**5. Current medical education and communication skills**

In the traditional medical model, effective and proper clinical communication was not valued nor was it included in the curriculum of many medical programs. The paradigm shift occurred during the eighties when consumerism in health care became a prevalent phenomenon. During this shift, consumers of health care became partners in the health care industry and the dynamics between health care providers and "clients" witnessed significant changes from the traditional medical model where "paternalistic" physicians were in control of all aspects of health care delivery including health-related decisions, and health-care recipients had very minimal roles and input, if any. The focus on including effective communication skills in medical curricula has emphasized the need for fostering positive physicianpatient dyads in different clinical settings and contexts which results in the professional confidence and satisfaction of physicians [32–34]. Effective communication skills (e.g., empathy, breaking bad news, theater, and drama-based educational

methods) in medical education should be taught, modeled, and re-demonstrated [33, 34]. However, even if communication skills such as interview skills and nonverbal behavior are taught and practiced, retention of these skills over time has been shown to fluctuate when physicians start practicing in the "real world" [34]. Relevant literature indicates that undergraduate medical students attain clinical communications skills along with other medical skills, but these skills are not fully maintained or retained when transitioning from medical student to practicing physician, or from the preclinical to clinical years of study, or even when transitioning from one course to another, [16, 34, 35].

## **6. Current medical education and research**

In medical education, up-to-date research evidence informs and directs medical science and clinical practice. As in other disciplines, medicine struggles with finding a research culture that enhances the medical profession as well as academia. Moreover, ethical approval, adequate funding, publishing, authorship, plagiarism, redundant publication, ethical conduct in research, and conflict of interests remain extant issues for both novice and expert researchers in medicine [36]. Historically, physicians from all subspecialities have had access to patients in clinical settings. There is a non-spoken norm that a physician's patients are automatically considered his/her research "subjects" and are under his/her will when recruiting patients in different research studies as well as granting or denying others (e.g., other health care team members such as nurses, pharmacists, dentists) access to these subjects.

Traditionally, research in medicine has been mostly quantitative designs, such as observational and cross-sectional studies [37]. The most common new trends of medical education research topics reported in the literature have been curriculum and teaching issues, skills and attitudes relevant to the structure of the profession, individual characteristics of medical students, and the evaluation of students and residents [36, 38, 39].

A fairly recent trend in medical research has been shifting to qualitative research methodology and employing different qualitative research designs stemming from a social sciences framework and interpretive paradigm. Physicians and educators in medicine have come to appreciate the richness and holistic viewpoint innate in qualitative research especially in investigating and comprehending complex phenomena such as health, illness, and team-based care [40]. Qualitative methodologies have also helped medical educators to gain insight and understand the experiences of medical students, teamwork dynamics among different health professionals as well as between students and faculty, and identify appropriate instructional methods in medical education [40].

### **7. Current medical education and leadership**

In medical education, a sense of leadership and what it entails is first acquired, appraised, and evaluated in many forms during undergraduate studies. These forms include group academic and clinical assignments with an assigned leader, the leadership of faculty in their respective courses, the leadership of the school administrative team, the leadership of professional medical associations, and the local, regional, and/or international leadership of the medical profession.

Leaders initiate and sustain change and direction in individuals and organizations. Leaders, as opposed to managers who run the day-to-day administrative activities and functions of an organization, inspire, motivate, set direction, and

*Toward a Holistic Approach in Medical Education DOI: http://dx.doi.org/10.5772/intechopen.100062*

focus on achieving organizational goals and aspirations [41]. In clinical practice, medical leaders focus their efforts toward achieving positive patient outcomes as well an organizational autonomy, accountability, and sustainability. The new trends in leadership in healthcare are now known as "transactional" and "transformative" leadership. Transactional leadership establishes a more authoritative relationship between leader and followers to achieve specific goals. The downfall of transactional leadership includes lack of innovation, incentive, and motivation has given rise to the adoption of "transformative leadership" in healthcare disciplines.

Transformative leadership focuses on influencing and "transforming" individuals in an effort to achieve organizational goals. The most recent trend in leadership is "team leadership" or "shared governance" in which the focus has shifted from the leader to the team. In this type of leadership, roles and responsibilities are shared by interdependent team members [41]. Thus, team collaboration is the main tool that can be used to achieve expected and desired outcomes. New leadership styles fit with the concept of "teamwork" since physicians realistically do not work in isolation of the other members of a health team including nurses, pharmacists, nutritionists, anesthetists. Etc.
