Jane Ege Møller

The social in medicine: Social techniques in patient education

The article investigates the role of the social in medicine through an empirical study of social technologies in Diabetes 2 and COPD patient education in Denmark. It demonstrates how the social at the same time is the cause of disease but also functions as a solution to the problem. Furthermore it suggests that the patient groups have an ambiguous role in medicine; they appear to be organized as communities of empowerment, critical of the individualizing effects of medicine, but at the same time these groups are embedded in medical practices, transferring responsibility for illness and health to the level of the citizens. The article provides an empirical analysis of how the social in patient education works. The empirical analysis challenges an existing understanding that patient groups automatically support healthy lifestyle changes. We point out the multiple ways in which the social works.

Workplace-based communication skills training in clinical departments: Examining the role of collegial relations through positioning theory

Abstract Introduction: Studies suggest that the workplace is a key to understanding how clinical communication skills learning takes place and that medical communication skills need to be reinforced over time in order not to deteriorate. This study explored the perceptions of doctors in four hospital departments who participated in a workplace-based communication training project. Its specific focus was the relationship between collegial relations and learning communication skills. Methods: The study applied a qualitative design using an ethnographic methodology, i.e. interviews and observations. Positioning theory was used as the theoretical framework. Results: Training communication skills with colleagues in the actual workplace setting was valued by the participants who experienced more sharing of communication challenges, previously understood as something private one would not share with colleagues. However, collegial relations were also barriers for providing critical feedback, especially from junior doctors to their seniors. Conclusion: The position as “colleague” both reinforced the communication skills training and hindered it. The communication skills educational model had a flat, non-hierarchical structure which disturbed the hierarchical structure of the workplace, and its related positions.

Cross cultural training in primary mental health care consultations in Moldova – The tEACH perspective

OBJECTIVE This article reports experiences and challenges encountered in a cross-cultural training project in Moldova that was undertaken by tEACH, the teaching subcommittee of EACH: International Association for Communication in Healthcare, in cooperation with local and international stakeholders. As part of a major health policy reform, the aim was to equip a group of trainers with the skills to train Moldovan professionals in skills for primary mental health care, including communication skills. METHODS The project consisted of 3 weeks of training using mainly experiential teaching methods to allow participants to practice content and methods, including interactive lecturing, roleplay, feedback and video. RESULTS A majority of the participants reported that they acquired key facilitation skills. They valued the opportunity to practice and receive feedback. However, some reported that there was too much focus on communication skills, which was thought to be less relevant in a Moldovan context. Furthermore our learner-centered approach was occasionally experienced as a lack of structure CONCLUSION: The tEACH expertise plays an important role in supporting trainers in cross-cultural contexts with effective communication skills methods. PRACTICE IMPLICATIONS Teaching in a cross-cultural context is only successful through continuous dialogue with stakeholders and demands attention to cultural differences.