Effectiveness of Teaching Communication Skills in Undergraduate Curriculum at Defence Services Medical Academy Myanmar: Mixed Qualitative and Quantitative Study

Abstract

Introduction: Good communication is the cornerstone of quality healthcare and it should be patient centered. Communication skills is taught and assessed with surrogates in undergraduate training. This study aimed to determine the effectiveness of communication skills taught in undergraduate period in reality. Methodology: It was a combined qualitative and quantitative methods. For qualitative assessment, phenomenology was used. Informal focus group semi-structured interview was done to groups of interns who had completed internship at medical wards. The responses were analyzed interpreted and classified; thematic analysis was done. For quantitative assessments, open ended questions were set by experts in medical education. The questions were answered anonymously; they were grouped into same themes. This study was approved by ‘Hospital Research and Ethics Committee’ of No(1) Defence Services General Hospital. Informed consent was taken from each intern. Results: A total 20 interns were included. Four themes were formed after thematic analysis: (1) the extent of applicability of communication skills they were taught in undergraduate days;(2) self-admitted confidence and degree of satisfaction; (3) the challenges/gaps they faced in reality; and (4) their suggestions on undergraduate teaching to fill the gaps. All interns admitted that the communication skills they taught was 100% applicable in practice. And they were confident out of proportion to their medical experience. They were satisfied with communication skills they were taught in undergraduate days. The challenges faced were as follows; difficulty in understanding volume and clarity of language when dealing with some nationality; low education level of patients leading to difficulty in understanding the information they have given; difficulty in getting trust from patient being youngest doctor in the team; and, taking long time due to emotional reaction of patient in breaking bad news. They admitted that they need to fill their knowledge gaps to answer the questions raised by patients particularly in explanation of diagnosis and management. They realized the importance of facial expression and tone of voice to express sympathy and empathy especially in breaking bad news. To improve communication skills in practice, they suggested to teach with real patients with real scenario. Conclusion: Teaching communication skills in undergraduate period was effective. The interns had good self-reported confidence. The interns need more training and self-directed learning. The challenges faced by interns were acceptable/logical. We should find better teaching method/media in undergraduate teaching to promote communication skills.