Communication skills are increasingly prioritised in the MPharm degree, and for good reason, because to be good pharmacists we have to know how to talk to patients and co-workers. Pharmacy students are taught both explicitly and implicitly that we are ‘typical’ communicators.
This focus on ‘typical’ communication leads to the inadvertent marginalisation of pharmacists, pharmacy students, and patients who communicate in a less conventional way. For pharmacy students and professionals, this could result in feelings of isolation and pressure to camouflage or ‘mask’ their differences, which can impact on learning and mental health. Further, we express this similarity in communication styles to patients, which can lead to more barriers in accessing healthcare for patients who communicate ‘differently’.
Roughly 20% of the population will experience a communication difficulty at some point in their life (1). Many people have conditions which can lead to communication differences, for example, cerebral palsy, autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), foetal alcohol spectrum disorder (FASD), learning disability, speech disorders, selective mutism, dementia, and brain injury (2). This list is not exhaustive but illustrates that people with communication difficulties may be overrepresented in the patient population.
Communication differences do not only exist in the patient population, but also in healthcare professionals. For example, one survey found that 1% of GPs identified as autistic (3), roughly the same as in the general population.
Imposing the idea that pharmacy students and professionals are ‘typical’ communicators is tempting because pharmacists are required to be good communicators, and many still combine ‘typical’ with good. However, good communication can take many forms and is not limited to ‘typical’ communicators.
People can very easily be good communicators with certain groups of patients and poor communicators with others. For instance, pharmacists who do not know British Sign Language (BSL) will not be as capable of good communication with a D/deaf person who uses BSL. This principle applies to other conditions which may result in differences in communication, like ASD and ADHD. When we draw up lines between ‘typical’ and ‘different’, we form a barrier between ourselves and our patients. Barriers such as these can manifest in poor patient experiences, because pharmacy students and professionals may not learn the importance of treating people with all styles and types of communication as equals
We do pharmacy students, professionals, and patients a disservice when we teach that it is always the patient that communicates differently. It is time to review how communication is taught in Schools of Pharmacy.
There are some steps that can be used in creating a new communication curriculum. Below is an action plan to improve communication teaching:
- Neurodiversity and disability awareness training: This can include teaching from neurodivergent and disabled adults, which includes strategies to bridge differences in communication between pharmacy students, and patients or colleagues
- Mentoring: Support students with ‘differences’ in communication and strive to create professionals who are tolerant and understanding of people with communication ‘differences’.
- Role-play and OSCEs: This should include simulated patients and healthcare professionals with differences in communication. Pharmacy schools should consider reasonable OSCE adjustments for neurodivergent and disabled students.
- Reviewing teaching: This is to ensure that teaching surrounding disabilities and communication differences follows the most current research, diagnostic criteria, and language. Inform students if outdated or offensive language is removed from teaching that they have previously completed.
By pharmacy student and PDA Student Rep, Rosie Barnes
References
- Royal College of Speech and Language Therapy. Communication Access UK. [no date] [accessed 23 Apr 2025].
- Communication Disabilities Access Canada. Disabilities that may affect Communication. [no date] [accessed 23 Apr 2025].
- Unigwe S, Buckley C, Crane L, Kenny L, Remington A, Pellicano E. GPs’ Confidence in Caring for Their Patients on the Autism spectrum: an Online self-report Study. British Journal of General Practice. 2017; 67(659):e445–52. doi: 10.3399/bjgp17X690449
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