Abstract
BackgroundThe changing trends of the society and revisions to medical education have changed the way medical students are trained to adroitly care for patients hence, patient centered care has become need of today’s society and communication skills are imperative in developing patient physician relationship. Increasingly, simulations are being used to aid medical students to incorporate theoretical knowledge into practice. There are innumerable studies regarding communication skills in terms of reliability, validity and feasibility but no such study has been documented using simulated patient’s feedback in improving communication skills in Pakistan. The aim of this study is to explore whether simulated patients’ feedback improves the communication skills of undergraduate medical students.MethodsDuring a randomized control trail a group of eighty students in the final year clerkship at Al-Nafees Medical College have participated in pre-post Objective Structured Clinical Exam (OSCE) on communication skills. The students were selected through convenience sampling technique. Four Objective Structured Clinical Exam (OSCE) stations based on different scenarios of communication skills were developed. Each station of fifteen minutes duration was assessed by both simulated patients and faculty using a validated tool LCSAS (Liverpool Communication Skills Assessment Scale). The difference between the pre and post-tests of two groups was explored by applying independent t-test. Cronbach’s alpha was used to check the reliability of scores and effect size was calculated.ResultsResults of this study have showed that there is significant improvement in communication skills after receiving feedback from simulated patients (p value ≤0.05) was observed. An overall Cronbach α = 0.83 on LCSAS reveal a high internal consistency and there was adequate demonstration of effect size(r = 0.8).ConclusionThe results on the scores of the students on the Liverpool Communication Skills Assessment Scale confirm that simulated patient’s feedback is essential to enhance the communication skills of the medical students. This study offers significant evidence towards successful conduction of a formal communication skills development initiative at Al-Nafees Medical College using simulated patient feedback during teaching and assessments.
Highlights
Introduction of self and roleGeneral audibility and enunciation Eye contactNonverbal facilitation Respect patient EmpathyAppropriate open and closed questionsClarifying and summarizingSensitivity of questionsUses clear languageEnsures understanding and closes appropriately ‘respect patient’ and item eleven ‘uses clear language’ had a mean > 2.Table 2 shows that the lowest mean was on item eleven ‘uses clear language’
Qureshi and Zehra BMC Medical Education (2020) 20:15 communicator to be one of the essential competencies of graduating student [12] and Pakistan Medical and Dental Council [13] have stressed on teaching communication skills in curriculum for undergraduate MBBS program
In the study pre and post-test Objective Structured Clinical Exam (OSCE) was conducted for all four stations on communication skills
Summary
Patient centered care is gaining prime importance globally [1]; it is defined as giving priority and respect to patient’s desires, requests and preferences, so patient can choose the treatment plan that best fit their personal needs [2]. This egalitarian approach is unlike the doctorcentered or paternalistic approach, which encourages patient to play role of a partner [3] and makes them more accountable for their own health [4]. Due to lack of proper training system, students are left to learn communication skills by themselves this leads to poor communication skills and dissatisfaction amongst patients [16]
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