees adopted a meta-perspective, using self-monitoring skills to develop a personalised style, adapt communication to patients’ needs, and work collaboratively, driven by curiosity to understand each patient’s context. 

Conclusions: 

We identified communication challenges in workplace learning that trigger the development of skilled communication. To help learners recognise and share these challenges, a safe learning environment is crucial, along with scaffolded guidance from educators to support learners in identifying challenges and fostering self-monitoring skills throughout their learning journey.