Curriculum factors influencing knowledge of communication skills among medical students

Per Hjortdahl,Terje Risberg,Are Holen,Tor Anvik,Per Vaglum,Anders Baerheim,Ole Bernt Fasmer,Tore Gude,Hilde Grimstad

doi:10.1186/1472-6920-7-35

Abstract

BackgroundCommunication training builds on the assumption that understanding of the concepts related to professional communication facilitates the training. We know little about whether students' knowledge of clinical communication skills is affected by their attendance of communication training courses, or to what degree other elements of the clinical training or curriculum design also play a role. The aim of this study was to determine which elements of the curriculum influence acquisition of knowledge regarding clinical communication skills by medical students.MethodsThe study design was a cross-sectional survey performed in the four Norwegian medical schools with different curricula, spring 2003. A self-administered questionnaire regarding knowledge of communication skills (an abridged version of van Dalen's paper-and-pencil test) was sent to all students attending the four medical schools. A total of 1801 (59%) students responded with complete questionnaires.ResultsAt the end of the 1st year of study, the score on the knowledge test was higher in students at the two schools running communication courses and providing early patient contact (mean 81%) than in the other two medical schools (mean 69–75%, P ≤ 0.001), with students studying a traditional curriculum scoring the lowest. Their scores increased sharply towards the end of the 3rd year, during which they had been subjected to extensive patient contact and had participated in an intensive communication course (77% vs. 72% the previous year, P ≤ 0.01). All students scored generally lower in academic years in which there was no communication training. However, at the end of the final year the difference between the schools was only 5% (81% vs. 86%, P ≤ 0.001).ConclusionThe acquisition of knowledge regarding communication skills by medical students may be optimised when the training is given together with extensive supervised patient contact, especially if this teaching takes place in the initial years of the curriculum.

Highlights

Communication training builds on the assumption that understanding of the concepts related to professional communication facilitates the training [4,5]
We know little about whether students' knowledge of clinical communication skills is affected by their attendance of communication training courses, or to what degree other elements of the clinical training or curriculum design play a role
Our results indicate that communication training combined with supervised clinical work with patients is most strongly correlated with high scores for knowledge of clinical communication skills, especially when the combination takes place early in the medical school curriculum

Summary

Introduction

Communication training builds on the assumption that understanding of the concepts related to professional communication facilitates the training. We know little about whether students' knowledge of clinical communication skills is affected by their attendance of communication training courses, or to what degree other elements of the clinical training or curriculum design play a role. The aim of this study was to determine which elements of the curriculum influence acquisition of knowledge regarding clinical communication skills by medical students. Excellent communication skills are essential to medical professionalism [1]. Clinical communication is complex in nature, and both personal and curricular factors will influence how medical students master the relevant skills [2]. Basic or general communication skills are developed early in life. Theoretical knowledge about communication skills comes years later, and not through medical studies alone. Contrary to clinical procedural skills, communication skills appear to be an integral part of one's cognition [3]

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