1. Jagdish Vankar1, Anusha Prabhakaran1, Suman Singh2,
Attitudes Towards and Perceived Need for Learning Communication Skills in Fresher Undergraduate Medical Students
Jagdish Vankar1, Anusha Prabhakaran1, Suman Singh2,
1-Dept. of Psychiatry, 2-Dept. of Microbiology, Pramukhswami Medical College, Karamsad.
Introduction
Revised Graduate Medical Education Regulation (2012) identifies patient-provider communication as a competency, training for which may begin from foundation itself.1
From this academic year, Medical Council of India would be implementing Attitude & Communications (AT-COM) module for addressing these needs in undergraduate medical students at Nodal and Regional centers.
Western research on attitudes towards communications skills found no difference in first and fourth year medical students, and female students had more positive attitudes.2
Similar research in Sri Lankan undergraduates found that a significant minority of students had reservations towards attending communication skills training (CST) sessions.3
We undertook this study to determine undergraduate students attitudes towards CST.
Modified CSAS scale consists of 25 items which includes two subscales. Subscale I measures positive attitude (PAS), subscale II measures negative attitude (NAS) with higher scores indicating stronger attitudes.
We adapted some questions on Modified CSAS for use amongst 1st MBBS students.
Importance and need for CST were moderately to weakly correlated with CSAS items.
The mean PAS score was 3.90 (0.46) and mean NAS score was 2.54 (0.34). These was no significant difference in PAS scores of males compared to females (p>0.05).
Those who agreed on importance of CST and need for CST held significantly higher favorable attitudes (PAS) on CSAS (p=0.001 and 0.002).
Those who were ambiguous or disagreed on need for CST held significantly higher unfavorable attitudes (NAS) on CSAS (p=0.011).
Results
Seventy-six students [42 (55.3%) females and 34 (44.7%)] responded to the survey.
Importance, need for CST and knowledge of CS
Conclusions
Importance of and need for CST and negative attitudes towards CST have to be addressed in subsequent training by having activities that illustrate the 1) Lifelong nature of the skill 2) How CS can help respect patient and colleagues & improve team working 3) How CS can help in ethical practice & prevent litigation.
As unfavourable attitudes are much more amenable in early years, CST should begin early in the course and delivered in ways to make it interesting.
Students feel that their knowledge will get them through medical school probably because there is no concept of assessment of one’s soft skills during schooling years and as part of high stakes exams faced till now. All formative and summative evaluations should incorporate assessment of CS, because assessment drives learning.
Selected CSAS items
Objectives
This study was undertaken to assess the following affective domains for first year MBBS students:
Perceptions of need for and importance of communication skills training (CST), perception of self-knowledge on communication skills (CS)and attitudes towards CST
Materials and Methods
Ethical approval was taken prior to the conduct of an anonymous cross sectional survey amongst fresher Ist MBBS Students.
Questionnaire consisted of Likert-type questions rated from strongly disagree (1) to strongly agree (5), with 3 being neutral or undecided.
Single questions assessing perception of need for CST, importance of CST and self-knowledge of communication skills were used.
Attitudes toward learning communication skills were measured using modified version of communication skills attitude scale (CSAS).4
Modified version of the original scale used amongst Sri Lankan undergraduates was used.3
Implications
Faculty development program in communication skills training and assessment at various levels of the course are required.
Description of innovation
References
1. Regulations on graduate medical education. (2012). Medical Council of India, New Delhi.
2. Wright KB, Bylund C, Ware J, Parker P, Query JL, Baile W. Medical student attitudes toward communication skills training and knowledge of appropriate provider-patient communication: a comparison of first-year and fourth-year medical students. Medical Education Online, 2009:11.
3. Marambe KN, Edussuriya DH, Dayaratne K. Attitudes of Sri Lankan Medical Students toward Learning Communication Skills. Educ Health 2012;25:
4. Rees, C., Sheard, C., & Davies, S. (2002). The development of a scale to measure medical students' attitudes towards communication skills learning: the Communication Skills Attitude Scale (CSAS). Medical education, 36(2),