Educational Methodologies

A Communication Skills Course for

Undergraduate Dental Students
Annette Hannah, Ph.D.; C. Jane Millichamp, Ph.D.; Kathryn M.S. Ayers, M.D.S.
Abstract: Sixty-seven third-year dental students in Dunedin, New Zealand, participated in a communication skills course, using
simulated patients, case-based scenarios, videotaped interviews, and class roleplays. The course introduced active listening
techniques, taking a medical history, and emotion-handling skills. This course was adapted from an existing course for medical
students run by the Department of Psychological Medicine, Dunedin School of Medicine. The results of the student evaluation
questionnaire (n = 59) indicated that students rated the course very highly. Retrospective ratings indicated that the students
considered communication skills to be significantly more important as a component of their undergraduate training after
completion of the course than prior to it. As might be expected, students whose ratings were higher after the course also reported
that the course helped them to develop new communication skills and techniques; increased their interest in the subject and their
self-confidence; rated the tutor as more effective and the course materials as more helpful; and considered the course to be
significantly more stimulating than those students whose ratings of the importance of communication skills remained the same or
decreased.
Dr. Hannah is Lecturer, Department of Psychological Medicine, Dunedin School of Medicine; Dr. Millichamp is Lecturer,
Department of Psychological Medicine, Dunedin School of Medicine; and Dr. Ayers is Senior Lecturer, Department of Oral
Sciences, Faculty of Dentistry—all at the University of Otago, Dunedin, New Zealand. Direct correspondence and requests for
reprints to Dr. Annette Hannah, Department of Psychological Medicine, Dunedin School of Medicine, University of Otago, P.O.
Box 913, Dunedin, New Zealand; 64-3-474-7989 phone; 64-3-474-7934 fax; annette.hannah@stonebow.otago.ac.nz.
Key words: communication, dentist-patient relations, dental education, program evaluation, psychosocial factors, behavioral
sciences
Submitted for publication 4/29/04; accepted 7/6/04

I
n the field of dentistry, knowledge and technical Amongst dental practitioners themselves and
skills are not the only prerequisites for good prac- specialist groups working in the field, there has also
tice. An ability to communicate effectively with been a general acceptance of behavioral sciences and
patients—in particular, to use active listening skills, communication skills as important components of
to gather and impart information effectively, to handle dental education.12-15 Dental students and teaching
patient emotions sensitively, and to demonstrate staff have evaluated communication skills training
empathy, rapport, ethical awareness, and profession- as highly relevant as well.12,16-20 Only a small minor-
alism—is crucial. Among the benefits noted when ity of surveys have indicated that attitudes towards
dentists demonstrate effective communication skills communication skills training and behavioral sci-
are increased patient satisfaction, improved patient ences have been less positive or have worsened over
adherence to dental recommendations, decreased time.10,15
patient anxiety, and lower rates of formal complaints Despite widespread recognition of the impor-
and malpractice claims.1-9 tance of communication skills training in the dental
The importance of behavioral sciences, and in curriculum, the reality of what is practiced is some-
particular communication skills, was formally rec- what different. Two recent reviews, one of North
ognized in the United Kingdom with the 1990 publi- American dental schools and one of UK dental
cation of the General Dental Council’s guidelines for schools, have identified a number of problems with
the inclusion of behavioral sciences teaching in den- communication skills training to date. Yoshida et al.21
tal schools.10 In the United States, the American As- conducted a survey of forty U.S. and Canadian den-
sociation of Dental Schools’ 1993 guidelines11 iden- tal schools and found that only one-third of them had
tified core areas of behavioral science and courses focusing specifically on interpersonal com-
communication skills in the dental curriculum. munication. The authors noted that where programs

970 Journal of Dental Education ■ Volume 68, Number 9

did exist, they often took the form of lectures or pas- eotaped dentist-patient interactions. The students who
sive learning rather than active skills-based practice received communication skills training were signifi-
using simulated or real patients. Training tended to cantly more likely to explore and recapitulate pa-
occur on a one-course only basis, with little oppor- tients’ statements than the control students. However,
tunity for students to learn in a gradual, systematic the authors concluded that methodological problems
fashion with increasingly complex material. Assess- raised questions about the validity of their findings.
ment of students was generally conducted by grad- Davis et al.24 compared the effects of two meth-
ing participation in class exercises, rather than di- ods of instruction for teaching communication skills
rectly evaluating student performance or assessing to senior dental students. They found no significant
knowledge via written or oral tests. The authors con- differences between conventional instruction, in
cluded that there is a current lack of emphasis on which instructors provided students with formal feed-
teaching communication skills in North America. back about their interactions with patients, and vid-
McGoldrick and Pine22 conducted a review of eotape feedback instruction, which entailed an in-
behavioral sciences teaching, including communi- structor-guided review of videotaped student-patient
cation skills, in all fourteen dental schools in the interviews. In the study conducted by Davis et al.,
United Kingdom. They found that thirteen schools students in both instructional groups interviewed
offered formal behavioral sciences programs in the actual dental patients, rather than simulated patients.
undergraduate curriculum, with all fourteen schools One further study, Koerber et al.25 explored the
covering the topic of communication skills to some effect of brief motivational interviewing (BMI) train-
extent. However, considerable variation was found ing in relation to smoking cessation counseling. They
with regard to the course content, the teaching meth- found both clinical and statistically significant im-
ods employed, and the credentials of teaching staff provements in interviews conducted by those dental
involved. In particular, many programs emphasized students who had completed three sessions (twelve
theoretical aspects of communication rather than pro- hours) of BMI training compared to the control
viding opportunities for skills-based practice. Teach- group. On the other hand, there was no effective dif-
ing methods generally entailed the use of a didactic ference in rapport between the student and the simu-
teaching style and a large group format, and teach- lated patient across the two groups.
ing staff were usually selected from one discipline The field of medicine has generated a number
only (e.g., dentists) with little interdisciplinary teach- of research studies to evaluate the effects of differ-
ing by dentists, psychologists, and sociologists. ent teaching methods and materials in communica-
McGoldrick and Pine expressed concern over the lack tion skills training.26-30 Some important principles for
of time and resources allocated to communication effective teaching have been identified by such re-
skills training and the failure of many programs to search. Teaching recommendations include the use
adopt a skills training approach. of: 1) a skills-based approach (as opposed to a di-
The need for systematic teaching of communi- dactic approach), 2) clinically relevant scenarios, 3)
cation skills in dentistry is widely recognized, but self-assessment by students, 4) videotaping methods,
there has been limited research that delineates teach- 5) simulated patients with expertise in a variety of
ing approaches and compares the effectiveness of clinical roles and in the monitoring of student per-
different strategies. Many articles were published in formance and the delivery of feedback, 6) an inte-
the 1970s that addressed teaching communication grated teaching team comprising health sciences staff
skills, but most of them were discussion papers and and human sciences disciplines, and 7) small groups
few presented research. There have also been few for optimal student learning.
attempts to describe the nature of such teaching pro- The purpose of this article is to describe a com-
grams in the literature. munication skills program that was offered for the
When reviewing the literature, we found two first time in 2003 to third-year dental students at the
studies that compared strategies for teaching com- Otago School of Dentistry, Dunedin, New Zealand.
munication skills to dental students. Ter Horst et al.23 The program was based on a format designed and
compared two randomly assigned groups of dental used for communication skills teaching of medical
students: those who received a three-day communi- students at the Dunedin School of Medicine, Otago
cation skills training program, and those who re- University, New Zealand, and based on the research
ceived no training (control group). Students were findings for effective communication skills teach-
assessed in terms of their written responses to vid- ing. New roleplay scenarios were developed to por-

September 2004 ■ Journal of Dental Education 971

 tray challenging aspects of dental practice. Compo- The first two-hour class was an introductory
nents of the program included videotaped interviews, workshop in which the tutor outlined the course and
simulated patients, an interview of a member of the discussed specific communication skills techniques.
public, self-evaluation, interdisciplinary teaching Demonstration videotaped interviews were shown
teams, and group and individual student feedback. and discussed, and specific communication skills
Program evaluation was conducted after the were practiced in roleplays.
course was completed. Retrospective student reports In the following two workshops, each student
of their views about the importance of communica- recorded a six-minute videotaped interview with a
tion skills training prior to and after completion of simulated patient in front of their peers. Four differ-
the program were sought. Ideally, we would have ent patients and scenarios were used to ensure that
sought students’ opinions on communication skills students did not have prior knowledge of the sce-
prior to commencing the program. However, as this nario or the patient they were interviewing. This way,
data was not available, we asked students to provide students had the advantage of observing their peers’
this information retrospectively. interviewing styles and could contribute in provid-
ing group feedback to each student after their inter-
view. Prior to their interview, each student was given
Methods a completed medical history form and some basic
clinical information about the simulated patient. The
A new communication skills course was intro- tutor facilitated group feedback after each interview.
duced in 2003 as a component of the “Preventive A patient response form was completed by the pa-
and Interventive Dental Care” course for dental stu- tient (actor) after each student interview, while the
dents in their third year of training. A class of sixty- tutor (psychologist) completed a student marking
seven students was divided into two streams, each schedule, providing individual written feedback for
of which was randomly assigned to two groups, cre- each student about his or her performance. These
ating four groups of sixteen to seventeen students. forms were given to the students at the beginning of
Overall, the course consisted of four two-hour the final workshop after they had analyzed their own
classes. Two classes were held weekly, with two of videotaped interview. A dental clinician (pediatric
the four groups meeting on alternate weeks. Each dentist) attended the groups on alternate weeks to
group was tutored by a psychologist experienced in provide support and clinical information related to
teaching communication skills (AH or JM), with the the scenarios.
assistance of a dental specialist (KA). The fourth workshop concentrated on group
Attendance and participation in the communi- discussion of specific skills relating to the handling
cation skills course were mandatory for all students. of personal and patient emotion, feedback from stu-
The class comprised thirty-five females and thirty- dent interviews with the public, and class participa-
two males with a mean age of 22.6 years and 22.3 tion in a revolving interview with two simulated pa-
years, respectively. A student communication skills tients (actors) using different scenarios. One student
handbook documented the course objectives, course would begin the interview, and consecutive students
outline, student groups, evidence-based rationale, and would either continue the interview or repeat parts
specific communication skills to be learned. This of it to practice different ways of gathering and giv-
handbook was designed to facilitate self-directed ing information and engaging in personal interac-
learning and complement in-class instruction. A stu- tion with patients. The simulated patients spent half
dent logbook was developed to further encourage the time with each group.
self-directed homework exercises and personal analy- A standard University of Otago course evalua-
sis of each student’s individual communication style. tion, with additional questions about the students’
The first assignment consisted of a reflective exer- views before and after the course, offered all stu-
cise to analyze the student’s videotaped interview dents an opportunity to provide anonymous feedback
with a simulated patient. The second assignment re- about the communication skills program. Evaluation
quired each student to interview a member of the forms were distributed at the end of the final work-
public to obtain information about what people liked shop, completed by the students, collected by a class
and/or disliked about their dentist’s communication representative, and sent to the Higher Education
and clinical practice. Department (HEDC) for collation and initial analy-

972 Journal of Dental Education ■ Volume 68, Number 9

sis. Tutor consent was obtained before construction Interpolated median ratings31 were calculated,
of the questionnaire. Student consent was implicit in but as they followed a similar pattern, the means and
their completion of the course evaluation form. A 5- standard deviations are presented. As can be seen
point Likert-type scale was utilized (1 = not impor- from Table 1, the means were mostly around or just
tant at all to 5 = very important). The twelve closed- below M = 4.00 on the Likert scale, with the highest
ended questions are presented in Table 1. scores for obtaining a balance between tutor and stu-
dent participation, effectiveness of the tutor, and tu-
tor evaluations (or feedback) of students’ perfor-
Results mance. The lowest rating was for how stimulating
the students found the course (M = 3.55).
Of the sixty-seven students who participated Eighty-three percent of students rated commu-
in the communication skills course, fifty-nine (88 nication skills as more important after the program
percent) completed the retrospective evaluation ques- (Q12), while only 63 percent reported holding this
tionnaire. Using SPSSX, the distribution of the data opinion before the course began. A planned compari-
was found not to meet the assumption of normality; son between Question 1 and Question 12, using a
therefore, both non-parametric and parametric tests Paired T-Test, demonstrated that a larger proportion
were performed. As the pattern of significance was of students considered communication skills to be
consistent between both forms of analyses, only the significantly more important after the course (M =
parametric results are presented. 4.2, SD = 0.9) than before the course (M = 3.7, SD
Table 1 shows that most students were posi- 1.2), t (58) = -2.967, p < .004. However, these are
tive about the course: across all twelve questions the retrospective reports and subject to a potential stu-
percentage of students giving the course a rating of dent response bias due to experiences on the course,
4 or 5 on the Likert scale ranged from 59 percent to which may color their impression of the way they
83 percent. might have felt. To investigate which aspects of the

Table 1. Percentage of students who rated the course on the highest two categories on the Likert scale (4 & 5) and
the mean and standard deviation of student ratings
Percent rated
4 or 5 Mean and SD
Question (n = 59) (n = 59)

Q1 Before the course, did you view Communication Skills as an

important part of your training? not / very important 62.7% 3.71 (1.18)
Q2 How valuable was this course in terms of developing new skills
and techniques? not / valuable 71.2% 3.90 (1.08)
Q3 Did this course increase your interest in the subject matter?
not / greatly 61.0% 3.73 (1.19)
Q4 Has this course helped you develop more confidence in yourself?
not / greatly 69.5% 3.75 (1.08)
Q5 How effective was the tutor in teaching this course?
poor / very effective 67.8% 4.00 (1.17)
Q6 Was a good balance of student participation and tutor contribution
achieved? poor / very good 72.9% 4.02 (0.94)
Q7 Did the tutor seem genuinely concerned about each student’s progress?
no / yes 67.8% 3.92 (0.92)
Q8 The tutor was sensitive to student needs and concerns:
never / always 66.1% 3.86 (1.12)
Q9 Evaluations of my work were made in a constructive manner:
never / always 69.0% 4.00 (0.99)
Q10 Overall, rate the course reading materials (texts, assigned readings,
handouts, etc.): poor / excellent 59.3% 3.71 (0.95)
Q11 On the whole, my tutorials/seminars in this course proved:
boring / stimulating 58.6% 3.55 (1.19)
Q12 How do you view Communication Skills now (after completing this
course)? not / very important 82.8% 4.24 (0.87)

September 2004 ■ Journal of Dental Education 973

 course may have impressed those students who in- Students were also asked to give open-ended
creased their ratings of the importance of communi- written feedback about what aspects of the course
cation skills, participants were divided into two they liked the best and areas that could be improved
groups based on whether their importance ratings upon in subsequent years. Overall, students indicated
increased (n = 22) or did not increase (n = 36). that they would prefer to have this type of course
A 2 (group) x 12 (questions) repeated measures earlier in their training and continuing throughout
ANOVA was performed on the student ratings, and subsequent years. They also felt they would like a
significant main effects of group were found for sev- further videotaped interview so they could see how
eral variables. Students in the “increase” group were much their communication skills had improved.
more convinced that the course helped them develop While students found the videotaping a little anxi-
new communication skills and techniques (Q2); in- ety-inducing, they rated it as extremely useful. They
creased their interest in communication skills (Q3); liked the clinically oriented case-based scenarios and
reported greater increases in self-confidence (Q4); the clinical input from a dental specialist as well as
and thought that the tutor was more effective (Q5), the opportunity to learn from watching their peers
the course reading materials were better (Q10), and interview patients.
the course was more stimulating (Q11) compared to
the “no increase” group. There was also a trend for
the “increase” group to rate the tutor evaluations as
more constructive. The means, standard deviations,
Discussion
and significance levels of these analyses are presented This study describes a communication skills
in Table 2. course that emphasizes a skills-based approach, the
use of realistic clinical scenarios, videotaped inter-

Table 2. Means, standard deviations, and ANOVA values, of student ratings for two groups: a) those who considered
communication skills (CS) as more important (increased ratings) compared with b) all other student ratings

Question Group n Mean S.D. df F Sig.

Q1 CS importance a) Increased rating 22 2.68 1.04 1.56 52.496 .000

b) No increase 36 4.36 0.72
Q2 New skills a) Increased rating 22 4.41 0.73 1.56 8.414 .005
b) No increase 36 3.61 1.15
Q3 Interest a) Increased rating 22 4.36 0.73 1.56 11.068 .002
b) No increase 36 3.39 1.25
Q4 Confidence a) Increased rating 22 4.14 0.77 1.56 4.337 .042
b) No increase 36 3.56 1.16
Q5 Effective tutor a) Increased rating 22 4.41 1.05 1.56 4.144 .047
b) No increase 36 3.78 1.20
Q6 Participation a) Increased rating 22 4.23 0.92 1.56 1.518 .223
b) No increase 36 3.92 0.94
Q7 Tutor concern a) Increased rating 22 4.18 0.96 1.56 2.744 .103
b) No increase 36 3.78 0.87
Q8 Tutor sensitive a) Increased rating 22 4.18 1.10 1.56 2.636 .110
b) No increase 36 3.69 1.12
Q9 Tutor feedback a) Increased rating 22 4.32 0.95 1.55 3.442 .069
b) No increase 35 3.83 0.99
Q10 Course materials a) Increased rating 22 4.14 0.83 1.56 7.403 .009
b) No increase 36 3.47 0.94
Q11 Stimulating a) Increased rating 22 3.95 1.05 1.55 4.088 .048
b) No increase 35 3.31 1.23
Q12 CS importance a) Increased rating 22 4.55 0.67 1.56 4.665 .035
b) No increase 36 4.06 0.92

974 Journal of Dental Education ■ Volume 68, Number 9

views, simulated patients, and an integrated teach- each patient. Clinically relevant scenarios enable stu-
ing team. Previous research has indicated that, for dents to develop skills such as problem solving, in-
many dental schools in the United Kingdom and the creased knowledge of referral processes, and an
United States, communication skills training has in- awareness of ethical/legal issues.
volved didactic teaching practices, few opportuni- Learning communication skills can be very
ties for in-vivo practice, and the use of teaching staff challenging, as communication skills are often
from one discipline as opposed to an integrated viewed as an intrinsic part of the person’s personal-
team.21,22 ity, cognitive functioning, and social experience. Stu-
The results of this study showed that the ma- dents are often asked to make changes to aspects of
jority of students rated the communication skills their appearance and behavior that are of a highly
course highly in all areas. These results are consis- personal nature. In addition, a shift from dentist-cen-
tent with those of previous dental studies that docu- tered to patient-centered communication is necessary
mented favorable evaluations of communication and requires a change in the way in which the stu-
skills programs.12,16-19 One reason for the positive dent gathers patient information. For example, be-
evaluations made by students in the present study fore training, students tend to focus on the disease
may be that they found the clinical scenarios and the process to the virtual exclusion of psychosocial is-
opportunity to practice skills with simulated patients sues.
a realistic and challenging learning task. Some stu- Giving student feedback can affect intrinsic
dents commented that they had encountered similar motivation to learn and elicit both emotion and
situations in clinical settings and they appreciated arousal, which can negatively affect learning and
the opportunity to practice different approaches in performance.33,34 Sims-Knight and Upchurch33 sug-
the safety of the roleplay situation. There is research gest that classroom climate and self-reflective analy-
from the medical communication skills training lit- sis improve students’ learning and performance more
erature to support the use of clinically relevant sce- so than tutor feedback. This course was designed with
narios and simulated patients.30 In contrast, didactic a large requirement of self-reflective analysis as well
teaching practices involving more abstract concepts as some group feedback and tutor evaluation. Feed-
and large group sizes may provide fewer opportuni- back regarding a student’s interpersonal skills needs
ties for active student participation and skills-based to be skillfully given. It should occur as soon as pos-
practice. sible after the clinical encounter and should be con-
The use of simulated patients (actors) who are structive as well as sensitive. Students may become
skilled at presenting complex clinical conditions, defensive if feedback is excessively critical or nega-
monitoring the student’s performance, and deliver- tive or if feedback is delivered in an insensitive man-
ing specific feedback is an essential component of ner when pertaining to their personal mannerisms or
this program. Simulated patients are selected to rep- characteristics. The use of skilled instructors, pref-
resent a wide variety of psychological, ethical, and erably from both the social sciences/psychology field
cultural viewpoints that are common to dental prac- and the dental profession, has many benefits for stu-
tice and that students will need to handle effectively dent learning. Student evaluations of the tutors in
in their professional work. Students who have diffi- the current program were very favorable overall. Stu-
culties with the English language are able to improve dents commented positively about the team teach-
their language skills and to develop expertise in ar- ing approach involving psychologists and a dental
eas such as the avoidance of dental jargon and fa- clinician. This combination allowed instructors to
miliarization with colloquialisms, which are common contribute different areas of expertise when provid-
sources of misunderstanding.32 ing feedback, answering students’ questions, and
Realistic, clinically based scenarios are another during group discussion.
important component of any effective communica- Students were required to carry out self-assess-
tion skills program. The roleplay scenarios used in ments during the course. Each student analyzed his
our program were specifically designed to contain or her own videotaped interview and presented the
psychosocial and lifestyle factors that were particu- analysis to the group for discussion. Increasing stu-
larly relevant to oral disease processes. This further dents’ awareness of their communication strengths
contributed to students’ understanding of disease and weaknesses is designed to promote a lifelong
processes in dentistry and the necessary precautions learning process that continues long after formalized
and treatment options that need to be addressed with instruction has ceased.

September 2004 ■ Journal of Dental Education 975

 An interesting finding of our study was that a view with the patient in the absence of their class-
large percentage of students said they considered mates. Some students reported that it was difficult to
communication skills to be more important after hav- concentrate on the patient with an audience present.
ing completed the course. This finding is not sur- Changing this would likely reduce the level of anxi-
prising to us, since in years of teaching communica- ety that students experienced during this interview
tion skills, we have encountered initial resistance to process, which may subsequently improve student
these courses on the part of some students. Initial interview performance.
skepticism could be due to a lack of knowledge about Further course development in collaboration
the specific components of communication skills and with other schools would be useful. This saves “re-
the use of the term “communication skills,” which inventing the wheel” each time a course is devel-
may suggest to students that they will be learning oped. It is also important to elicit wider support of
skills that they already possess. communication skills training within the dental fac-
A related view is that skilled communication ulty, as well as to ensure that teaching in communi-
is just common sense or is acquired instinctively. This cation skills is consistent and being reinforced by
perception may stem from a lack of awareness of the other faculty members in all teaching situations, par-
unique nature of communication skills in clinical ticularly in the clinical setting. Other proposed de-
settings. In professional clinical consultations, for velopments to the teaching of communication skills
example, the expectation of reciprocity and equal at Otago include the development of videotaped
sharing of conversation are not the same as that which material for teaching purposes and initial class dis-
occurs in ordinary conversation. Similarly, closed and cussion.
leading questions are a characteristic of everyday While overall there has been an emphasis on
conversation but can be counterproductive in a den- the need for teaching in the area of communication
tal consultation. Froelich and Bishop35 have noted skills in dentistry, there is also a need for educational
that “the ability to communicate skillfully and with research evaluating the effectiveness of communi-
purpose rarely occurs as a gift—it is learned.” cation skills-based teaching programs. Evaluative
Behavior change that is lasting requires numer- research will help ensure the continued development
ous opportunities for practice and ongoing reinforce- and delivery of effective patient-centered dental edu-
ment. For this reason, it is important to introduce cation.
skills-based communication training in the students’ Health professionals, and dentists in particu-
first clinical year and to continue training over an lar, are required to interact with patients on a very
extended time period where possible. This is not only intimate level within minutes of meeting. It is essen-
essential for the students’ ongoing practice of skilled tial, therefore, that dental students are provided with
communication, but is also likely to enhance patient skills-based communication training based on the
satisfaction and public image of the dental school. most recent research literature. In this way, dental
Although the majority of students favorably students will be better equipped for clinical practice
evaluated the current communication skills program, to deal with patient anxiety, to identify ethical is-
we would like to modify a number of features in fu- sues, and to recognize significant psychosocial fac-
ture programs. One aspect, the large group size, may tors that lead to more accurate diagnosis and treat-
have led to lower ratings of tutor sensitivity to stu- ment processes, thereby increasing patient
dents’ needs, concerns, and progress than anticipated. satisfaction and safety.
However, it should be noted that student ratings of
tutor characteristics were still very positive overall.
Smaller groups would increase student participation
Acknowledgments
and enable more individual teaching. Ideally, groups The authors wish to thank Judy Trevena, Ph.D.,
would contain a maximum of ten to eleven students. Judy Martin, M.A., Natasha Pomeroy, M.Sc., and
Another area that could be improved relates to the anonymous reviewers for their valuable sugges-
the manner in which students conducted their video- tions regarding analysis and presentation of this pa-
taped interview session. In the current program each per. We would also like to acknowledge the Depart-
student was asked to perform his or her interview in ment of Psychological Medicine, Dunedin School of
front of classmates. A better alternative would be for Medicine, which developed the communication skills
each student to conduct his or her videotaped inter- program for medical students from which our pro-
gram was adapted specifically for dental students.

976 Journal of Dental Education ■ Volume 68, Number 9

 19. Runyon HL, Cohen LA. The effects of systematic human
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