"Powerful placebo": A teaching and learning concept addressing placebo and nocebo effects in competency-based communication training

• Published in: GMS journal for medical education Vol. 41; no. 4; p. Doc38
• Main Authors: Öhlmann, Hanna, Icenhour, Adriane, Elsenbruch, Sigrid, Benson, Sven
• Format: Journal Article
• Language: English; German
• Published: Germany German Medical Science GMS Publishing House 01.01.2024
• Subjects: Clinical Competence - standards; Communication; competence; Competency-Based Education - methods; Curriculum; Education, Medical, Undergraduate - methods; expectations; Female; Humans; Learning; Male; nklm; Nocebo Effect; physician-patient interaction; Physician-Patient Relations; Placebo Effect; Students, Medical - psychology; Teaching; nocebo effect; competence; placebo effect; physician-patient interaction; NKLM; expectations; communication
• ISSN: 2366-5017; 2366-5017
• DOI: 10.3205/zma001693

Placebo and nocebo effects are based on expectations that are formed by how doctors communicate and can influence the efficacy of medical treatment. Given the implications for doctor-patient communication and the learning objectives listed in NKLM 2.0, we herein present a novel teaching and learning concept to impart competency-based knowledge about placebo and nocebo effects. The teaching and learning concept was piloted with N=324 third-semester medical students. It combines a self-guided, small-group component to gather communication strategies and apply them in a video-recorded conversation, followed by a classroom-based session to reflect on and discuss the videos and to learn basic scientific and theoretical knowledge. The evaluation involved written feedback from the students and lecturers (structure/process) and an analysis of the videos (students' learning success). To supplement this, the overall course evaluation was included since this new teaching concept was not specifically evaluated by the students. Course structure and process were rated positively. The active involvement of the students in the subject matter and the balance between theoretical, scientific and practical content was emphasized positively. Analysis of the learning success showed that the students were able to effectively transfer the knowledge gained about placebo and nocebo effects to conversational situations. The topic of placebo/nocebo is optimally suited to teach communication skills with its many links to knowledge, translational approaches and added value for medical practice. When doing this, video-recorded conversations appear to be an effective tool to achieve learning objectives. This teaching and learning strategy offers possibilities for expanding communication curricula.