1
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Development and pilot test of ComCare – a questionnaire for quick assessment of communicative and social competences in medical students after interviews with simulated patients Translated title: Entwicklung und Pilotstudie von ComCare – einem Fragebogen zur schnellen Einschätzung von kommunikativen und sozialen Kompetenzen von Medizinstudierenden nach Gesprächen mit Simulationspatienten und -patientinnen

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background: Physicians’ communicative and social competences are highly relevant for doctor-patient relationships. Simulation-based learning is frequently used to provide students with learning experiences resembling realistic medical situations. This study aims to assess communication and interpersonal skills in medical students after simulated consultations with a newly designed short questionnaire.

          Methods: In 2019, 103 final year students participated in a simulated consultation hour seeing four simulated patients. Communicative and social competences were assessed by a questionnaire including items for communication (Com) and interpersonal (Care) skills. The questionnaire was used by the simulated patients (ComCareP) after each consultation and as self-assessment by the students (ComCareD) after the fourth consultation. An explorative factor analysis was performed and the results of ComCareP and ComCareD were compared with respect to students’ sex and advancement in their final year.

          Results: All ComCareP items loaded on one factor, which explained 50.7% of the variance. The participants self-assessed their communication and interpersonal skills significantly better than the simulated patients. No significant differences were found for students’ sexes or advancement in their final year except for the item “responding to patients’ needs satisfactorily” which was significantly lower in students at the end of their final year. Patients’ general “satisfaction with the consultation” was higher while physicians’ general “satisfaction with the consultation” was lower than their total ComCare mean score. The general satisfaction with the consultation showed a significant positive correlation with both ComCares’ total mean scores.

          Conclusion: The ComCare measures communication and interpersonal skills as one factor. It can be used directly after consultations and shows significant positive correlation with the general satisfaction with a consultation. Since simulated patients’ satisfaction with the consultation was higher than their ComCare score, other factors than communication and interpersonal skills could play a role for patient satisfaction with a conversation and need to be further investigated.

          Zusammenfassung

          Hintergrund: Die kommunikativen und sozialen Kompetenzen Mediziner*innen sind für die Beziehung von Ärzt*innen und Patient*innen von großer Relevanz. Simulationsbasiertes Lernen wird häufig eingesetzt, um den Studierenden Lernerfahrungen zu vermitteln, die realistischen medizinischen Situationen ähneln. Diese Studie zielt darauf ab, die kommunikativen und sozialen Kompetenzen von Medizinstudierenden im Anschluss an simulierte Konsultationen mit einem neu gestalteten kurzen Fragebogen zu beurteilen.

          Methoden: Im Jahr 2019 nahmen 103 Studierende während des Praktischen Jahres (PJ) an einer simulierten Sprechstunde mit vier simulierten Patient*innen teil. Die kommunikativen und sozialen Kompetenzen wurden anhand eines Fragebogens bewertet, welcher Items für Kommunikations- (Com) und zwischenmenschliche (Care) Fähigkeiten enthielt. Der Fragebogen wurde von den simulierten Patient*innen (ComCareP) nach jeder Konsultation und als Selbsteinschätzung der Studierenden (ComCareD) nach der vierten Konsultation verwendet. Es wurde eine explorative Faktorenanalyse durchgeführt und die Ergebnisse von ComCareP und ComCareD wurden im Hinblick auf das Geschlecht und den Fortschritt der Studierenden im PJ verglichen.

          Ergebnisse: Alle ComCareP-Items luden auf einen Faktor, was 50,7% der Varianz erklärte. Die Teilnehmer*innen bewerteten ihre Kommunikations- und zwischenmenschlichen Fähigkeiten signifikant besser als die simulierten Patient*innen. Es wurden keine signifikanten Unterschiede in Bezug auf das Geschlecht oder den Fortschritt der Studierenden im PJ gefunden, mit Ausnahme des Items "zufriedenstellend auf die Bedürfnisse der Patient*innen eingehen", das bei den Studierenden am Ende des PJs signifikant niedriger war. Die allgemeine „Zufriedenheit der Patient*innen mit dem Erstgespräch“ war höher, während die allgemeine „Zufriedenheit der Ärzt*innen mit dem Erstgespräch“ niedriger war als der Gesamtmittelwert von ComCare. Die allgemeine „Zufriedenheit mit dem Erstgespräch“ zeigte eine signifikant positive Korrelation mit den Gesamtmittelwerten beider ComCare Bögen.

          Schlussfolgerung: Der ComCare misst Kommunikation und zwischenmenschliche Fähigkeiten als einen Faktor. Er kann direkt nach einer Konsultation eingesetzt werden und zeigt eine signifikant positive Korrelation mit der allgemeinen Zufriedenheit mit einer Beratung. Da die Zufriedenheit der simulierten Patient*innen mit dem Erstgespräch höher war als deren ComCare-Gesamtwert, könnten neben der Kommunikation und den zwischenmenschlichen Fähigkeiten noch andere Faktoren eine Rolle für die Zufriedenheit der Patient*innen mit dem Erstgespräch spielen und müssen weiter untersucht werden.

          Related collections

          Most cited references67

          • Record: found
          • Abstract: found
          • Article: not found

          Physician communication and patient adherence to treatment: a meta-analysis.

          Numerous empirical studies from various populations and settings link patient treatment adherence to physician-patient communication. Meta-analysis allows estimates of the overall effects both in correlational research and in experimental interventions involving the training of physicians' communication skills. Calculation and analysis of "r effect sizes" and moderators of the relationship between physician's communication and patient adherence, and the effects of communication training on adherence to treatment regimens for varying medical conditions. Thorough search of published literature (1949-August 2008) producing separate effects from 106 correlational studies and 21 experimental interventions. Determination of random effects model statistics and the detailed examination of study variability using moderator analyses. Physician communication is significantly positively correlated with patient adherence; there is a 19% higher risk of non-adherence among patients whose physician communicates poorly than among patients whose physician communicates well. Training physicians in communication skills results in substantial and significant improvements in patient adherence such that with physician communication training, the odds of patient adherence are 1.62 times higher than when a physician receives no training. Communication in medical care is highly correlated with better patient adherence, and training physicians to communicate better enhances their patients' adherence. Findings can contribute to medical education and to interventions to improve adherence, supporting arguments that communication is important and resources devoted to improving it are worth investing in. Communication is thus an important factor over which physicians have some control in helping their patients to adhere.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            The devil is in the third year: a longitudinal study of erosion of empathy in medical school.

            This longitudinal study was designed to examine changes in medical students' empathy during medical school and to determine when the most significant changes occur. Four hundred fifty-six students who entered Jefferson Medical College in 2002 (n = 227) and 2004 (n = 229) completed the Jefferson Scale of Physician Empathy at five different times: at entry into medical school on orientation day and subsequently at the end of each academic year. Statistical analyses were performed for the entire cohort, as well as for the "matched" cohort (participants who identified themselves at all five test administrations) and the "unmatched" cohort (participants who did not identify themselves in all five test administrations). Statistical analyses showed that empathy scores did not change significantly during the first two years of medical school. However, a significant decline in empathy scores was observed at the end of the third year which persisted until graduation. Findings were similar for the matched cohort (n = 121) and for the rest of the sample (unmatched cohort, n = 335). Patterns of decline in empathy scores were similar for men and women and across specialties. It is concluded that a significant decline in empathy occurs during the third year of medical school. It is ironic that the erosion of empathy occurs during a time when the curriculum is shifting toward patient-care activities; this is when empathy is most essential. Implications for retaining and enhancing empathy are discussed.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              The consultation and relational empathy (CARE) measure: development and preliminary validation and reliability of an empathy-based consultation process measure.

              S. Mercer (2004)
              Empathy is a key aspect of the clinical encounter but there is a lack of patient-assessed measures suitable for general clinical settings. Our aim was to develop a consultation process measure based on a broad definition of empathy, which is meaningful to patients irrespective of their socio-economic background. Qualitative and quantitative approaches were used to develop and validate the new measure, which we have called the consultation and relational empathy (CARE) measure. Concurrent validity was assessed by correlational analysis against other validated measures in a series of three pilot studies in general practice (in areas of high or low socio-economic deprivation). Face and content validity was investigated by 43 interviews with patients from both types of areas, and by feedback from GPs and expert researchers in the field. The initial version of the new measure (pilot 1; high deprivation practice) correlated strongly (r = 0.85) with the Reynolds empathy measure (RES) and the Barrett-Lennard empathy subscale (BLESS) (r = 0.63), but had a highly skewed distribution (skew -1.879, kurtosis 3.563). Statistical analysis, and feedback from the 20 patients interviewed, the GPs and the expert researchers, led to a number of modifications. The revised, second version of the CARE measure, tested in an area of low deprivation (pilot 2) also correlated strongly with the established empathy measures (r = 0.84 versus RES and r = 0.77 versus BLESS) but had a less skewed distribution (skew -0.634, kurtosis -0.067). Internal reliability of the revised version was high (Cronbach's alpha 0.92). Patient feedback at interview (n = 13) led to only minor modification. The final version of the CARE measure, tested in pilot 3 (high deprivation practice) confirmed the validation with the other empathy measures (r = 0.85 versus RES and r = 0.84 versus BLESS) and the face validity (feedback from 10 patients). These preliminary results support the validity and reliability of the CARE measure as a tool for measuring patients' perceptions of relational empathy in the consultation.
                Bookmark

                Author and article information

                Journal
                GMS J Med Educ
                GMS J Med Educ
                GMS J Med Educ
                GMS Journal for Medical Education
                German Medical Science GMS Publishing House
                2366-5017
                15 March 2021
                2021
                : 38
                : 3 , Communicative and Social Competencies/Kommunikative und soziale Kompetenzen
                : Doc68
                Affiliations
                [1 ]University Medical Center Hamburg-Eppendorf, Department of Internal Medicine, Hamburg, Germany
                [2 ]University Medical Center Hamburg-Eppendorf, III. Medical Clinic, Hamburg, Germany
                Author notes
                *To whom correspondence should be addressed: Sigrid Harendza, University Medical Center Hamburg-Eppendorf, III. Medical Clinic, Martinistr. 52, D-20246 Hamburg, Germany, Phone: +49 (0)40/7410-53908, Fax: +49 (0)40/7410-40218, E-mail: harendza@ 123456uke.de
                Article
                zma001464 Doc68 urn:nbn:de:0183-zma0014642
                10.3205/zma001464
                7994874
                33824904
                e3716fb7-0c29-49e0-8ee1-9ae3cbf26c65
                Copyright © 2021 Gärtner et al.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

                History
                : 31 March 2020
                : 20 November 2020
                : 17 October 2020
                Categories
                Article

                assessment,communication,interpersonal skills,social competence,medical students,undergraduate medical education

                Comments

                Comment on this article