Durable Skills Series Post 2: Clear Communication|Honing the skills of description

Introduction

Durable skills (sometimes referred to as soft or professional transferable skills) are essential for success in the workplace, especially in the health professions. Without durable skills in their toolkit, learners are ill-equipped for clinical practice. For example, lack of clear communication is reported to be the most common cause of medical errors.^[1]

Clear communication is also required in many aspects of veterinary practice. Our student veterinarians currently practice verbal communication with simulated clients^[2], and we wanted to give them more opportunities to practice communication skills in different contexts.

Our area of specialization is clinical pathology. Whether you are a vet in practice communicating with a pathologist or a pathologist writing a description in a cytology report, it is important to be able to describe what you see in a sample accurately.

We previously investigated whether fine arts-based observation training is helpful in improving student veterinarians’ observational skills and wanted to continue this work.^[3] We wondered if a drawing activity could help our student veterinarians practice their descriptive and communication skills by bringing attention to the processes of “slow looking”^[4] and thorough description.

The Activity

Students were divided into pairs and tasked with describing a cytology image to their partner. The partner could not see the image and would use colored markers to draw it as faithfully as possible from the description provided.^[5] After a few images, roles were swapped. This activity provided students with the opportunity to not only observe closely, but to formulate the order of information, vocabulary, and phrasing to best convey what they were seeing.^[6]

Five minutes were allowed for each image. When the time was up, students could see what their partners had drawn. The room buzzed with conversation and laughter, and echoes of “Oh, I see!” Many were able to create surprisingly accurate renditions, but varied in which details had been included, and to what extent. Other drawings showed wildly abnormal proportions or arrangements, highlighting omissions or exaggerations from the descriptor. By then swapping roles and repeating the process, students could immediately apply what they had learned from their partner–or their own realizations. They also received immediate feedback on the accuracy of their description from their partner’s drawing.

Real Time Observations

The most striking observations were those of standing in the room (Amber and Nicole). During the drawing activity, the lecture theatre was alive with conversation and enthusiasm, but also a sense of focus. The drawers asked clarifying questions and the describers paused to organize their thoughts.

In stark contrast, when it was time to write the pre- and post-tests^[7], a much more traditional lecture theatre activity, the room fell silent and somber. Both activities were allocated the same amount of time, but in both the students’ body language and their responses to a follow-up questionnaire, they found the activity component too short and over too suddenly, and the testing component too long and drawn out.

When asked about the impact of swapping roles, most students responded that it made them realize challenges about describing that they hadn’t previously considered. Many commented that they altered their approach in later rounds to better help their partner, either by catering to that partner’s thinking style, or by focusing on things they themselves would have found helpful.

While the analytical portion of our study can attempt to quantify the descriptive and observational skills using their test scores, there was also an element of communication learning that we cannot quantify. The aspect of fun and “something different in the classroom” makes activities like these memorable, and thus may add to the longevity of the durable skills gained.^[8]

The Potential

This activity has potential for helping students develop the durable skill of clear communication through practice with feedback. The literature suggests that durable skills are most valuable when students have the chance to practice them in various discipline-specific contexts and learn how to transfer them to different situations. This activity added to the students’ communication practice with simulated clients and seemed to provide several ‘eye-opening’ moments. From what we observed, It was a valuable addition that was both enjoyable and practical in that it helped to improve descriptive and communication skills.

Although this activity was originally developed as part of Amber’s research project, after observing the activity in action, we are considering integrating the drawing exercise into our clinical pathology teaching on an ongoing basis. Based on the initial review of the responses from the study that indicate that the activity itself was felt to be valuable, feedback on the “testing” was less positive. Although it is difficult, if not impossible, to determine the effects a single activity like this might have on students’ future communication success as veterinarians, practicing communication in such a memorable way is a good start!

For more information, please contact Nicole Fernandez. 

nicole.fernandez@usask.ca

^[1] The 8 Most Common Root Causes of Medical Errors states that, “Communication breakdowns are the most common causes of medical errors. Whether verbal or written, these issues can arise in a medical practice or a healthcare system and can occur between a physician, nurse, healthcare team member, or patient. Poor communication often results in medical errors.

^[2] In veterinary medicine, our clients are the animal owners and the patients are the animals.

^[3] Fernandez NJ, Fischer M, Dickinson RM, Burgess H, Meachem M, Elwood BW, Warren AL. Comparison of fine arts- and pathology-based observational skills training for veterinary students learning cytology. J Vet Med Educ. 2022;49(3):393-406. doi:10.3138/jvme-2020-0096.

^[4] “Slow looking” refers to the process of taking time to simply observe- it is a case of the more you look, the more you see. It is a term often associated with the arts but can be used in any situation.

^[5] The image for this blog post is an example that was used in the activity. Into the deeper end right off the hop!

^[6] It is important to note that the activity was to clearly describe the image so someone else could reproduce it and not to make judgments about what was in the image from a clinical perspective.

^[7] For the quantitative part of our study, students wrote pre- and post-tests where they described unrelated cytological images, in point or sentence form, and were scored against an expert rubric. The objective of the study was to determine if this exercise improved student observational or descriptive skills. While the quantitative data are still being analyzed, a great deal of qualitative information revealed itself about the students’ experiences.

^[8] And perhaps this durable skill originally practiced in an academic environment may find practical application in describing those table decorations at some point. 😉