Medical students’ communication skills in peer role-plays: An exploratory observational study

Introduction:Like many other people based professions, communications skills are essential to medical practice also. Traditional medical teaching in India does not address communication skills which are most essential in dealing with patients. Communication skills can be taught to medical students to increase clinical competence.Objective:To teach basic communication and counseling skills to fourth-year undergraduate students to increase their clinical competence.Methodology:A total of 48, fourth-year MBBS students participated in the study. They were given training in basic communication and counseling skills and taught the patient interview technique according to Calgary–Cambridge guide format. Improvement in communication was assessed by change in pre- and post-training multiple choice questions, clinical patient examination, and Standardized Patient Satisfaction Questionnaire (SPSQ) scores.Results and Analysis:About 88% of the students in the sample were convinced of the importance of learning communication skills for effective practice. Almost 90% students were communicating better after training, as tested by improved SPSQ. As judged by Communication Skill Attitude Scale, student's positive attitude toward learning communication skill indicated that there is a necessity of communication skill training during undergraduate years.Conclusion:The ability to communicate effectively is a core competency for medical practitioners. Inculcating habits of good communications skill during formative years will help the medical students and future practitioners. Regular courses on effective communication should be included in the medical school curriculum.

Background: Communication Skills (CS) in Medicine has been considered one of the most fundamental competencies to be required of medical professionals. However, there is not guarantee that students fully grasp the usefulness of CS for clinical practice. The objectives of our study were therefore to (1) describe Year 2 to Year 5 medical students’ attitudes towards CS training and its associations, and to (2) investigate Year 2 to Year 5 medical students’ self-assessment of CS training and effective medical CS training. Methods: This is a non-randomized control trial study, using the Communication Skills Attitudes Scale (CSAS) designed by Rees from Nottingham University and Gap-Kalamazoo Communication Skills Assessment Form (G-KCSF) designed by Rider from Harvard University. Results: In general, students showed positive attitudes towards CS training (positive attitude scale (PAS): 3.55 (0.5); negative attitude scale (NAS): 2.77 (0.43). Females showed higher scores on the PAS than males (p<0.001) and lower scores on the NAS (p<0.001). The second- or third-year medical students showed higher scores on the PAS (p<0.001) than their fourth- and fifth-year counterparts. The scores of all essential elements of CS were highest among the second-year students, decreasing among the third- and fourth-year students before increasing again among the fifth-year students. The students who had medical CS training scored higher on the PAS, lower on the NAS, and on all essential elements of CS. Conclusions: Medical students at Hue University of Medicine and Pharmacy expressed positive attitudes towards CS training. Training medical students in CS was able to improve their attitudes and CS.

Communication skills tend to decline with time unless they are regularly recalled and practiced. However, most medical schools still deliver clinical communication training only during pre-clinical years although the clinical environment is considered to be ideal for acquiring and teaching clinical communication. The aim of this article is to review the barriers that prevent communication skills teaching and training from occurring in clinical practice and describe strategies that may help enhance such activities. Barriers occur at several levels: students, junior doctors and clinical supervisors sometimes have negative attitudes towards communication training; structured training in communication skills is often insufficient; clinical supervisors behave as poor role models and lack effective communication and teaching skills; finally, there are organisational constraints such as lack of time, competing priorities, weak hierarchy support and lack of positive incentives for using, training or teaching good communication skills in clinical practice. Given the difficulty of assessing transfer of communication skills in practice, only few studies describe successful educational interventions. In order to optimise communication skills learning in practice, there is need to: (1.) modify the climate and structure of the working environment so that that use, training and teaching of good communication skills in clinical practice becomes valued, supported and rewarded; (2.) extend communication skills training to any field of medicine; (3.) provide regular structured trainings and tailor them to trainees' needs. Practical implications of such findings are discussed at the end of this review.

This review article aimed to obtain an understanding of the positive outcomes and challenges associated with the use of simulation-based approaches for teaching communication and counseling skills in clinical education in audiology as described in the literature. A scoping review was conducted during October 2023 to identify published journal articles that described how simulation-based approaches were used for teaching or assessing communication and/or counseling skills among audiology students. Database searches yielded 208 articles initially. Following abstract screening and full-text review, 17 articles were included for analysis. Most studies focused on using simulation-based approaches for teaching, and there was a stronger focus on pediatric audiology. Most studies involved the use of standardized patients, with data collected via quantitative approaches using rating scales and surveys. Simulation-based approaches can offer positive learning experiences and practice opportunities for students acquiring communication and counseling skills. However, the benefits of simulation over traditional methods are unclear. Students may struggle to integrate technical and communication skills in simulated learning experiences. Engaging with simulation-based approaches may provide important practice opportunities, but these methods are not sufficient to ensure acquisition of communication and counseling skills. More qualitative studies are needed to understand the nuances of if and how students might acquire such skills via simulated learning experiences. We offer some suggestions for improvement of future studies on this topic.

Shared decision-making (SDM) is crucial in healthcare to facilitate effective communication between providers and patients, aiding in making optimal medical decisions. Communication skills training (CST) can improve physicians' ability in SDM. However, SDM CST for medical students in Taiwan is scarce, and research comparing online versus in-person CST outcomes is lacking. This study aims to assess the effectiveness of online versus face-to-face SDM CST on medical students' decision-making proficiency and communication skills over time. This study employs a retrospective quasi-experimental design, analyzing 323 questionnaires from the CST training database. Participants (fourth-year medical students) were divided into two groups: face-to-face CST (n = 160) and online CST (n = 163). Assessments were conducted before (T0) and immediately after (T1) CST. Paired t-tests and generalized estimating equations were used to evaluate within-group and between-group differences in SDM decision-making proficiency and communication skills. In the within-group comparison, both groups showed a significant improvement in SDM decision-making proficiency and communication skills. For SDM decision-making proficiency, the face-to-face group demonstrated a large effect (t = 12.9, p < 0.001, d = 0.87), and the online group achieved a moderate effect (t = 8.98, p < 0.001, d = 0.64). In terms of communication skills, both groups reached a moderate effect (face-to-face, t = 9.77, p < 0.001, d = 0.67; online, t = 8.00, p < 0.001, d = 0.54). No significant differences were found between groups in SDM decision-making proficiency and communication skills. This study has demonstrated that both online and face-to-face SDM CST effectively enhance the SDM decision-making proficiency and communication skills of medical students. The effectiveness of online CST is on par with face-to-face CST. It is recommended to use online CST when face-to-face classes are not feasible, especially during epidemics or budget constraints. Future research should explore the long-term impacts of these CST methods on students' skills, considering additional follow-up time points.

A national questionnaire-based survey has found that palliative physicians report lower levels of burnout and similar levels of psychiatric morbidity than those reported by consultants in other specialties. To try to explain these findings, this study compared the sources of job stress and satisfaction reported by consultant palliative physicians with those reported by consultants working in four other specialties: surgery, gastroenterology, radiology and oncology. Stressful and satisfying aspects of work were assessed using questionnaires designed specifically for the study. The response rate for the palliative physicians was 126/154 (82%) and for the consultants in the other specialties 882/1133 (78%). Palliative physicians reported that feeling overloaded and its effect on home life made the greatest contribution to their job stress, and having good relationships with patients, relatives and staff made the greatest contribution to their job satisfaction. However, compared with the other specialist groups, palliative physicians reported less stress from overload (p < 0.001) and more satisfaction from having good relationships (p < 0.001). They also reported less stress and more satisfaction with the way they are managed and resourced (both p < 0.001). Hospital-based palliative physicians reported more stress and less satisfaction from their management and resources than their colleagues working in hospices (both p = 0.05). Thirty-five percent of palliative physicians felt insufficiently trained in communication skills and 81% felt insufficiently trained in management skills. Burnout was more prevalent among consultants who felt insufficiently trained in communication and management skills than among those who felt sufficiently trained. It is important therefore that effective training in communication and management skills are provided and that, at the very least, existing levels of resourcing and management practices within palliative medicine are maintained in order that physicians working in the specialty are able to provide care to dying patients without prejudicing their own mental health.

Formal communication skills teaching and training has been a feature of undergraduate medical education now for over two decades and, for postgraduate training, for over a decade in the UK, North America and Australasia. However, as the authors point out, it is generally not a core component of medical education elsewhere in the world. Quite apart from the idealistic aim of providing a better service to patients, there is also a financial imperative for organizations employing or indemnifying medical practitioners to ensure high-level communication skills, given that a large proportion of patient complains are at least in part attributable to issues of failed communication early on in the process. Either one believes (as I do and the GMC purports to do) that formally-taught modules are an important part of developing doctors' and medical students' communications skills (in which case there has to be some kind of remedial training established for overseas doctors graduating from medical schools or postgraduate specialty training programmes where this was not the case), or one has to believe that communication skills training is a modern ‘educationalists fad’ and that actually learning ‘on the job’ through interacting with patients and colleagues is the only worthwhile way forward. If one believes the former (as I do and the GMC purports to do), then the present situation exposes foreign medical graduates to an unnecessarily high risk of stress, litigation and disciplinary action, at least during initial phase of their working careers in the UK. If one doesn't believe it (as these non-UK medical schools presumably feel) then it has to be assumed that UK medical graduates are missing out on invaluable elements of education in human disease that have been displaced from the UK curriculum through greater focus on ‘soft skills’.

BackgroundThe Chinese healthcare system is affected by frequent disputes between physicians and patients. Although recent reforms have contributed towards improving the patient-physician relationship, distrust in physicians is still high. Communication skills (CS) training of physicians holds the key to improving patient confidence and diffusing stressful situations. This survey reports on the status of CS training in medical education in China, and the experiences and attitudes of physicians towards CS training.MethodsA cross-sectional survey was conducted at medical institutions across China. A questionnaire developed for this study included the status of CS training, current aspects of patient-physician relationships, perceived own CS and patient-centeredness with Likert-scaled items from 1 (most negative) to 6 (most positive). Physicians’ attitude towards CS training was measured with the Communication Skills Attitude Scale (CSAS) and its subscales PAS (Positive Attitude Scale) and NAS (Negative Attitude Scale). Data were analyzed descriptively and for group differences between the hospital level and operating vs. non-operating physicians. Binary logistic regression analysis was done to find associations explaining the occurrence of verbal and physical attacks and the role of CS attitudes.ResultsOut of 1080 questionnaires, 772 physicians met inclusion criteria. A total of 466/772 participants (60.4%) had received at least one CS training during their career. The participants rated the current situation related to patient-physician relationship in China as highly stressful (mean = 4.52, SD = 1.26, 95% CI: 4.43–4.60), experiencing verbal attacks in the past three years once a year in 372/772 cases (48.2%) and physical attacks 111/772 times (14.4%). The mean PAS was 62.96 (SD = 7.63, 95% CI: 62.41–63.47). Being female was associated with increased risk of verbal attacks (OR = 1.51, 95% CI: 1.01–2.25) while working in a tertiary hospital and showing high levels of PAS decreased this risk (OR = 0.62, 95% CI: 0.43–0.89, and OR = 0.95, 95% CI: 0.93–0.98). Having received a previous CS training decreased the odds of physical attacks (OR = 0.54, 95% CI: 0.35–0.83).ConclusionsA majority of Chinese physicians showed a high positive attitude towards CS training, were trained in CS and would value further training. Our results highlight that CS training is likely to promote patient-centered communication and reduce attacks against physicians. Both of these effects are to improve the patient-physician-relationship in the long run. More CS training should be offered to Chinese physicians, especially at secondary- and primary-care hospitals, where such practices remain infrequent.

Review Question/Objective The objective is to identify and assess the effectiveness of tools and methods of teaching communication skills to health professional students in undergraduate and postgraduate programs, to facilitate communication in hospitals, nursing homes and mental health institutions. For this review, effective communication will be defined as that which enhances patient satisfaction, safety, symptom resolution, psychological status, or reduces the impact/burden of disease and/or improved communication skills within undergraduate or postgraduate students The review question is: What is the best available evidence on strategies to effectively teach communication skills to undergraduate and postgraduate medical, nursing and allied health students (nutrition and dietetics, occupational therapy, physiotherapy, speech pathology etc)? Inclusion Criteria Types of participants The review will consider quantitative studies that include any students involved in an undergraduate or post graduate health professional degree program; regardless of degree course or year of study. Types of interventions The review will consider interventions providing communication skills education, relating to patient health and safety within health institutions, to undergraduate and postgraduate health professional students regardless of the type, frequency, duration and timing of the intervention. In comparative studies, they were required to have tested the above review question versus other educational institutions or other methods of communication skills prescription. Types of outcomes - Improved patient outcomes e.g. improved nutritional status due to correct prescription of supplementation - Reduced patient disease burden e.g. shorter consultation times - Improved patient satisfaction e.g. satisfied with students’ listening skills - Improved communication skills in undergraduate and postgraduate students: pre- and post-intervention assessment e.g. improved confidence, improved verbal communication such as providing advice at an appropriate level of understanding Due to the exploratory nature of this review, a better understanding of the outcomes to be measured will come with a more detailed review of the current literature

Good communication skills are essential for an optimal doctor-patient relationship, and also contribute to improved health outcomes. Although the need for training in communication skills is stated as a requirement in the 1997 Graduate Medical Education Regulations of the Medical Council of India, formal training in these skills has been fragmentary and non-uniform in most Indian curricula. The Vision 2015 document of the Medical Council of India reaffirms the need to include training in communication skills in the MBBS curriculum. Training in communication skills needs approaches which are different from that of teaching other clinical subjects. It is also a challenge to ensure that students not only imbibe the nuances of communication and interpersonal skills, but adhere to them throughout their careers. This article addresses the possible ways of standardizing teaching and assessment of communication skills and integrating them into the existing curriculum.

Malnutrition is common among children aged 6–24 months in developing countries. It increases the risk of mortality. Interventions to improve infant-feeding hold the promise of reducing malnutrition among these children. A study in Brazil has shown the success of training in communication and counselling skills among health workers in improving the nutritional status of young children. Questions were raised whether the method used in the study in Brazil would also be effective when applied in other countries. The aim of the present study was to reduce growth faltering in young children through proper nutrition-promotion techniques. The objective of the study was to determine the efficacy of training health workers in nutrition counselling in enhancing their communication skills and performance, improving feeding practices, and reducing growth faltering in children aged 6–24 months. A cluster-randomized controlled trial was carried out. The method used in this study was a replica of the method in a similar study in Pelotas, Brazil. Forty health centres were paired, and one centre of each pair was randomly allocated to the intervention group, and the other to the control group. The Integrated Management of Childhood Illness (IMCI) module—‘Counsel the mother'—was used for training health workers in the health centres in the intervention group. Data from 36 paired health centres and 375 mothers and their children aged 6–24 months recruited from these health centres following consultation with health workers were included in analysis. Independent observers, masked to the intervention status, examined the performance of health workers within the first month after training. Mother-child pairs were visited at home within two weeks, 45 days, and 180 days after recruitment. Information was recorded on the feeding practices, recall of the recommendations of health workers, and sociodemographic variables at these home-visits. Weight and length of the child were measured at each contact. The communication skills and consultation performance of health workers were significantly better in the intervention group than in the control group. The mothers' recall of the recommendation of health workers and reported infant-feeding practices were also significantly better in the intervention group than in the control group, even 180 days after the recruitment consultation. Growth faltering was less in the intervention group, with the largest effect observed among children in the age-group of 12 + months. These results indicate that training in IMCI feeding counselling can enhance the communication skills and performance of health workers. Improved feeding practices of counselled mothers can, in turn, reduce growth faltering in their children.

BackgroundEffective communication with patients and their families is a fundamental skill for medical students to cultivate during their undergraduate training. However, communicating with pediatric patients presents unique challenges. This study investigated the perceptions, attitudes, and confidence levels of undergraduate medical students regarding communication skills in pediatrics.MethodsA cross-sectional, quantitative, descriptive, and analytical survey was conducted by applying a validated questionnaire, the Housestaff Communication Survey (HCS), to medical students from two higher education institutions in Minas Gerais, Brazil. Data analysis was conducted using SPSS and Excel, employing descriptive statistical tests and multiple logistic regression analyses to evaluate communication, importance, and confidence.ResultsA total of 520 (52%) students participated in the study, with 422 (81.15%) aged from 20 to 29 years and 365 (68.27%) women. While only 113 (21.73%) students reported receiving training in communication skills with both adults and children during their undergraduate studies, over half (270) reported no such training. Those lacking training exhibited lower confidence levels compared with those trained exclusively with adults. Although most students recognized the importance of communication skills, their confidence levels were generally below 60%. Multiple logistic regression analysis identified gender, institution, academic period, and training as significantly associated variables with communication scores.ConclusionsTraining, gender, and academic period emerged as the most significant variables influencing communication skills. Most students expressed lower confidence in interviewing children. To enhance communication with pediatric patients and their families, comprehensive training in pediatric communication skills during undergraduate studies is imperative.

Longitudinal study: Impact of communication skills training and a traineeship on medical students’ attitudes toward communication skills

Good communication is central to effective social work practice, helping to develop constructive working relationships and improve the outcomes of people in receipt of social work services. There is strong consensus that the teaching and learning of communication skills for social work students is an essential component of social work qualifying courses. However, the variation in communication skills training and its components is significant. There is a sizeable body of evidence relating to communication skills training therefore a review of the findings helps to clarify what we know about this important topic in social work education. We conducted this systematic review to determine whether communication skills training for social work students works and which types of communication skills training, if any, were more effective and lead to the most positive outcomes. This systematic review aimed to critically evaluate all studies which have investigated the effectiveness of communication skills training programmes for social work students. The research question which the review posed is: 'What is the effectiveness of communication skills training for improving the communicative abilities of social work students?' It was intended that the review would provide a robust evaluation of communication skills training for social work students and help explain variations in practice to support educators and policy-makers to make evidence-based decisions in social work education, practice and policy. We conducted a search for published and unpublished studies using a comprehensive search strategy that included multiple electronic databases, research registers, grey literature sources, and reference lists of prior reviews and relevant studies. Study selection was based on the following characteristics: Participants were social work students on generic (as opposed to client specific) qualifying courses; Interventions included any form of communication skills training; eligible studies were required to have an appropriate comparator such as no intervention or an alternative intervention; and outcomes included changes in knowledge, attitudes, skills and behaviours. Study selection was not restricted by geography, language, publication date or publication type. The search strategy was developed using the terms featuring in existing knowledge and practice reviews and in consultation with social work researchers, academics and the review advisory panel, to ensure that a broad range of terminology was included. One reviewer conducted the database searches, removing duplicates and irrelevant records, after which each record was screened by title and abstract by both reviewers to ensure robustness. Any studies deemed to be potentially eligible were retrieved in full text and screened by both reviewers. Fifteen studies met the inclusion criteria. Overall, findings indicate that communication skills training including empathy can be learnt, and that the systematic training of social work students results in some identifiable improvements in their communication skills. However, the evidence is dated, methodological rigour is weak, risk of bias is moderate to high/serious or incomplete, and extreme heterogeneity exists between the primary studies and the interventions they evaluated. As a result, data from the included studies were incomplete, inconsistent, and lacked validity, limiting the findings of this review, whilst identifying that further research is required. This review aimed to examine effects of communication skills training on a range of outcomes in social work education. With the exception of skill acquisition, there was insufficient evidence available to offer firm conclusions on other outcomes. For social work educators, our understanding of how communication skills and empathy are taught and learnt remain limited, due to a lack of empirical research and comprehensive discussion. Despite the limitations and variations in educational culture, the findings are still useful, and suggest that communication skills training is likely to be beneficial. One important implication for practice appears to be that the teaching and learning of communication skills in social work education should provide opportunities for students to practice skills in a simulated (or real) environment. For researchers, it is clear that further rigorous research is required. This should include using validated research measures, using research designs which include appropriate counterfactuals, alongside more careful and consistent reporting. The development of the theoretical underpinnings of the interventions used for the teaching and learning of communication skills in social work education is another area that researchers should address.

BackgroundFeedback is regarded a key element in teaching communication skills. However, specific aspects of feedback have not been systematically investigated in this context. Therefore, the aim of this study was to investigate the effectiveness of communication skills training (CST) integrating specific, structured and behavioral feedback.MethodsWe condensed best practice recommendations for feedback in a CST for undergraduate medical students and compared the effect of specific, structured and behavior-orientated feedback (intervention group CST-behav) to general, experience-orientated feedback (CST- exp. as our control group) in a randomized controlled trial (RCT). We investigated changes on communication skills evaluated by independent raters, and evaluated by standardized patients (SP). To do that, every student was video-recorded in a pre and post assessment.ResultsSixty-six undergraduate medical students participated voluntarily in our study. Randomization did not result in equally skilled groups at baseline, so valid inter-group comparisons were not possible. Therefore, we analyzed the results of 34 students of our intervention group (CST-behav). Five out of seven domains in communication skills as evaluated by independent raters improved significantly, and there was a significant change in the global evaluation by SP.ConclusionsAlthough we were unable to make between-group comparisons, the results of the within group pre-post evaluation suggest that specific feedback helps improve communication skills.