Ice, Ice baby- the hidden curriculum around communication skills

A few years ago I wrote a post about the challenges of teaching "communication skills". The YouTube video above is about the Clinical Skills Assessment (CSA)  that doctors training as GPs in the UK take. It emphasised the need to ask patients about their ideas, concerns and expectations (ICE) during a consultation. But it frames the need to do this as a requirement of an exam rather than something that will benefit patients. For example, the first clinical episode described is about a doctor feeling that they have to ask a patient who has symptoms very suggestive of a heart attack about their ideas and expectation of the consultations. This is something that the doctor seems to feel is delaying the patient's care and they may well be right about that.

So what is the take away message? What does this song tell us about how our assessments frame doctors understanding of communication skills?