Improving communication in the South African healthcare context

Background. The teaching of communication is an essential component of health professions curricula internationally and in South Africa (SA) for its benefits to healthcare. The teaching, however, remains concentrated in certain disciplines, resulting in an incoherent approach. SA medical schools have incorporated international guidelines into their curricula, but limited research is available on the suitability of amended guidelines for local use. Research in different sociocultural contexts has shown benefits in redefining guidelines for suitability for local contexts. Objective. To explore suggestions of participants for improving communication teaching and learning in the KwaZulu-Natal (KZN) healthcare context. Methods. Participants, including medical students, urban- and rural-based clinical educators, and Department of Health employees, were purposively sampled. Focus group discussions and semi-structured interviews were conducted. The data were analysed for emergent themes to make recommendations for improved teaching. Results. Recommendations to improve communication teaching and learning at institutional level included developing isiZulu language and intercultural communication and other aspects of the curriculum. At an individual level, emphasis should be placed on patient-centred care and appropriate professional behaviours, as the 'hidden curriculum was a noticeable and powerful influence. Conclusion. Teaching and modelling good communication in clinical skills and clinical teaching should be integrated and complementary Students require a good grounding in communicating in isiZulu and improved cultural competence. A unified approach that is reached by consensus and tailored to the KZN context is recommended.