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
skills are not the only prerequisites for good prac-
tice. An ability to communicate effectively with
patients—in particular, to use active listening skills,
to gather and impart information effectively, to handle
patient emotions sensitively, and to demonstrate
empathy, rapport, ethical awareness, and profession-
alism—is crucial. Among the benefits noted when
dentists demonstrate effective communication skills
are increased patient satisfaction, improved patient
adherence to dental recommendations, decreased
patient anxiety, and lower rates of formal complaints
and malpractice claims.1-9
The importance of behavioral sciences, and in
particular communication skills, was formally rec-
ognized in the United Kingdom with the 1990 publi-
cation of the General Dental Council’s guidelines for
the inclusion of behavioral sciences teaching in den-
tal schools.10 In the United States, the American As-
sociation of Dental Schools’ 1993 guidelines11 iden-
tified core areas of behavioral science and
communication skills in the dental curriculum.
Amongst dental practitioners themselves and
specialist groups working in the field, there has also
been a general acceptance of behavioral sciences and
communication skills as important components of
dental education.12-15 Dental students and teaching
staff have evaluated communication skills training
as highly relevant as well.12,16-20 Only a small minor-
ity of surveys have indicated that attitudes towards
communication skills training and behavioral sci-
ences have been less positive or have worsened over
time.10,15
Despite widespread recognition of the impor-
tance of communication skills training in the dental
curriculum, the reality of what is practiced is some-
what different. Two recent reviews, one of North
American dental schools and one of UK dental
schools, have identified a number of problems with
communication skills training to date. Yoshida et al.21
conducted a survey of forty U.S. and Canadian den-
tal schools and found that only one-third of them had
courses focusing specifically on interpersonal com-
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-
sive learning rather than active skills-based practice
using simulated or real patients. Training tended to
occur on a one-course only basis, with little oppor-
tunity for students to learn in a gradual, systematic
fashion with increasingly complex material. Assess-
ment of students was generally conducted by grad-
ing participation in class exercises, rather than di-
rectly evaluating student performance or assessing
knowledge via written or oral tests. The authors con-
cluded that there is a current lack of emphasis on
teaching communication skills in North America.
McGoldrick and Pine22 conducted a review of
behavioral sciences teaching, including communi-
cation skills, in all fourteen dental schools in the
United Kingdom. They found that thirteen schools
offered formal behavioral sciences programs in the
undergraduate curriculum, with all fourteen schools
covering the topic of communication skills to some
extent. However, considerable variation was found
with regard to the course content, the teaching meth-
ods employed, and the credentials of teaching staff
involved. In particular, many programs emphasized
theoretical aspects of communication rather than pro-
viding opportunities for skills-based practice. Teach-
ing methods generally entailed the use of a didactic
teaching style and a large group format, and teach-
ing staff were usually selected from one discipline
only (e.g., dentists) with little interdisciplinary teach-
ing by dentists, psychologists, and sociologists.
McGoldrick and Pine expressed concern over the lack
of time and resources allocated to communication
skills training and the failure of many programs to
adopt a skills training approach.
The need for systematic teaching of communi-
cation skills in dentistry is widely recognized, but
there has been limited research that delineates teach-
ing approaches and compares the effectiveness of
different strategies. Many articles were published in
the 1970s that addressed teaching communication
skills, but most of them were discussion papers and
few presented research. There have also been few
attempts to describe the nature of such teaching pro-
grams in the literature.
When reviewing the literature, we found two
studies that compared strategies for teaching com-
munication skills to dental students. Ter Horst et al.23
compared two randomly assigned groups of dental
students: those who received a three-day communi-
cation skills training program, and those who re-
ceived no training (control group). Students were
assessed in terms of their written responses to vid-
September 2004 ■ Journal of Dental Education
eotaped dentist-patient interactions. The students who
received communication skills training were signifi-
cantly more likely to explore and recapitulate pa-
tients’ statements than the control students. However,
the authors concluded that methodological problems
raised questions about the validity of their findings.
Davis et al.24 compared the effects of two meth-
ods of instruction for teaching communication skills
to senior dental students. They found no significant
differences between conventional instruction, in
which instructors provided students with formal feed-
back about their interactions with patients, and vid-
eotape feedback instruction, which entailed an in-
structor-guided review of videotaped student-patient
interviews. In the study conducted by Davis et al.,
students in both instructional groups interviewed
actual dental patients, rather than simulated patients.
One further study, Koerber et al.25 explored the
effect of brief motivational interviewing (BMI) train-
ing in relation to smoking cessation counseling. They
found both clinical and statistically significant im-
provements in interviews conducted by those dental
students who had completed three sessions (twelve
hours) of BMI training compared to the control
group. On the other hand, there was no effective dif-
ference in rapport between the student and the simu-
lated patient across the two groups.
The field of medicine has generated a number
of research studies to evaluate the effects of differ-
ent teaching methods and materials in communica-
tion skills training.26-30 Some important principles for
effective teaching have been identified by such re-
search. Teaching recommendations include the use
of: 1) a skills-based approach (as opposed to a di-
dactic approach), 2) clinically relevant scenarios, 3)
self-assessment by students, 4) videotaping methods,
5) simulated patients with expertise in a variety of
clinical roles and in the monitoring of student per-
formance and the delivery of feedback, 6) an inte-
grated teaching team comprising health sciences staff
and human sciences disciplines, and 7) small groups
for optimal student learning.
The purpose of this article is to describe a com-
munication skills program that was offered for the
first time in 2003 to third-year dental students at the
Otago School of Dentistry, Dunedin, New Zealand.
The program was based on a format designed and
used for communication skills teaching of medical
students at the Dunedin School of Medicine, Otago
University, New Zealand, and based on the research
findings for effective communication skills teach-
ing. New roleplay scenarios were developed to por-
971
 tray challenging aspects of dental practice. Compo-
nents of the program included videotaped interviews,
simulated patients, an interview of a member of the
public, self-evaluation, interdisciplinary teaching
teams, and group and individual student feedback.
Program evaluation was conducted after the
course was completed. Retrospective student reports
of their views about the importance of communica-
tion skills training prior to and after completion of
the program were sought. Ideally, we would have
sought students’ opinions on communication skills
prior to commencing the program. However, as this
data was not available, we asked students to provide
this information retrospectively.
Methods
A new communication skills course was intro-
duced in 2003 as a component of the “Preventive
and Interventive Dental Care” course for dental stu-
dents in their third year of training. A class of sixty-
seven students was divided into two streams, each
of which was randomly assigned to two groups, cre-
ating four groups of sixteen to seventeen students.
Overall, the course consisted of four two-hour
classes. Two classes were held weekly, with two of
the four groups meeting on alternate weeks. Each
group was tutored by a psychologist experienced in
teaching communication skills (AH or JM), with the
assistance of a dental specialist (KA).
Attendance and participation in the communi-
cation skills course were mandatory for all students.
The class comprised thirty-five females and thirty-
two males with a mean age of 22.6 years and 22.3
years, respectively. A student communication skills
handbook documented the course objectives, course
outline, student groups, evidence-based rationale, and
specific communication skills to be learned. This
handbook was designed to facilitate self-directed
learning and complement in-class instruction. A stu-
dent logbook was developed to further encourage
self-directed homework exercises and personal analy-
sis of each student’s individual communication style.
The first assignment consisted of a reflective exer-
cise to analyze the student’s videotaped interview
with a simulated patient. The second assignment re-
quired each student to interview a member of the
public to obtain information about what people liked
and/or disliked about their dentist’s communication
and clinical practice.
972
The first two-hour class was an introductory
workshop in which the tutor outlined the course and
discussed specific communication skills techniques.
Demonstration videotaped interviews were shown
and discussed, and specific communication skills
were practiced in roleplays.
In the following two workshops, each student
recorded a six-minute videotaped interview with a
simulated patient in front of their peers. Four differ-
ent patients and scenarios were used to ensure that
students did not have prior knowledge of the sce-
nario or the patient they were interviewing. This way,
students had the advantage of observing their peers’
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
a completed medical history form and some basic
clinical information about the simulated patient. The
tutor facilitated group feedback after each interview.
A patient response form was completed by the pa-
tient (actor) after each student interview, while the
tutor (psychologist) completed a student marking
schedule, providing individual written feedback for
each student about his or her performance. These
forms were given to the students at the beginning of
the final workshop after they had analyzed their own
videotaped interview. A dental clinician (pediatric
dentist) attended the groups on alternate weeks to
provide support and clinical information related to
the scenarios.
The fourth workshop concentrated on group
discussion of specific skills relating to the handling
of personal and patient emotion, feedback from stu-
dent interviews with the public, and class participa-
tion in a revolving interview with two simulated pa-
tients (actors) using different scenarios. One student
would begin the interview, and consecutive students
would either continue the interview or repeat parts
of it to practice different ways of gathering and giv-
ing information and engaging in personal interac-
tion with patients. The simulated patients spent half
the time with each group.
A standard University of Otago course evalua-
tion, with additional questions about the students’
views before and after the course, offered all stu-
dents an opportunity to provide anonymous feedback
about the communication skills program. Evaluation
forms were distributed at the end of the final work-
shop, completed by the students, collected by a class
representative, and sent to the Higher Education
Department (HEDC) for collation and initial analy-
Journal of Dental Education ■ Volume 68, Number 9
sis. Tutor consent was obtained before construction
of the questionnaire. Student consent was implicit in
their completion of the course evaluation form. A 5-
point Likert-type scale was utilized (1 = not impor-
tant at all to 5 = very important). The twelve closed-
ended questions are presented in Table 1.
Results
Of the sixty-seven students who participated
in the communication skills course, fifty-nine (88
percent) completed the retrospective evaluation ques-
tionnaire. Using SPSSX, the distribution of the data
was found not to meet the assumption of normality;
therefore, both non-parametric and parametric tests
were performed. As the pattern of significance was
consistent between both forms of analyses, only the
parametric results are presented.
Table 1 shows that most students were posi-
tive about the course: across all twelve questions the
percentage of students giving the course a rating of
4 or 5 on the Likert scale ranged from 59 percent to
83 percent.
Interpolated median ratings31 were calculated,
but as they followed a similar pattern, the means and
standard deviations are presented. As can be seen
from Table 1, the means were mostly around or just
below M = 4.00 on the Likert scale, with the highest
scores for obtaining a balance between tutor and stu-
dent participation, effectiveness of the tutor, and tu-
tor evaluations (or feedback) of students’ perfor-
mance. The lowest rating was for how stimulating
the students found the course (M = 3.55).
Eighty-three percent of students rated commu-
nication skills as more important after the program
(Q12), while only 63 percent reported holding this
opinion before the course began. A planned compari-
son between Question 1 and Question 12, using a
Paired T-Test, demonstrated that a larger proportion
of students considered communication skills to be
significantly more important after the course (M =
4.2, SD = 0.9) than before the course (M = 3.7, SD
1.2), t (58) = -2.967, p < .004. However, these are
retrospective reports and subject to a potential stu-
dent response bias due to experiences on the course,
which may color their impression of the way they
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-
creased their ratings of the importance of communi-
cation skills, participants were divided into two
groups based on whether their importance ratings
increased (n = 22) or did not increase (n = 36).
A 2 (group) x 12 (questions) repeated measures
ANOVA was performed on the student ratings, and
significant main effects of group were found for sev-
eral variables. Students in the “increase” group were
more convinced that the course helped them develop
new communication skills and techniques (Q2); in-
creased their interest in communication skills (Q3);
reported greater increases in self-confidence (Q4);
and thought that the tutor was more effective (Q5),
the course reading materials were better (Q10), and
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,
and significance levels of these analyses are presented
in Table 2.
Students were also asked to give open-ended
written feedback about what aspects of the course
they liked the best and areas that could be improved
upon in subsequent years. Overall, students indicated
that they would prefer to have this type of course
earlier in their training and continuing throughout
subsequent years. They also felt they would like a
further videotaped interview so they could see how
much their communication skills had improved.
While students found the videotaping a little anxi-
ety-inducing, they rated it as extremely useful. They
liked the clinically oriented case-based scenarios and
the clinical input from a dental specialist as well as
the opportunity to learn from watching their peers
interview patients.
Discussion
This study describes a communication skills
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-
ing team. Previous research has indicated that, for
many dental schools in the United Kingdom and the
United States, communication skills training has in-
volved didactic teaching practices, few opportuni-
ties for in-vivo practice, and the use of teaching staff
from one discipline as opposed to an integrated
team.21,22
The results of this study showed that the ma-
jority of students rated the communication skills
course highly in all areas. These results are consis-
tent with those of previous dental studies that docu-
mented favorable evaluations of communication
skills programs.12,16-19 One reason for the positive
evaluations made by students in the present study
may be that they found the clinical scenarios and the
opportunity to practice skills with simulated patients
a realistic and challenging learning task. Some stu-
dents commented that they had encountered similar
situations in clinical settings and they appreciated
the opportunity to practice different approaches in
the safety of the roleplay situation. There is research
from the medical communication skills training lit-
erature to support the use of clinically relevant sce-
narios and simulated patients.30 In contrast, didactic
teaching practices involving more abstract concepts
and large group sizes may provide fewer opportuni-
ties for active student participation and skills-based
practice.
The use of simulated patients (actors) who are
skilled at presenting complex clinical conditions,
monitoring the student’s performance, and deliver-
ing specific feedback is an essential component of
this program. Simulated patients are selected to rep-
resent a wide variety of psychological, ethical, and
cultural viewpoints that are common to dental prac-
tice and that students will need to handle effectively
in their professional work. Students who have diffi-
culties with the English language are able to improve
their language skills and to develop expertise in ar-
eas such as the avoidance of dental jargon and fa-
miliarization with colloquialisms, which are common
sources of misunderstanding.32
Realistic, clinically based scenarios are another
important component of any effective communica-
tion skills program. The roleplay scenarios used in
our program were specifically designed to contain
psychosocial and lifestyle factors that were particu-
larly relevant to oral disease processes. This further
contributed to students’ understanding of disease
processes in dentistry and the necessary precautions
and treatment options that need to be addressed with
September 2004 ■ Journal of Dental Education
each patient. Clinically relevant scenarios enable stu-
dents to develop skills such as problem solving, in-
creased knowledge of referral processes, and an
awareness of ethical/legal issues.
Learning communication skills can be very
challenging, as communication skills are often
viewed as an intrinsic part of the person’s personal-
ity, cognitive functioning, and social experience. Stu-
dents are often asked to make changes to aspects of
their appearance and behavior that are of a highly
personal nature. In addition, a shift from dentist-cen-
tered to patient-centered communication is necessary
and requires a change in the way in which the stu-
dent gathers patient information. For example, be-
fore training, students tend to focus on the disease
process to the virtual exclusion of psychosocial is-
sues.
Giving student feedback can affect intrinsic
motivation to learn and elicit both emotion and
arousal, which can negatively affect learning and
performance.33,34 Sims-Knight and Upchurch33 sug-
gest that classroom climate and self-reflective analy-
sis improve students’ learning and performance more
so than tutor feedback. This course was designed with
a large requirement of self-reflective analysis as well
as some group feedback and tutor evaluation. Feed-
back regarding a student’s interpersonal skills needs
to be skillfully given. It should occur as soon as pos-
sible after the clinical encounter and should be con-
structive as well as sensitive. Students may become
defensive if feedback is excessively critical or nega-
tive or if feedback is delivered in an insensitive man-
ner when pertaining to their personal mannerisms or
characteristics. The use of skilled instructors, pref-
erably from both the social sciences/psychology field
and the dental profession, has many benefits for stu-
dent learning. Student evaluations of the tutors in
the current program were very favorable overall. Stu-
dents commented positively about the team teach-
ing approach involving psychologists and a dental
clinician. This combination allowed instructors to
contribute different areas of expertise when provid-
ing feedback, answering students’ questions, and
during group discussion.
Students were required to carry out self-assess-
ments during the course. Each student analyzed his
or her own videotaped interview and presented the
analysis to the group for discussion. Increasing stu-
dents’ awareness of their communication strengths
and weaknesses is designed to promote a lifelong
learning process that continues long after formalized
instruction has ceased.
975
 An interesting finding of our study was that a
large percentage of students said they considered
communication skills to be more important after hav-
ing completed the course. This finding is not sur-
prising to us, since in years of teaching communica-
tion skills, we have encountered initial resistance to
these courses on the part of some students. Initial
skepticism could be due to a lack of knowledge about
the specific components of communication skills and
the use of the term “communication skills,” which
may suggest to students that they will be learning
skills that they already possess.
A related view is that skilled communication
is just common sense or is acquired instinctively. This
perception may stem from a lack of awareness of the
unique nature of communication skills in clinical
settings. In professional clinical consultations, for
example, the expectation of reciprocity and equal
sharing of conversation are not the same as that which
occurs in ordinary conversation. Similarly, closed and
leading questions are a characteristic of everyday
conversation but can be counterproductive in a den-
tal consultation. Froelich and Bishop35 have noted
that “the ability to communicate skillfully and with
purpose rarely occurs as a gift—it is learned.”
Behavior change that is lasting requires numer-
ous opportunities for practice and ongoing reinforce-
ment. For this reason, it is important to introduce
skills-based communication training in the students’
first clinical year and to continue training over an
extended time period where possible. This is not only
essential for the students’ ongoing practice of skilled
communication, but is also likely to enhance patient
satisfaction and public image of the dental school.
Although the majority of students favorably
evaluated the current communication skills program,
we would like to modify a number of features in fu-
ture programs. One aspect, the large group size, may
have led to lower ratings of tutor sensitivity to stu-
dents’ needs, concerns, and progress than anticipated.
However, it should be noted that student ratings of
tutor characteristics were still very positive overall.
Smaller groups would increase student participation
and enable more individual teaching. Ideally, groups
would contain a maximum of ten to eleven students.
Another area that could be improved relates to
the manner in which students conducted their video-
taped interview session. In the current program each
student was asked to perform his or her interview in
front of classmates. A better alternative would be for
each student to conduct his or her videotaped inter-
976
view with the patient in the absence of their class-
mates. Some students reported that it was difficult to
concentrate on the patient with an audience present.
Changing this would likely reduce the level of anxi-
ety that students experienced during this interview
process, which may subsequently improve student
interview performance.
Further course development in collaboration
with other schools would be useful. This saves “re-
inventing the wheel” each time a course is devel-
oped. It is also important to elicit wider support of
communication skills training within the dental fac-
ulty, as well as to ensure that teaching in communi-
cation skills is consistent and being reinforced by
other faculty members in all teaching situations, par-
ticularly in the clinical setting. Other proposed de-
velopments to the teaching of communication skills
at Otago include the development of videotaped
material for teaching purposes and initial class dis-
cussion.
While overall there has been an emphasis on
the need for teaching in the area of communication
skills in dentistry, there is also a need for educational
research evaluating the effectiveness of communi-
cation skills-based teaching programs. Evaluative
research will help ensure the continued development
and delivery of effective patient-centered dental edu-
cation.
Health professionals, and dentists in particu-
lar, are required to interact with patients on a very
intimate level within minutes of meeting. It is essen-
tial, therefore, that dental students are provided with
skills-based communication training based on the
most recent research literature. In this way, dental
students will be better equipped for clinical practice
to deal with patient anxiety, to identify ethical is-
sues, and to recognize significant psychosocial fac-
tors that lead to more accurate diagnosis and treat-
ment processes, thereby increasing patient
satisfaction and safety.
Acknowledgments
The authors wish to thank Judy Trevena, Ph.D.,
Judy Martin, M.A., Natasha Pomeroy, M.Sc., and
the anonymous reviewers for their valuable sugges-
tions regarding analysis and presentation of this pa-
per. We would also like to acknowledge the Depart-
ment of Psychological Medicine, Dunedin School of
Medicine, which developed the communication skills
program for medical students from which our pro-
gram was adapted specifically for dental students.
Journal of Dental Education ■ Volume 68, Number 9

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