Korean J Med Educ.  2009 Mar;21(1):3-16.

Communication Skills Improvement of Medial Students According to Length and Methods of Preclinical Training

Affiliations
  • 1Department of Surgery, School of Medicine, Kangwon National University, Chuncheon, Korea. hyerinr@kangwon.ac.kr
  • 2Department of Family Medicine, School of Medicine, Kangwon National University, Chuncheon, Korea.
  • 3Department of Pediatrics, School of Medicine, Kangwon National University, Chuncheon, Korea.
  • 4Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon, Korea.
  • 5Clinical Performance Center, School of Medicine, Kangwon National University, Chuncheon, Korea.

Abstract

PURPOSE: The purpose of this study is to evaluate the changing pattern of communication skills of medical students according to length and methods of training.
METHODS
We evaluated a 1-week communications training course in 2003, a 1-year course in 2004, and a 1-semester course in 2005 during development of our curriculum. We have conducted the 10-minute CPX on abdominal pain annually since 2002 to assess the clinical performance of medical students who have completed the 3rd year clerkship. We selected CPX videos that were appropriate for assessment. One hundred sixty-four videos were available (1-week didactics: 42 cases, 1-week training: 28 cases, 1-semester training: 50 cases, 1-year training: 44 cases). We developed a 10-item global rating checklist to assess communication skills. A 5-point Likert scale was used to evaluate each item (4-very likely, 0-least likely). Two expert standardized patient (SP) raters evaluated the communication skills of students independently. We analyzed the outcomes based on the training length and methods. The reliability (G coefficient) was 0.825 with 2 SPs and 1 station.
RESULTS
The communication skills of students improved with practice and longer training, especially with regard to opening the interview, expressing empathy, understanding the patient's perspective, and preparing for the physical examination. Rapport-building, organization of the interview, understandable explanation, nonverbal communication, active listening and consideration during the physical examination was unchanged between durations of training. The scores for empathetic expression, active listening and understanding the patient's perspective were low across all groups.
CONCLUSION
We should concentrate our efforts to improve students' skills in empathetic expression, active listening and understanding the patient's perspective.

Keyword

Communication; Patient-physician relations; Reproducibility of results; Educational measurement

MeSH Terms

Abdominal Pain
Checklist
Curriculum
Educational Measurement
Empathy
Humans
Nonverbal Communication
Physical Examination
Reproducibility of Results
Students, Medical
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