Medical students’ communication skills in peer role-plays: An exploratory observational study

Background: Medical students are commonly taught two counselling protocols: breaking bad news and brief motivational interviewing for behaviour change. They must demonstrate advanced skills such as empathy, active listening, clear communication, offering support and creating a safe space for patients and their families to express their emotions. Medical students are taught communication skills through various methods, including peer role-play. Aim: This study aimed to document medical students’ communication skills as evident across recorded peer role-play scenarios and observe how students engage with this approach to practice communication skills. Setting: Final-year medical students at a medical school in Gauteng, South Africa. Methods: The study involved an observational approach to analyse 45 video- and audio-recorded student-led peer role-play scenarios that included breaking bad news and brief motivational interviewing skills, as part of an exploratory qualitative design. Thematic analysis was conducted. Results: The three main challenges students experienced were basic information giving and clinical correctness, doctor-centred versus patient-centred talk and providing psychosocial support and showing empathy. The authenticity of the peer-role-play was also a challenge. Conclusion: Making the transition from communication theory to practice may be difficult for students to achieve and learning how to integrate these complex communication skills is not straightforward. Training in communication and counselling skills must start early for medical students. Contribution: Family Medicine often takes responsibility for training communication and counselling skills in medicine, and our study can contribute to the discussion on training communication skills.