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This study is an investigation of: the communication skill proficiency of two-year technical-vocational students; the effects of age, ethnic background, and socio-economic index on standardized reading and writing test performance; and of communication skill priorities with respect to content emphasis as perceived by technical-vocational teaching personnel within the Tarrant County Community College system. The purpose of this study is to provide information pertinent to; the development of a functional communication skills program which will complement the occupational student's trade skills; the further development of a pre-technical program currently in operation at Tarrant County Junior College; and the construction of similar programs in other community college systems. This study concludes that the research evidence warrants unique support curriculum programs designed to provide compensatory work and specific training for terminal students in general academic skill areas such as communications.

Research subject is the peculiarities of communication skills training of children with moderate and severe intellectual disabilities at pre-school age. Hypothesis: the communication between children is stimulated when education goals, tasks, methods and activities meet children communication abilities. Research aim is to analyze the peculiarities of communication education of children with moderate and severe intellectual disabilities. Research methods: theoretical analysis of scientific sources, question airing that allows summarizing the educational experience of specific communication training cases. The research data on the persons under research is provided by special educators of pre-school education institutions. Persons under research – children of pre-school age (4 – 8 years) with moderate and severe intellectual disabilities and moderate and severe speech development. Conclusions. Communication abilities of children with moderate and severe intellectual disabilities are of a low level, revealing themselves by active responsive reactions of children into communication initiative, but not with the initiative of children themselves.

Technological advances mean that medical education bodies can now teach doctors in training using sophisticated engineering systems. Clearly, it is important to establish the efficacy of such innovative educational methods. This study was undertaken primarily to determine whether or not an interactive computerised teaching programme could train medical students and junior house officers to impart effectively distressing information. Subjects were fifth year medical undergraduates at the University of Aberdeen during the 1997/98 academic year. Subjects were separated into two groups. One group had access to the teaching programme during their final undergraduate year, whilst the other did not. Subjects conducted simulated interviews toward the end of their fifth year at medical school and toward the end of their pre-registration year. All subjects were assessed on one of three cases. Subjects were assessed on the same case at both assessment points. All interviews were videotaped. Performances were scored independently by two raters. Subjects rated their own performances. Of 132 medical undergraduates, 94 (71%) conducted interviews toward the end of their fifth year. Of the 63 who could participate one year later, 45 (71%) conducted a second assessment interview. The interaction teaching programme did not improve subjects' ability to give bad news at either test point. Regarding subjects' ratings, at the undergraduate test point, the two significant differences favoured those subjects given access to the teaching programme. At the postgraduate assessment point, the four significant differences favoured those subjects not given access to the teaching programme. Analyses indicated that the skills of doctors in training could be reliably evaluated using three ten-minute interviews. Subjects were poor at evaluating their own communication skills. Those who gave bad news more frequently as junior house officers performed at a similar level to those who gave bad news less frequently. The implications for medical education are discussed.

Advance care planning for adults is a process of consideration, discussion and decisions about care at the end of life. There is evidence that advance care planning improves outcomes such as the achievement of preferred place of death and the quality of dying. However, the uptake of advance care planning is variable. There are calls for more research to understand what influences people to carry it out to plan services and improve the quality of life of patients and their families. This dissertation reports on a qualitative, video interview study of 15 adult hospice patients. The study was interpretative influenced by the narrative approach with data driven thematic analysis and a video aide memoir. Coding was carried out using the Computer Assisted Qualitative Data Software programme Transana. The rigour and credibility of the study was viewed through the lens of trustworthiness which included the development of a Continuous Conversation Framework. The aim of the study was to investigate what would influence hospice patients to discuss their advance care planning to develop future education programmes based upon the perspectives of people at the end of their life: 1. What influences hospice patients in their advance care planning? 2. What communication skills do hospice patients find helpful when clinicians discuss advance care planning? Three findings are reported. These suggest that the influences on advance care planning activity and conversations is the less reported relationship of the personal context of a person's life (as well as services, diagnosis and prognosis considerations). First, the findings highlight the relevance of how people with an incurable illness live with and talk about their dying within the individual context of their daily lives. Secondly, differences are illustrated between how people prepare (for themselves) and plan (for others) in their dying. Thirdly, clinician communication behaviours such as empathy (through mutual connection and visible behaviours), tailored conversations (through accessible and selective honesty) and the design and use of space empower people to carry out conversations which support them as they live with, prepare and plan for dying. The three findings contribute to the perspective which supports the complexity of advance care planning that should focus on the context of person's life as well as the paperwork, prognosis or diagnosis. A contribution to person-centred care is suggested through a model of relational advance care planning.

The purpose of this project was to design a package to train ninth-grade students in basic interpersonal communication awareness and skills.

The aim of this thesis is to study (1) the impact of physicians' locus of control (LOC) on their communication styles in interviews with cancer patients as well as (1) the impact of physicians' LOC on their acquisition of effective communication skills in a communication skills training program. LOC is a generalised belief regarding the extent to which life outcomes are controlled by an individual's actions (“internal” LOC) or by external forces such as luck, fate or other individuals (“external” LOC). (1) Although is it widely recognised that physicians' characteristics could influence their communication styles and may thus interfere with a patient-centred communication, no empirical evidence is currently available. No studies are available on the impact of physicians' LOC on their communication skills. It was hypothesised that physicians with an “external” LOC have a different communication style than physicians with an “internal” LOC. Eighty-one voluntary physicians with a practice in oncology were recorded performing an actual and a simulated interview with a cancer patient as wall as an actual and a simulated interview with a cancer patient and a relative. Physicians' communication skills were assessed using the Cancer Research Campaign Workshop Evaluation Manual. Physicians' LOC was assessed using the Rotter I-E scale. Communication skills of the upper and lower quartiles of physicians in respect of their scores on this scale were compared using Student's t-test. Results show that physicians with “external” LOC give more appropriate information than physicians with “internal” LOC in simulated interviews with a cancer patient (P=0.011) and less premature information than physicians with “internal” LOC in clinical interviews with a cancer patient (P=0.015). Moreover, in actual interviews with a cancer patient and a relative, physicians with an “external” LOC talked more to the relative (P=0.017) and used more utterances with an assessment function (P=0.010) than physicians with an “internal” LOC. In simulated interviews with a cancer patient and a relative, physicians with an “external” LOC used less utterances giving premature information (P=0.031) and used more utterances with a supportive function such as empathy and reassurance (P=0.029) than physicians with an “internal” LOC. (2) Although it is widely recognised that educational interventions may be more effective for people with an “internal” LOC compared to people with an “external” LOC, no study has yet assessed the influence of physicians' LOC on communication skills learning. This study aims to test the hypothesis that, in a communication skills training program, physicians with an “internal” LOC would demonstrate communication skills acquisition to a greater degree than those with an “external” LOC. A non-randomised longitudinal intervention study was conducted between January 1999 and April 2001. Sixty-seven volunteer physicians from private and institutional practice in Belgium participated to a learner-centred, skills-focused, practice-oriented communication skills training program. Communication skills changes were assessed in 2 standardised simulated interviews before and after training (one two-person and one three-person interview). Communication skills were assessed using the Cancer Research Campaign Workshop Evaluation Manual. Physicians' LOC was assessed using the Rotter I-E scale. Communication skills changes of the upper and lower third of physicians in respect of their scores on this scale were compared using group by time repeated measures of variance. In the two-person and three-person interviews, the increase in open directive questions was more important among physicians with an “internal” LOC compared to physicians with an “external” LOC (P=0.066 and P=0.004 respectively). In the three-person interview, the increase in directive questions (P=0.001), in assessing functions (P=0.002) and in the use of moderate feelings stated explicitly (P=0.011) was more important among physicians with an “internal” LOC compared to physicians with an “external” LOC. Conclusion. These results provide evidence that physicians' LOC can influence their communication styles as well as the efficacy of a communication skills training program. Physicians' awareness of first results constitutes a step towards a tailoring of their communication skills to every patient's and relative's concerns and needs and thus towards a patient-centred communication. The second results support the idea that a psychological characteristic such as "internal" LOC may facilitate communication skills acquisition through physicians' belief that communication with patients may be controlled by physicians themselves.

Prelinguistic Milieu Teaching (PMT) is an intervention designed to teach young children to initiate nonverbal communication using vocalizations, gestures, and eye-gaze. Children are taught through social routines in their natural environment. Techniques include contriving an environment in which the children will be motivated to communicate and using a hierarchy of prompting and modeling to evoke the desired communicative behaviors, such as requesting and commenting. PMT has been previously studied in young children (ages 1-5) with developmental delays. In this study, it is implemented with six school-age children with Autism (ages 5-8). A multiple baseline design across participants was used to evaluate the effects of the intervention on the variables of frequency, clarity, and maintenance of the participants’ communication. All six participants showed increases in the targeted prelinguistic communication skills during treatment and maintained the increases during follow-up. Analysis of individual behavioral profiles was helpful for disambiguating individual differences in response to intervention across the three variables. Future research should target generalization of learned behaviors across implementers and settings. / text

Shy children often have difficulty communicating; however, it is not clear whether these difficulties stem from a skills deficit or from an anxiety-driven performance deficit. Therefore, the present study examined how shy children’s communication skills differed from those of average, non-shy children, using the Internet as a medium for social communication. It was hypothesized that shy children may be more reticent than average children to initiate conversation in a novel situation. However, over time shy children were expected to become more comfortable in discussions with their on-line partner and to become less anxious as they acknowledge the anonymity of chat groups. This study also investigated potential changes in negative effects associated with shyness over time. Fifteen shy children (Mean shyness score=72.3; SD=6.43) and 15 average children (Mean shyness score=53.7; SD=5.6) participated in the 10 MSN conversation groups. Children were also given a series of questionnaires prior to and after the 10 sessions. Results from this study suggest that shy children communicate in a similar manner to their average partners when online. Results also suggest that shy children had higher levels of social anxiety than average children before beginning an online conversation with an unknown partner. However, by the end of the 10 sessions, their anxiety had been significantly reduced. No other changes or differences in psychological functioning were noted between shy and average children.