The interaction provided opportunities to develop rapport with the patients which subsequently permitted an exploration of some of the more sensitive issues related to the illness, diagnosis, prognosis and dying. The experience highlighted a number of critical incidents that influenced the students' perspectives in relation to some aspects of palliative care. In spite of the change that has occurred in medical education and medical practice in recent years certain clinical skills remain constant. These continue to be defined as essential because they cannot be separated from the operational definition of the clinician. One of them is the ability to effectively communicate and interact with patients, relatives and members of the health care team.
Most medical curricula contain communication skills instruction.
This suggests that current educational strategies are inadequate. It therefore seems sensible to consider educational opportunities for better preparation of new graduates in the skills of communication with terminally ill patients and their relatives, within formal courses of palliative medicine. In the School of Medicine at the University of Western Australia, undergraduate palliative medicine instruction occurs over two years. Communication skills are emphasised during year 4, and this is reinforced in year 6 with a short visit to a patient in their home. Being aware of the fact that this is likely to be inadequate for addressing the problems faced by new graduates, it was decided to explore a learning opportunity that might address some of the issues.