Medical students’ perspectives on learning challenging patient communication through simulated patients: insights mirrored by teachers

Future physicians must develop the necessary knowledge and skills to effectively manage challenging patient communication. To design linked meaningful learning activities, perspectives from students and teachers need to be taken into account as well as students' previous knowledge. Aiming to better understand how this knowledge can be acquired through patient simulation, we examined students' perceptions, mirrored in teachers' reflections, and how these relate to the medical curriculum.
Data were collected from students and teachers during the ninth semester of a medical program in Sweden. A narrative survey and individual interviews were conducted. Using thematic analysis, we analyzed nineteen student surveys, five student interviews, and four teacher interviews to explore perceptions of learning. The student themes were then used to identify corresponding subthemes in the teacher data through a mirroring process.
Self-knowledge was identified as a crucial skill in order to effectively convey empathy in challenging patient communications. Patient simulation was described as a valuable learning activity which, however, lacked integration with adjacent learning activities in the medical program. Learning progression was hindered by a disconnect between communication-related learning activities and those focused on medical knowledge.
Both self-knowledge and medical knowledge are perceived as essential for learning how to manage challenging patient communication. Our findings suggest that the learning of patient communication and medical knowledge should be integrated in the curriculum and reinforced across various settings. Patient simulation is a valuable method for developing self-knowledge and communication skills.