Medical Student Communication Research Articles

Shared Decision-Making at the Intersection of Disability, Culture, and Language Accessibility: An Educational Session for Medical Students.

People with disabilities and those with non-English language preferences have worse health outcomes than their counterparts due to barriers to communication and poor continuity of care. As members of both groups, people who are Deaf users of American Sign Language have compounded health disparities. Provider discomfort with these specific demographics is a contributing factor, often stemming from insufficient training in medical programs. To help address these health disparities, we created a session on disability, language, and communication for undergraduate medical students. This 2-hour session was developed as a part of a 2020 curriculum shift for a total of 404 second-year medical student participants. We utilized a retrospective postsession survey to analyze learning objective achievement through a comparison of medians using the Wilcoxon signed rank test (α = .05) for the first 2 years of course implementation. When assessing 158 students' self-perceived abilities to perform each of the learning objectives, students reported significantly higher confidence after the session compared to their retrospective presession confidence for all four learning objectives (ps < .001, respectively). Responses signifying learning objective achievement (scores of 4, probably yes, or 5, definitely yes), when averaged across the first 2 years of implementation, increased from 73% before the session to 98% after the session. Our evaluation suggests medical students could benefit from increased educational initiatives on disability culture and health disparities caused by barriers to communication, to strengthen cultural humility, the delivery of health care, and, ultimately, health equity.

High-fidelity simulation versus case-based discussion for training undergraduate medical students in pediatric emergencies: a quasi-experimental study

ObjectiveTo evaluate the effect of high-fidelity simulation of pediatric emergencies compared to case-based discussion on the development of self-confidence, theoretical knowledge, clinical reasoning, communication, attitude, and leadership in undergraduate medical students. Methods33 medical students were allocated to two teaching methods: high-fidelity simulation (HFS, n = 18) or case-based discussion (CBD, n = 15). Self-confidence and knowledge tests were applied before and after the interventions and the effect of HFS on both outcomes was estimated with mixed-effect models. An Objective Structured Clinical Examination activity was conducted after the interventions, while two independent raters used specific simulation checklists to assess clinical reasoning, communication, attitude, and leadership. The effect of HFS on these outcomes was estimated with linear and logistic regressions. The effect size was estimated with the Hedge's g. ResultsBoth groups had an increase in self-confidence (HFS 59.1 × 93.6, p < 0.001; CDB 50.5 × 88.2, p < 0.001) and knowledge scores over time (HFS 45.1 × 63.2, p = 0.001; CDB 43.5 × 56.7, p-value < 0.01), but no difference was observed between groups (group*time effect in the mixed effect models adjusted for the student ranking) for both tests (p = 0.6565 and p = 0.3331, respectively). The simulation checklist scores of the HFS group were higher than those of the CBD group, with large effect sizes in all domains (Hedges g 1.15 to 2.20). ConclusionHFS performed better than CBD in developing clinical reasoning, communication, attitude, and leadership in undergraduate medical students in pediatric emergency care, but no significant difference was observed in self-confidence and theoretical knowledge.

Words and numbers: a comparative study of medical and journalism students’ descriptors of risk, numeracy and preferences for health risk communication

BackgroundGiven the complementary roles of health professionals and journalists in communicating health risks to patients and the public, there have been calls for physicians to work with journalists to improve the quality of health information received by the public. Understanding the preferences of medical and journalism students for the way in which health risks are communicated and their understanding of words used to describe risk is an important first step to inform interdisciplinary learning.MethodsMedical and journalism students (n = 203) completed an online survey where they were given qualitative descriptors of risk such as ‘a chance’, ‘probably’ and ‘unlikely’, and asked to assign a number that represents what the word means to them. Different formats of communicating risk (percentages, natural frequency and visual aids) were provided and students were asked to select and explain their preference. A thematic analysis of reasons was conducted. Numeracy and perceived mathematics ability were measured.ResultsNumbers assigned to the descriptor ‘A chance’ had the highest variability for medical students. Numbers assigned to the descriptor ‘Probably’ had the highest variability for journalism students. Using visual aids was the most popular format for risk communication for both courses (56% of medical students and 40% of journalism students). Using percentages was twice as popular with journalism students compared to medical students (36% vs. 18%). Perceived mathematics ability was lower in students with a preference for natural frequencies and in journalism students, however performance on an objective numeracy scale was similar for all three formats (percentages, natural frequency and visual aids). Reasons for choosing a preferred format included good communication, eliciting a response, or learning style.ConclusionsEducation on health risk communication for medical and journalism students should emphasize the need for qualitative descriptors of risk to be combined with the best available number. Students are already considering their role as future communicators of health risks and open to tailoring the mode of presentation to their audience. Further research is required on the design and evaluation of interdisciplinary workshops in health risk communication for medical and journalism students to maximise the opportunities for future inter-professional working.

Visual Intelligence Education as a Tool for Enhancing Medical Students' Self-Perception of Communication Skills.

Visual arts-based exposure and training are effective tools to enhance medical education. The visual arts can increase emotional intelligence and critical thinking skills. This study, conducted at Georgetown University School of Medicine (GUSoM) and the National Gallery of Art (NGA) in Washington, DC, was designed to measure the effect of a visual arts elective course on medical students' self-perception of their communication skills. This 6-week course involved lessons at the NGA and GUSoM for16 second-year medical students. The intervention students were age and gender-matched to14 second-year medical student control participants who took different elective courses. Prior to and following the intervention, the participants completed the Communication Skills Attitude Scale (CSAS). Statistical analysis was performed with either the 2-sided t-test or 2-sided Wilcoxon rank-sum test. There were no statistically significant differences in the presurvey scores between the groups. However, there were 6 CSAS questions in the postsurveys that had statistically significant differences between the 2 groups. Within each group, there were also numerous statistically significant differences between their presurvey and postsurvey responses, with positive changes occurring in the intervention group (IG) and primarily negative changes occurring in the control group (CG). The NGA course improved the self-perception of communication skills, with students reporting stronger views on the importance of communication skills in teamwork and patient rapport. The CG, on the other hand, did not have as many improved perceptions of communication skills and had stronger opinions regarding not needing the ability to communicate well to be a good physician. This study indicates that medical student communication skills can benefit from exposure to visual arts activities and experiences. Future physicians must become effective communicators, and this study paves the way for research investigating the relationship between visual arts education and the development of a physician's communication skills.

Study of the level of development of intercultural communication among foreign students of medical specialties at Khoja Ahmet Yassavi International Kazakh-Turkish University

Relevance. Intercultural communicative competence is a priority component of the process of learning a foreign language. At the moment, the question of improving the quality of such skills among foreign students is relevant. This is due to the fact that their ability and success in using a foreign language during education depends on the level of development of their multicultural communicative competence.Purpose. Therefore, the aim of the scientific work was to evaluate the results of the dissemination of knowledge about Kazakh culture, traditions and customs in Kazakh language classes among foreign students.Methodology. The article uses various methods of scientific research, in particular, analysis, synthesis, survey.Results. As a result, it was possible to characterize the level of intercultural communication of first-year foreign medical students who attended additional Kazakh language classes at Khoja Ahmet Yassawi International Kazakh-Turkish University. It was established that their indicators were quite high. It was proven that such approach could stimulate students' interest in language learning and development of their competence. In addition, the development and spread of intercultural competence among students is positively reflected not only on their educational and professional activities, but also on personal development.Conclusions. This indicates that such a vector contributes to the development of a successful educational environment in a higher educational institution. The practical value of the work lies in the fact that its results can be used in the formation of methodological materials for training foreign students and developing their knowledge of the Kazakh language.

SCIENTIFIC AND METHODOLOGICAL PRINCIPLES OF FORMING FOREIGN MEDICAL STUDENTS’ READINESS TO OVERCOME COMMUNICATION BARRIERS IN PROFESSIONAL COMMUNICATION

The academic paper is devoted to studying scientific and methodological principles ensuring effective training of foreign medical students to overcome communication barriers in professional communication. It has been revealed that readiness for professional communication is a component of the professional readiness of future healthcare professionals. Three interrelated levels of communicative interaction at which professional communication of foreign medical students takes place are identified: linguistic, paralinguistic, and non-verbal. It is noted that the communication of foreign students of medical specialties is characterized by the presence of linguistic, ethnic and discursive communication barriers. It has been determined that the primary objective of instructing foreign medical students to surmount communication barriers within professional discourse is to cultivate their requisite preparedness. The author’s definition of the readiness of foreign students of medical specialties to overcome communication barriers in professional communication as a complex personal and professional phenomenon, which is determined by their individual psychological characteristics and peculiarities of their professional activity, is given. It is substantiated that the readiness of foreign students of medical specialties to overcome communication barriers in professional communication is the result of their professional training and professional development. The motivational, cognitive, operational, and reflective components of the structure of foreign medical students' readiness to surmount communication barriers are delineated. The major components of educational and methodological support aimed at forming students’ readiness to overcome communication barriers in communication are identified, namely: orientation of language training towards the purposeful formation of readiness to overcome communication barriers and ensuring its continuity at all stages of education; formation of a system of foreign medical students’ professional-communicative social-perceptual qualities, which form the basis of relevant professional skills; establishment of an enriched communication environment in a medical higher education institution.

Model of Professional Communication of Medical Students in English and Its Implementation

The article talks about what the model of professional communication of medical students in English can be and how it can be implemented in medical professional education. The requirements of competition with a market approach, which are characteristic of modern society, are considered, it is shown how important it is to provide quality education in English, the need for individualized training in the context of medical professional education. It is noted that the problem will be correctly solved only if the English language in medical vocational education in Kyrgyzstan is taught taking into account the conditions that meet the needs of citizens.

Exploring medical and veterinary student perceptions and communication preferences related to antimicrobial resistance in Ontario, Canada using qualitative methods

BackgroundAntimicrobial resistance (AMR) threatens our ability to treat and prevent infectious diseases worldwide. A significant driver of AMR is antimicrobial use (AMU) in human and veterinary medicine. Therefore, education and awareness of AMR among antimicrobial prescribers is critical. Human and animal health professionals play important roles in the AMR issue, both as contributors to the emergence of AMR, and as potential developers and implementers of effective solutions. Studies have shown that engaging stakeholders prior to developing communication materials can increase relevance, awareness, and dissemination of research findings and communication materials. As future antimicrobial prescribers, medical and veterinary students’ perspectives on AMR, as well as their preferences for future communication materials, are important. The first objective of this study was to explore medical and veterinary student perceptions and understanding of factors associated with emergence and spread of AMR. The second objective was to identify key messages, knowledge translation and transfer (KTT) methods, and dissemination strategies for communication of AMR information to these groups.MethodsBeginning in November 2018, focus groups were conducted with medical and veterinary students in Ontario, Canada. A semi-structured format, using standardized open-ended questions and follow-up probing questions was followed. Thematic analysis was used to identify and analyze patterns within the data.ResultsAnalyses showed that students believed AMR to be an important global issue and identified AMU in food-producing animals and human medicine as the main drivers of AMR. Students also highlighted the need to address society’s reliance on antimicrobials and the importance of collaboration between different sectors to effectively reduce the emergence and transmission of AMR. When assessing different communication materials, students felt that although infographics provide easily digestible information, other KTT materials such as fact sheets are better at providing more information without overwhelming the target audiences (e.g., professional or general public).ConclusionOverall, the study participants felt that AMR is an important issue and emphasized the need to develop different KTT tools for different audiences. This research will help inform the development of future communication materials, and support development of AMR-KTT tools tailored to the needs of different student and professional groups.

O.O.2.1Development and evaluation of a class on bad news communication for medical students: Presenter(s): Paulo Vitoria, Beira Interior University, Portugal

O.O.2.1Development and evaluation of a class on bad news communication for medical students: Presenter(s): Paulo Vitoria, Beira Interior University, Portugal

The Consequences of Step 2 Clinical Skills Examination Discontinuation for Medical Schools and Sustainability Plans for Clinical Skills Assessment.

Comprehensive clinical skills examinations using standardized patients are widely used to assess multiple physician competencies. However, these exams are resource intensive. With the discontinuation of the Step 2 Clinical Skills (CS) exam in 2021, how medical schools will change their approaches to comprehensive clinical skills exams is unknown. This study explores school responses to this change and future directions of comprehensive clinical skills exams using the program sustainability framework. This cross-sectional, descriptive study surveyed medical school curriculum deans at 150 Liaison Committee on Medical Education-accredited U.S. medical schools from September to October 2021. The 30-question survey included questions about medical school and participant role, current comprehensive clinical skills exams, sustainability dimensions, and challenges and future directions. Descriptive statistics were used to characterize responses, and content analysis was used to identify themes in the open-ended responses. Educators at 75 of 150 institutions (50%) responded. Sixty-three respondents (84%) reported conducting a comprehensive clinical skills exam. The comprehensive clinical skills exam assessed readiness for graduation (51 [81%]), provided feedback for students (49 [78%]), evaluated curricula (38 [60%]), provided information for medical student performance evaluation or communication with residency (10 [16%]), and assessed other factors (6 [10%]), including preparation for Step 2 CS in the past and readiness for advancement to fourth year of medical school (multiple responses were allowed). Factors facilitating sustainability included sufficient funding to continue the exam (55 [87%]) and the belief that clinical skills assessment in medical school is now more important after discontinuation of the Step 2 CS exam (55 [87%]). Challenges to sustainability included organizational capacity and limited interinstitutional collaboration. Educators remain committed to the purpose of comprehensive clinical skills exams. Adapting to changed licensing requirements while sustaining clinical skills exams enables innovation and improvement in assessment of clinical competence.

Effectiveness of a New Clinical and Communication Curriculum for Medical Students: Result of a Double-Blinded Randomized Controlled Educational Trial.

To improve 4 skills (communication, history-taking, past history-taking, and documentation) in medical students, we designed and pilot-tested a curriculum to teach a sample of Year 4 (Y4) students these skills and compared the clinical performance of these students with students not receiving the intervention. The study focused on the new curriculum's effectiveness in enhancing students' performance of these skills. To minimize exposure across groups, participants were divided into intervention and control groups at random and placed in various classrooms. We evaluated each group's clinical competency 3 times: prior to the intervention, 9 weeks afterward, and 2 years later. There was no difference at baseline between the 2 groups. Immediately following the intervention, the mean score of the intervention group's skills was significantly higher than before and higher than the control group in each clinical skill. The performance difference between the 2 groups was maintained for 2 years following the intervention. Following a 9-week curriculum, evaluators rated students' performance higher than their counterparts who learned these skills through standard informal exposure in the clinical setting. The fact that this performance advantage was maintained for 2 years following the intervention is a testament to the durability of the intervention and the value of dedicated training in these critical areas at an early point in students' clinical careers.

К ВОПРОСУ О КОММУНИКАТИВНЫХ ПОЗИЦИЯХ В ОБЩЕНИИ СТУДЕНТОВ ЛЕЧЕБНОГО ФАКУЛЬТЕТА ВГМУ

Objectives.To study the communicative positions (CP) in the communication of medical faculty students of VSMU and to analyze their dynamic features. Material and methods.The study involved 532 students of the medical faculty. The 2nd-year students numbered 386 people (117 boys and 269 girls); the 6th-year students were represented by 146 persons (33 boys and 113 girls).The study of communicative positions in communication was carried out using the methodology of E.I. Rogov «Transactional analysis of communication». Results.The students showed a higher representation of a child’s («dependent») position among the 2nd-year medical students, the dominance of an adult’s position among the 6th-year medical students, the lowest representation of the parental position in the total sample, a more pronounced dynamic increase in the «adult - child - parent» (ACP) formula and a decrease in the «adult - parent - child » (APC) formula in girls compared to young men. Conclusions.The identified general and gender features of CP in communication indicate that the information and educational environment created at VSMU on the whole has a beneficial effect on the formation of communication skills of future doctors, which is manifested in the flexible choice of CP in communication, adequate to the requirements of the educational process by the medical faculty students.The results of the study can be used in the educational process of VSMU, the activities of the socio-pedagogical and psychological services, the work of academic group tutors.

CREATIVITY AS AN ESSENTIAL ASPECT IN MEDICAL EDUCATION

The article deals with the issues of developing students’ creative skills at medical educational institutions. Intensification of students’ creative potential occurs through the formation of thinking, research and communication skills, ability to interact with information means and technologies. Second-year students of General Medicine Faculty were involved in the experiment at Danylo Halytsky Lviv National Medical University in Ukraine. Experimental and control groups included 172 students in each one. We singled out two groups: a control group – training based on the available basic course “Professional English in Medicine” and an experimental group – training based on a combination of two courses: the basic course “Professional English in Medicine” and the elective course “Special Medical Terminology”. Homogeneity of the control and experimental groups was checked using Student’s t-test. Testing 0-hypothesis showed no significant differences between samples for the reliability level 0.05 (5% probability). At the first stage of the experimental study, students’ performance was considered at the beginning of the experiment in the control and experimental groups. Students were divided into three levels: high (82–100 points), medium (64–81 points) and low (50–63 points). Certainty of differences between groups was tested using Pearson’s chi-squared test (χ2), according to which the critical value was = 5.991, and the corresponding empirical value = 0.414. Thus, any differences between the results of the control and experimental groups are random variations with a probability of less than 5%, and, therefore, the samples are homogeneous by the research indicator. Verification of reliability of the obtained results in improving the level of creativity in students was checked by Pearson’s chi-squared test (χ2), according to which the critical value equaled 5.991 and the corresponding empirical value = 6.11. Thus, any differences between the results of the control and experimental groups are with a probability of less than 5% and based on the result of introduction of an active pedagogical factor into the educational process, and, therefore, the difference between the control and experimental groups is expected for the studied indicator. To define creative abilities, we used Joy Paul Guilford’s parameters and factors for interpreting variations in creativity: sensitivity to problems; flexibility and fluency; originality; synthesis, analysis; reorganizing or redefining; complexity and evaluation; to determine verbal aspect of students’ creativity, we applied the techniques suggested by Walther Moede and Sarnoff A. Mednick. All students performed significant improvement in the ability to generate a lot of ideas; they also showed a steady increase in such forms of creativity as sensitivity to problems, flexibility and fluency. Slight increase was noticed in reorganizing or redefining, complexity and evaluation. The students’ ability to solve problems by realization of relevant analytical and synthetic operations must be taken into consideration while developing creativity and creative communication of medical students.

COVID-19 epidemic and Chinese medical students: perception, emotions, attitudes, and conformity during domicile quarantine.

Students from Shantou University Medical College were subject to domicile quarantine during the early phase of the COVID-19 outbreak. We investigated their experience during March-April 2020 using a cross-sectional, self-administered, anonymous online survey. Out of 531 respondents, 75.7% became aware of the outbreak via the Internet (61.7%), WeChat (57.8%), and Weibo (49%). Nearly all students knew COVID-19 manifestations, incubation period, and transmission modes; about half considered wearing facemask and hand hygiene as effective epidemic interventions. They experienced various emotional reactions that changed significantly in response to the outbreak, lockdown, and quarantine (ps < 0.001), with depression in 23.3%. Most students (83.4%-99.4%) had positive attitudes and good compliance towards domicile quarantine and preventive measures. Females were significantly better than males in hand hygiene compliance (p = 0.04). More students with positive attitudes and good compliance than those without educated their families (ps < 0.05 - ps < 0.001). Multiple logistic regression showed negative relationships between anger and hand hygiene attitude (OR = 0.06, 95% CI = 0.01-0.87); confusion and quarantine compliance (0.30, 0.12-0.76); and anger and compliance with quarantine (0.32, 0.11-0.93), facemask (0.12, 0.03-0.50), and hand hygiene (0.27, 0.08-0.88). This study revealed how multichannel risk communication, early awareness, positive attitudes, and conformity of medical college students might have contributed to the favorable outcome from the COVID-19 epidemic in China. Clear, accurate, consistent, early risk communication by the local, national, and international public health authorities seems critical to promote public understanding, correct risk perception, and rational emotions and attitudes, leading to optimal conformity.

A return-on-investment analysis of impacts on James Cook University medical students and rural workforce resulting from participation in extended rural placements.

Although all medical students at James Cook University (JCU), Queensland, Australia, undertake rural placements throughout their course, a proportion (currently about 20 per year out of 170-190 final-year students) undertake extended rural placements in rural and remote towns - 5-month Integrated Rural Placement (IRP) or 10-month Longitudinal Integrated Clerkship (LIC) programs. This study uses a return-on-investment (ROI) approach to quantify student and rural medical workforce benefits arising from these 'extended placements' between 2012 and 2018. Seventy-two JCU MBBS graduates participated in extended rural placements between 2012 and 2018. In 2019, 46 of these graduates who had reached at least postgraduate year 2 and provided consent to be contacted for health workforce research were emailed a link to an online survey. Questions explored the key benefits to students' development of competencies and to rural medical workforce as a direct result of student participation in the IRP/LIC activities, as well as estimations of costs to students, deadweight (how much change would have occurred without participating in an extended placement), and attribution (how much change was due to other programs or experiences). The key student and rural medical workforce benefits were each assigned a 'financial proxy' to allow calculation of ROI from 2013 to 2019 as a dollar value, compared with the costs to students and to the JCU medical school from implementing the IRP/LIC programs between 2012 and 2018. Twenty-five of the 46 JCU medical graduates who undertook an extended placement responded (response rate 54%), reporting that the most common (96%) and most important benefit (56%) from their extended placement was 'greater depth and breadth of clinical skills'. Seventy-five percent (18/24; one missing response for this question) of the respondents also reported intending to have a full-time career in rural and remote practice. The overall cost of undertaking an IRP or LIC program for students between 2012 and 2018 was calculated to be $60,264, while the cost to the JCU medical school for sending 72 students out on extended rural placements was calculated as $32,560, giving total costs of $92,824. Given the total value of benefits ($705,827) calculated for the key student benefit of increased clinical skills and confidence in the internship year from participating in an extended placement ($32,197) and for the key rural medical workforce benefit of willingness to work in a rural or remote town ($673,630), the ROI from the extended rural programs between 2013 and 2019 (after students graduated and entered the workforce) is calculated at $7.60 for every dollar spent. This study confirms that undertaking an extended placement has significant positive impacts on final-year medical students' clinical confidence, clinical skills and communication skills into their internship year. In addition, the extended placements have longer-term impacts on the non-metropolitan health workforce by inspiring more JCU medical graduates to take up rural generalist, rural general practitioner or generalist specialist positions in rural and remote towns. This positive ROI from extended rural placements is important evidence for shifting the conversation around supporting these programs from one of cost to one of value.

Current status of simulation-based medical education in India and the way forward

India is waking up to the importance of simulation-based education (SBE). More and more institutions are setting up centralized simulation training facilities, while others have such facilities at the departmental level. The new National Medical Commission curriculum mandates communication and procedural skills training for undergraduate medical students and it is likely that SBE will soon be mandated for postgraduates as well. In my experience there are several difficulties with a universal adoption of SBE in healthcare in India. This article describes the current situation of SBE in healthcare in India before proposing strategies to enhance uptake and acceptance.

COMMUNICATION SKILLS FORMATION OF MEDICAL STUDENTS

The competence of the physician is determined not only by scientific and clinical knowledge, but also by excellent communication skills to ensure optimal doctor – patient interactions. Patients should be partners in the process of choosing diagnosis and treatment methods, which encourages them to be responsible for their own health and helps to improve the effectiveness of medical care. It is the responsibility of the physician to facilitate the process "joint decision – making", which promotes this partnership, using good communication skills.&#x0D; The article considers the general advice for the organization of communication of medical students in different situations and with different categories of patients, as well as mechanisms for their integration into the existing curriculum.&#x0D; One of the important parts of developing communication skills at the beginning of medical career is observing others. The student should take every opportunity to observe the interaction of doctor and patient, it is important to be present during serious conversations. The student needs to consider whether the behavior he sees should be imitated or avoided, thinking about how he can adjust his future behavior in such a situation. The student needs to choose the things he likes and use them as his own – creating his own structure of communication techniques.&#x0D; Effective communication goes a long way in building a relationship of trust between physician and patients. Patients expect doctors to support them, be compassionate, open, and honest about the details of their illness, treatment choices, side effects of medications, and the expected relief of symptoms. Non-verbal aspects of communication such as body language, eye contact, facial expression, touch, gestures and interpersonal distance have extraordinary importance in building relationships between doctor and patient.&#x0D; Studing the communication skills of medical students is an important component of the educational process, so it is recommended to incorporate them in higher medical school programs from the very beginning. One challenge with formal communication skills in higher medical schools is the gap that students observe between the communication patterns taught in training situations and the actual behavior of physicians in clinical practice. This can be a major barrier to overcome. A possible strategy to remove this barrier could be an integration of clinical and communication skills teaching in clinical situations. An important condition for teaching and assessing the communication skills of future physicians is the modeling of real professional communication conditions in order to involve each student in practical communication activities. However, the best demonstration of professional communication skills takes place in real clinical situations – "near the patient's bedside", where students learn to communicate effectively and master communication skills using their own experience.The ultimate goal is not only to teach students the particularities of communication, but also to use them throughout the practical activities.

Teaching communication in medical students – a cornerstone for patient’s outcome

Communication is definitely one of the most important contributing factor for an ideal doctor-patient relationship. The major importance of communication is to build a proper relationship with the patients, in which the empathy and respect play an essential role and can be taught and improved with proper training. This process is defined as cross-culture communication and it has to be taught during medical school. Patient-centered communication is a concept closely related to cross-culture communication and it might be defined by the physician’s ability to tailor communication to each patient’s need and level of understanding in order to provide patient-centered care. Training of clinical communication skills in medical students is an incontestable emergency for the patient’s outcome. Medical education formerly focused on training students for solving only the medical problems by providing the treatment for their organic problems. Medical schools recently included in undergraduate curricula clinical communication courses in order to improve student’s and future physician’s the ability to obtain relevant information from their patients, to build strong doctorpatient relationships and provide patient-centered care. Various models were elaborated for teaching and assessing clinical communication skills, which were found to improve multiple aspects of physician-patient communication among which counseling, interviewing techniques and prescription. Medical schools should properly address to clinical communication skills by including training courses in each year of education focused on the specific of the learned medical fields. It is crucial for implementing proper assessment methods in order to prevent and diminish as much as possible the factors that might negatively impact the development of doctor-patient relationship. Proper medical training in terms of clinical communication skills should be initiated during medical school in all students that deal with patients, but also after the graduation, periodically in all health care providers for assuring an ideal outcome for their patients.

Improv to improve medical student communication.

Effective patient provider communication skills can be difficult and time-consuming to teach. Deliberate practice of communication skills through improvisational theatre exercises, with structured debriefing, can provide a solution for teaching patient-centred communication skills in time-limited settings. The objective of this study was to determine if improvisational theatre exercises improved the ratings of patient satisfaction and empathetic communication by standardised patients. This was a randomised controlled trial looking at the effect of improvisational theatre exercises on ratings of patient satisfaction and empathetic communication. Third-year medical students (n=188) participated in a formative team-based standardised patient (SP) experience. Prior to the SP experience, teams of students were randomly assigned to receive a 45-minute communication-focused improvisation intervention (immediately before the SP experience) or to a control arm without intervention. All teams then participated in the SP experience; the SPs (blinded to team randomisation assignment) then assessed each team's empathetic communication and completed patient satisfaction questions focused on physician behaviours derived from Press GaneyTM and the Hospital Consumer Assessment of Healthcare Providers and System SurveysTM . Fifty teams of three or four students participated; 20 teams in the intervention arm and 30 teams in the control arm. Student teams in the improvisation intervention group had increased measures of empathetic communication (p=0.04) compared to the control group. The intervention group had increased patient satisfaction survey ratings of 'ability to listen carefully' (p=0.001) and of 'physician skills' compared to control groups (p=0.03). Improv exercises with students increased students' empathetic communication and patient satisfaction as assessed by standardised patients.

Role of written examination in the assessment of attitude ethics and communication in medical students: Perceptions of medical faculties.

BACKGROUND:The study aims to record the perceptions of medical faculties regarding the effectiveness of theory-based examination to assess the newly introduced competencies of attitude ethics and communication (AETCOM) in the competency-based medical curriculum for Indian medical graduates.MATERIALS And METHODS:This is an analytical cross-sectional study performed on the month of February 2020 where a prevalidated questionnaire consisting of components of AETCOM was e-mailed to the teaching faculties of IQ City Medical College via Google Forms. Consenting faculties responded. Their results were analyzed by inbuilt Google statistics and were cross-verified with SPSS 20.0.RESULTS:Sixty percent faculties strongly agree regarding the beneficial role of mandatory inclusion of AETCOM competencies in competency-based medical education. About 61.66% of faculties strongly agree that both formative assessment and summative assessment of AETCOM are essential. Although 48.33% of faculties believed that theoretical questions can be used to assess AETCOM, 51.66% of faculties do not agree that theory examination serves as an effective tool to assess AETCOM. They believe that AETCOM cannot be written on paper and attitude can change in reality when facing a real-world clinical scenario in contrast to what is written in answer script during creative writing.CONCLUSIONS:Assessment of AETCOM is essential and it should be preferably done via a practical approach in a real-world simulated scenario and not by written theoretical examination.