However, these skills were not transferred to the NEG and DTR consultations, and the effect of CST background was not present in these
consultations. Thus, communication skills training appears to have rather case-specific effects, and the goals and structure of, and required skills for the NEG and DTR consultations apparently vary too greatly from those of the BBN consultation in order to make the transfer of skills possible. The larger inconsistencies in the dissimilar consultation combinations support this presumption. At the same time, we did not find a PLX4032 clinical trial relationship between CST background and inconsistency for the BBN-PMD consultation combination, which
one would expect if the transfer of learned skills not only results in higher performance quality but also in less inconsistency. Nevertheless, we conclude that a set of generic or transferable communication skills that show a high level of stability and have applicability to a wide range of encounters, as suggested by several authors [14], [25], [26], [29] and [30], does not exist. Rather, our results confirm the existence of both generic and case-specific skills [13], [16] and [31]. Communication skills that are learned in medical education are generalizable to other consultations but only if these consultations are fairly similar in goals, structure, and required skills. In addition to these transferable skills, there are case- and context-specific communication skills that find more can only be practiced
in specific consultations. This conclusion accords with the concern of Hodges that this would have troubling implications for both the teaching and evaluation of communication skills, because it would imply that each type of clinical problem that a student might encounter would have to be taught and evaluated separately [21]. At the same time, however, this conclusion is in line with our view that communication expertise requires more than learning a generic set of communication skills [46]. Parvulin Learning new communication behavior implies the acquisition of new skills, but also the incorporation of mental representations of these skills in communication schemata as well as the formation of new links between these schemata and the mental representations of situations in which the use of the skills and schemata is appropriate. Therefore, communication behavior that is learnt in a specific context, is not readily generalizable to other contexts and communication education has limited effects if training is restricted to a predetermined set of skills in standardized situations.