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      A Latin American, Portuguese and Spanish consensus on a core communication curriculum for undergraduate medical education

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          Abstract

          Background

          To present learning outcomes in clinical communication for a Core Curriculum for medical undergraduate students in Latin America, Portugal and Spain (LAPS-CCC) and to establish an expert network to support a transnational implementation.

          Methods

          Through an iterative process, an international group of 15 experts developed an initial set of learning outcomes following a review and discussion of relevant international and local literature. A two-round Delphi survey involving 46 experts from 8 countries was performed. Quantative and qualitative analisis permited the definition of the final consensus.

          Results

          The initial proposal included 157 learning outcomes. The Delphi process generated 734 comments and involved the modification, deletion and addition of some outcomes. At the end of the process, a consensus was reached on 136 learning outcomes grouped under 6 competency domains with a high overall acceptance (95.1 %).

          Conclusions

          The learning outcomes of this proposal provide a guide to introduce, support and develop communication curriculae for undergraduate medical studies in the countries involved or in other Spanish- or Portuguese-speaking countries.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s12909-016-0610-8) contains supplementary material, which is available to authorized users.

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          Most cited references66

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            Measuring patient-centered communication in patient-physician consultations: theoretical and practical issues.

            The goal of patient-centered communication (PCC) is to help practitioners provide care that is concordant with the patient's values, needs and preferences, and that allows patients to provide input and participate actively in decisions regarding their health and health care. PCC is widely endorsed as a central component of high-quality health care, but it is unclear what it is and how to measure it. PCC includes four communication domains: the patient's perspective, the psychosocial context, shared understanding, and sharing power and responsibility. Problems in measuring PCC include lack of theoretical and conceptual clarity, unexamined assumptions, lack of adequate control for patient characteristics and social contexts, modest correlations between survey and observational measures, and overlap of PCC with other constructs. We outline problems in operationalizing PCC, choosing tools for assessing PCC, choosing data sources, identifying mediators of PCC, and clarifying outcomes of PCC. We propose nine areas for improvement: (1) developing theory-based operational definitions of PCC; (2) clarifying what is being measured; (3) accounting for the communication behaviors of each individual in the encounter as well as interactions among them; (4) accounting for context; (5) validating of instruments; (6) interpreting patient ratings of their physicians; (7) doing longitudinal studies; (8) examining pathways and mediators of links between PCC and outcomes; and (9) dealing with the complexity of the construct of PCC. We discuss the use of observational and survey measures, multi-method and mixed-method research, and standardized patients. The increasing influence of the PCC literature to guide medical education, licensure of clinicians, and assessments of quality provides a strong rationale for further clarification of these measurement issues.
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              Essential elements of communication in medical encounters: the Kalamazoo consensus statement.

              G Makoul (2001)
              In May 1999, 21 leaders and representatives from major medical education and professional organizations attended an invitational conference jointly sponsored by the Bayer Institute for Health Care Communication and the Fetzer INSTITUTE: The participants focused on delineating a coherent set of essential elements in physician-patient communication to: (1) facilitate the development, implementation, and evaluation of communication-oriented curricula in medical education and (2) inform the development of specific standards in this domain. Since the group included architects and representatives of five currently used models of doctor-patient communication, participants agreed that the goals might best be achieved through review and synthesis of the models. Presentations about the five models encompassed their research base, overarching views of the medical encounter, and current applications. All attendees participated in discussion of the models and common elements. Written proceedings generated during the conference were posted on an electronic listserv for review and comment by the entire group. A three-person writing committee synthesized suggestions, resolved questions, and posted a succession of drafts on a listserv. The current document was circulated to the entire group for final approval before it was submitted for publication. The group identified seven essential sets of communication tasks: (1) build the doctor-patient relationship; (2) open the discussion; (3) gather information; (4) understand the patient's perspective; (5) share information; (6) reach agreement on problems and plans; and (7) provide closure. These broadly supported elements provide a useful framework for communication-oriented curricula and standards.
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                Author and article information

                Contributors
                c.garcia.prof@ufv.es
                r.ruiz.prof@ufv.es
                f.caballero@ufv.es
                acavaco@ff.ul.pt
                moore.philippa@gmail.com
                liladupuy@gmail.com
                acyrino@gmail.com
                tere_cortes2003@yahoo.com.mx
                marilen.gorostegui@gmail.com
                emfl@med.up.pt
                boschfontcuberta@gmail.com
                lcasasbuenas@gmail.com
                larakretzer@gmail.com
                ebarrighi@uic.es
                Journal
                BMC Med Educ
                BMC Med Educ
                BMC Medical Education
                BioMed Central (London )
                1472-6920
                28 March 2016
                28 March 2016
                2016
                : 16
                : 99
                Affiliations
                [ ]Escuela de Medicina, Universidad Francisco de Vitoria, Facultad de Medicina, Edificio E, Ctra Pozuelo-Majadahonda, Km 1,800, Pozuelo de Alarcón, Madrid 28223 Spain
                [ ]Universidade de Lisboa, Faculdade de Farmácia, Lisbon, Portugal
                [ ]P. Universidad Católica de Chile, Facultad de Medicina, Santiago de Chile, Chile
                [ ]Universidad Maimonides, Facultad de Medicina, Buenos Aires, Argentina
                [ ]Universidade Estadual Paulista, Faculdadede Medicina, Botucatu, Brazil
                [ ]Universidad Nacional Autónoma de México, Facultad de Medicina, Ciudad de México, México
                [ ]Universidad de Chile, Facultad de Medicina, Santiago de Chile, Chile
                [ ]Universidade do Porto, Faculdade de Medicina, Porto, Portugal
                [ ]Universidad Autónoma de Barcelona, Facultad de Medicina, Barcelona, Spain
                [ ]Universidad de Antioquia, Facultad de Medicina, Medellín, Colombia
                [ ]Universidade Federal de Santa Catarina, Faculdadede Medicina, Florianópolis, Brazil
                [ ]Universidad Internacional de Cataluña, Barcelona, Spain
                [ ]Foro Español de Pacientes (Spanish Patient Forum), Barcelona, Spain
                Article
                610
                10.1186/s12909-016-0610-8
                4809037
                27017939
                a4759641-11cf-4458-a0a5-526715bf7e88
                © García de Leonardo et al. 2016

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 24 August 2015
                : 5 March 2016
                Funding
                Funded by: Universidad Francisco de Vitoria
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2016

                Education
                physician patient communication,interpersonal skills,health communication,delphi technique,consensus method,medical education,medical curriculum,learning outcomes

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