Our Faculty hosted on 5 July at the Egas Moniz Building the II National Congress of Clinical Communication in Health Care “Relation and Communication in Health Care” and was represented by several bodies: Board of directors, Pedagogical Council, Department of Medical Education, Student Association and the NEICCR (Teaching and Research of Communication and Relational Competencies Centre) coordinator, who presided over the Congress in which representatives, teachers and researchers from national and international medical schools participated from a perspective of productive interdisciplinary collaboration.

Pioneers in the national scene, our Faculty hosted this scientific event for the first time, coinciding with a school year in which it was possible to carry out a transversal communication/relational curricular plan throughout all the years of the pre-graduate course. The grounds for this were developed and presented to the whole Faculty through the publication Relational Centered Medicine: Contributions to Medical Education prepared as a support document towards the reform of clinical education in progress.

The teaching of communication skills is considered by many international documents to be an essential component of medical education and, in recent years, there has been growing interest in this subject by various schools. They have been gradually integrating it through a variety of teaching and evaluation methodologies of student performance, using methods that encompass the behavioural dimension of student-patient interaction, along with theoretical knowledge.

The Faculty of Medicine of the University of Lisbon has been a national pioneer in the promotion of communication training activities, namely the postgraduate workshop on communication skills (1982). These were held at the University Psychiatry Clinic and integrated several in-house professors during the course of several editions, and later, in the free courses on End-of-Life Care (since 2002), Relational Ethics (since 2007) and in the Master’s Degree in Palliative Care (since 2002)).

Within the scope of pre-graduate education, it’s worth mentioning the integration of the communication module in the subject of Introduction to Medicine, since 1998, in addition to multiple interventions using role-playing in Mental Health disciplines. It has been possible to improve on a proper pedagogical model based on the concept of Relational Centered Medicine. On the scientific side, the research conducted in this area has focused essentially on five lines: (a) communication attitudes among students and health professionals; (b) health literacy; (C) emotion and empathy; (d) experience with the disease; and (e) evaluation of the impact of training programs on communication and relational skills. This last line of research has incorporated the comparative experimental evaluation of several methodologies, the creation and validation of codification systems and instruments for the evaluation of communication skills, already widely disseminated in national and international scientific forums and publications.

Communication/relational practice of students with actors (representing simulated patients) was integrated in several years of the pre-graduate course in our faculty. Resorting to video-recording and autoscopy in addition to constructive classroom feedback in the third year (Introduction to Clinical Practice) and the use of role-playing between students and teachers in the first year (Introduction to Medicine), in the 3rd year (Mental Health), both with mandatory experiential evaluation, and in the 4th year (Psychiatry) through an OSCE, with general satisfaction from the students. From the perspective of a Relational Centered Medicine, it is considered that there is no good diagnosis or symptomatic control without effective communication as there is no assistance quality without compassionate relational quality, these competencies can and should be trained and continuously evaluated throughout the course.

The NEICCR, which was a co-organizer of this initiative with SP3CS – Portuguese Society of Clinical Communication in Health Care (also part of the Board) presented, at this congress, its specific training activities and the result of several investigations, as well as the initiatives developed with students across different years within the scope of health literacy and partnerships with other schools concerning the goals of the congress and SP3CS towards promoting the development of communication skills in health care and to foster research in the field of clinical communication and the dissemination of good communication practices.

Three plenary panels were held respectively on: Teaching of relational and clinical communication; Relation and communication in clinical practice; and Clinical communication in health care in Portugal. There were also several parallel sessions on: Relation and empathy; The patient’s perspective; Communication and technology; and Communication and teaching.

On the 6th, four pedagogical workshops were held on: Communication/relational practices in palliative care (FMUL); How to turn a difficult consultation into a stimulating challenge (FMUP), Motivational Interview (UBI); and A skill-based approach to persuasion in health promotion covered by Professor Sara Rubinelli of the University of Lucerne’s Department of Health and Health Policy and Swiss Paraplegic Research Switzerland, the current president of EACH: International Association for Communication in Healthcare- which SP3CS is part of and rendered the opening conference “Health promotion in information society: Challenges for health communication” moderated by Professor António Vaz Carneiro.

The relevance and role of the communicational/relational process in the development of a clinical relationship, in the efficiency of the medical act and in the prevention of the error was well emphasised in this highly participated event. The need to teach, develop, train and create skills for efficient communication / relations through the layout of curricular units dedicated to communication / clinical relations, throughout the educational path (pre- and postgraduate) of the health professionals was also reiterated. These should be in accordance with the context of the different schools, and capable of decisively influencing the communication / relations capacity of future physicians in the different contexts of professional practice: communication with patients (ensuring the best aid); intra / interprofessional practice in health teams (optimizing resources) but also in the public sphere (promoting health and well-being) in a current systemic perspective of future medical education as a leadership agent; transformation and change in health systems, education and society.

Professor Doctor António Barbosa

University Psychiatry Clinic

Faculty of Medicine of the University of Lisbon