Abstract
BackgroundAs good communication skills are crucial for doctor-patient interactions, it is recommended to incorporate them in medical school programs from the very beginning. On this basis medical schools in Germany introduced the OSCE (objective structured clinical examination) to examine and by this foster learning of communication skills as assessment drives learning. The aim of the study was to examine the development of the communication skills of medical students during an OSCE to investigate how communication competence has developed between different student cohorts.MethodsThis study is a longitudinal trend study based on seven semester-cohorts, examining the communication skills of medical students in the OSCE both from the perspective of students and from the viewpoint of standardized patients (SP). Altogether, 1027 students from seven semester cohorts were asked to rate their own communication skills (self-perception) before the OSCE exam started. Here, sub-analyses were performed to outline a potential influence of previous history-taking group participation. The SP evaluated the students’ communication skills in external perception during the OSCE exam at each station with history-taking or physical examinations. The communication skills in both groups were ascertained in the dimensions of empathy, content structure, verbal expression, and non-verbal expression.ResultsOnly in the dimension of non-verbal expression could a statistically significant change be found in students’ self-perception over the years. Notably, the rating of communication skills as self-rated by the students has risen constantly, whereas they deteriorated from the perspective of standardized patients (SP). It has also been found that previous history-taking courses have a positive influence on the structural dimension of communication skills in particular.ConclusionsThe results of this study support conclusions of other studies which also suggest differences between self- and external perception of medical students’ communication skills. Nevertheless, students showed good overall communication skills in the four dimensions of empathy, content structure, verbal expression, and non-verbal expression, as demonstrated in a longitudinal trend study over seven semesters. However, we noted that externally rated empathy levels declined over the semester cohorts, suggesting the need for new priorities to be set in student teaching.
Highlights
Communication skills of medical students As good communication skills are crucial for doctorpatient interactions, it is recommended to incorporate them in medical school programs from the very beginning [14, 15]
The aim of the study was to examine the development of the communication skills of medical students during an Objective measurement of learning in clinical examinations (OSCE) as part of a longitudinal trend study in order to investigate how the communication competence has developed between different student cohorts
While in cohort studies the same persons are interviewed at regular intervals, trend studies pursue the target to survey different persons of the same population at regular intervals
Summary
As good communication skills are crucial for doctor-patient interactions, it is recommended to incorporate them in medical school programs from the very beginning. On this basis medical schools in Germany introduced the OSCE (objective structured clinical examination) to examine and by this foster learning of communication skills as assessment drives learning. Patients should be involved as partners in the diagnostic process and subsequent treatment to encourage them to take responsibility for their own health and to improve compliance and engagement in an efficient patient-based health service [7,8,9] It is the physician’s responsibility to foster this process of ‘shared decision making’ by utilizing good communication skills [10, 11]. At our own faculty in Tübingen, the OSCE has been an integral part of the curriculum since 2004 [29]
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