Introduction

This introduction presents an overview of the key concepts discussed in the subsequent chapters of this book. The book talks about clinical communication and clinical education. It draws on notions which are standard in linguistics since Chomsky about the difference between how people 'perform' on particular occasions, and what this says about the underlying 'competence' - and it is about the distinction between 'training' and 'education'. In precise Chomskyean terms, this ought simply to read 'all clinicians perform less well when they are tired, distracted or annoyed'. The search for a set of skills which can be identified and taught as 'good clinical communication' has been of considerable value in persuading decision makers at medical schools and other bodies that communication matters. The difficulty is compounded by societal and educational demands for transparency. Within medical education, traditional approach is entirely consonant with the general principles of problem-based learning.