Verbessern Anamneseübungen die kommunikative Kompetenz von Studierenden der Medizin? Ein Prä-Post-Vergleich

Abstract

Do communication training programs improve students communication skills? - a follow-up study - Background: In contrast to Anglo-American countries, German medical students do usually not receive a formal training in communication skills. However, courses covering communication techniques were recently introduced, but have not been evaluated. The aim of the current study was to compare the level of communica-ion skills at the beginning and the end of a basic medical skills course (the so called Ärztliche Basisfähigkeiten module). Methods: A sample of 32 students agreed to perform interviews with simulation patients at the beginning and end of the one-semester course basic skills module; 29 complete datasets could be entered into comparison. The interviews were re-corded on video and subsequently scored by two independent raters each using the Calgary-Cambridge Observation Guide (CCOG, Kurtz and Silvermann 1996). Scores were analysed using non-parametric Wilcoxon rank-score tests as well as parametric t-tests for independent or repeated measure samples. Inter-rater relia-bility was assessed with Spearman`s correlation coefficients and Cohen s Kappa. Results: Strongest improvements were detected in the domains Gathering Infor-mation about social status, job and further medical history (p<0,0003), Open questions at the end of the interview (p<0,0001), Structuring of the interview (p:0,03), and Closing the session (p<0,0001). Inter-rater reliability was poor at the item level (Kappa <=.3), but acceptable for the total score Spearman s correla-tion rho= 55). The second interview was longer in the post-assessment, female interviewers started also at lower levels at the pre-assessment and showed larger improvements. Conclusion: The innovative teaching methods applied in the basic skills modul yielded several indications of improvements in the students communication skills. Thus, the current investigation highlights that the concept may well be on the right track. However, it is also obvious that these complex interventions require more systematic and concise evaluation efforts in order to provide further fine-tuning of the curriculum.