Blended-learning training in communication skillsusing Doc.com for primary care faculty in Brazil

Brazil’s national health system is expanding toward universal coverage as a result of the Family Health Strategy (FHS), a community-based approach where interdisciplinary health care teams provide primary care for a geographically defined population. FHS teams are composed of a physician, a nurse, a nurse assistant and four to six full-time community health agents and each team member has defined roles and responsibilities.1 Community health agents are lay members of the community selected and trained to provide care management around where they live. Each agent provides a set of activities in health promotion and basic clinical care. They verify if patients have been taking their medications regularly, help patients to schedule appointments in the healthcare unit, look for risk factors such as smoking and symptoms of common chronic disease and identify warning signs of violence, neglect or drug abuse 1. The access and adherence of the families to the FHS can be strengthened by the patient-centered communication approach once it promotes partnership between the patient and health professionals, offering the opportunity to empower patients to become more active in managing their health.2,3,4 Patient-centered communication approach has been associated with improvement of clinical parameters of chronic diseases.4 The “Project Leonardo” demonstrated the benefits of a collaborative “team” consisting of physicians, care manager nurses and specialists working as “patients partners” to change in a positive way some clinical indicators related to cardiovascular disease such as LDL levels, BMI rating and blood pressure values 4. For this reason, communication skills should be part of the undergraduate medical curriculum and of the healthcare professional team training.4,5 However, instruction in doctor-patient communication skills remains a challenge for many medical schools with some concerns regarding the diversity of faculty specialties and the lack of faculty training in communication skills.5,6 Therefore, faculty should be prepared to teach these abilities.5