Communication skills in medical students - An exploratory study before and after clerkships

Abstract

Introduction: Effective communication is the cornerstone of a fruitful patient-physician relationship. Teaching clinical communication has become a pivotal goal in medical education. However, approaches measuring the maintenance of learned skills are needed since a decline in some communication skills during medical school has been reported.

Objective: Explore medical students' communication skills in a simulated clinical encounter before and after clerkships.

Methods: Two-hundred-fifty-five undergraduate students attending the second year of medical course, at the Faculty of Medicine of University of Porto, completed a 1.5-h per week course over 4 months on basic communication skills. The students' final evaluation consisted in an interview with a simulated patient, assessed by a teacher using a standardized framework. Three years later, while attending clerkships, 68 students from the same population completed a re-evaluation interview following the same procedure.

Results: Medical students maintained a communication skill mean level similar to that of the original post-training evaluation, but significant differences in specific communication abilities were detected in this group of students. Empathic attitudes and ability to collect information improved whereas interview structure and non-verbal behavior showed a decline during clerkships expressing a balance between the competencies that improved, those that declined, and those that remained unchanged.

Conclusion: Present findings emphasize the importance of patient contact, context and clinical role models on the maintenance of learned skills, underscoring the importance of an integrated approach of clinical communication teaching throughout medical school.

Keywords: Assessment; Clerkships; Communication skills; Empathy; Medical education.

Fig. 1.

Curriculum structure and the re-evaluation protocol.

Fig. 2.

Differences between mean values per item between T1 and T2 evaluations. *p < 0.0025 (paired samples t-test).