Have medical students\u2019 attitudes towards clinical communication skills changed over a 12- year period? A comparative long-term study

Tore Gude,Hilde Grimstad,Tor Anvik,Anders Baerheim,Are Holen,Per Vaglum,Lise Løvseth,Reidar Tyssen

doi:10.1186/s12909-019-1915-1

Abstract

BackgroundAttitudes towards learning clinical communication skills at the end of medical school are likely to reflect the students’ training and motivation for the continued development of their skills as doctors. Students from two Norwegian medical schools, one with a traditional, and the other with an integrated curriculum, were approached in 2003 and 2015; with regard to changes in students’ attitudes towards acquiring communication skills in two diverse learning environments. This comparison might reveal the effects of the training programs from a long-term perspective, as neither of the medical schools made any major curriculum changes within the study period.MethodsThe samples comprised final-year medical students. Two separate cross-sectional surveys performed 12 years apart (2003 and 2015) used items from the Communication Skills Attitude Scale in addition to age and gender. The traditional curriculum included only theoretical teaching and no contact with patients was made during the first 2 to 2.5 years of medical school. However, the integrated curriculum combined training in theoretical and clinical communication skills with early patient contact from the beginning.ResultsAttitudes improved from the first to the second survey at both schools, however, students from the integrated school reported more positive attitudes than those from the traditional school. Female students from the integrated school contributed the most to the difference in attitudes in both surveys.ConclusionsStudents in both traditional and integrated curricula improved their attitudes from the first to the second assessment. However, compared with the traditional curriculum, the integrated one fostered even higher levels of positive attitudes towards acquiring communication skills, and a pronounced influence was observed on female students. These findings suggest that an educational program with greater emphasis on improving attitudes among male students may be required.

Highlights

Attitudes towards learning clinical communication skills at the end of medical school are likely to reflect the students’ training and motivation for the continued development of their skills as doctors
Concerning the gender aspect, we found in an earlier study within our research group that female students improved their observed communication skills significantly, while male peers did not show this improvement from end of medical school to the end of an obligatory internship 2 years later [13]
A significant increase in positive attitudes was detected in both schools from 2003 to 2015, as the 95% confidence intervals of the means Communication Skills Attitude Scale (CSAS) scores did not overlap

Summary

Introduction

Attitudes towards learning clinical communication skills at the end of medical school are likely to reflect the students’ training and motivation for the continued development of their skills as doctors. Students from two Norwegian medical schools, one with a traditional, and the other with an integrated curriculum, were approached in 2003 and 2015; with regard to changes in students’ attitudes towards acquiring communication skills in two diverse learning environments. This comparison might reveal the effects of the training programs from a long-term perspective, as neither of the medical schools made any major curriculum changes within the study period. Attitudes towards the importance of clinical communication as part of the doctor-patient relationship in the society and in the mass media over the 12-year study period, should be considered an impact factor in regard to attitudes among medical students

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Results

Discussion

Conclusion