Medical students trained in communication skills show a decline in patient-centred attitudes: An observational study comparing two cohorts during clinical clerkships

Patient Education and Counseling

Volumn 84, Issue 3, 2011, Pages 310-318

  Bombeke, Katrien ^a   Van Roosbroeck, Sofie ^a   De Winter, Benedicte ^a   Debaene, Luc ^a   Schol, Sandrina ^b   Van Hal, Guido ^a   Van Royen, Paul ^a  

^a UNIVERSITY OF ANTWERP   (Belgium)

^b VRIJE UNIVERSITEIT BRUSSEL   (Belgium)

Author keywords

Clinical clerkships; Communication skills teaching; Medical education; Patient centred attitudes

Indexed keywords

ARTICLE; CLINICAL EDUCATION; COHORT ANALYSIS; COMMUNICATION SKILL; CONTROLLED STUDY; FEMALE; HEALTH CARE; HUMAN; LEARNING; MALE; MEDICAL EDUCATION; MEDICAL STUDENT; OBSERVATIONAL STUDY; PATIENT CENTEREDNESS; PRIORITY JOURNAL; PROSPECTIVE STUDY; QUESTIONNAIRE; SCORING SYSTEM; STUDENT ATTITUDE; TEACHER; TRAINING; VALIDITY;

ATTITUDE OF HEALTH PERSONNEL; CHI-SQUARE DISTRIBUTION; CLINICAL CLERKSHIP; CLINICAL COMPETENCE; COMMUNICATION; CONFIDENCE INTERVALS; CURRICULUM; EDUCATION, MEDICAL, GRADUATE; EDUCATIONAL MEASUREMENT; FEMALE; HUMANS; INTERPERSONAL RELATIONS; MALE; MODELS, PSYCHOLOGICAL; PHYSICIAN-NURSE RELATIONS; PROSPECTIVE STUDIES; PSYCHOMETRICS; QUESTIONNAIRES; STATISTICS, NONPARAMETRIC; STUDENTS, MEDICAL; YOUNG ADULT;

EID: 80051708694     PISSN: 07383991     EISSN: 18735134     Source Type: Journal    
DOI: 10.1016/j.pec.2011.03.007     Document Type: Article

References (47)

1. Mead N., Bower P. Patient-centredness: a conceptual framework and review of the empirical literature. Soc Sci Med 2000, 51:1087-1110.
2. De Haes H. Dilemmas in patient centeredness and shared decision making: a case for vulnerability. Patient Educ Couns 2006, 62:291-298.
3. Institute of Medicine Crossing the quality chasm: a new health system for the 21st century. Committee on Health Care in America 2001, National Academy Press, Washington, DC.
4. Department of Health The NHS plan 2000, Stationery Office, London.
5. Epstein R.M., Franks P., Shields C.G., Meldrum S.C., Miller K.N., Campbell T.L., et al. Patient-centered communication and diagnostic testing. Ann Fam Med 2005, 3:415-421.
6. Little P., Everitt H., Williamson I., Warner G., Moore M., Gould C., et al. Observational study of effect of patient centredness and positive approach on outcomes of general practice consultations. Brit Med J 2001, 323:908-911.
7. Little P., Everitt H., Williamson I., Warner G., Moore M., Gould C., et al. Preferences of patients for patient centred approach to consultation in primary care: observational study. Brit Med J 2001, 322:468-472.
8. Stewart M., Brown J.B., Donner A., McWhinney I.R., Oates J., Weston W.W., et al. The impact of patient-centered care on outcomes. J Fam Practice 2000, 49:796-804.
9. Stewart M., Brown J.B., Weston W.W., McWhinney I.R., McWilliam C.L., Freeman T.R. Patient-centered medicine: transforming the clinical method 2003, Radcliffe Medical Press, Abingdon. 2nd ed.
10. Bensing J.M., Verhaak P.F., van Dulmen A.M., Visser A.P. Communication: the royal pathway to patient-centered medicine. Patient Educ Couns 2000, 39:1-3.
11. General Medical Council Tomorrow's doctors: outcomes and standards for undergraduate medical education 2009, GMC, London, p. 19-29.
12. Nederlandse Federatie van Universitair Medische Centra. The 2009 framework for undergraduate medical education in The Netherlands. NFU; 2009.
13. Association of American Medical Colleges. Medical school objectives project. Report III: contemporary issues in medicine: communication in medicine. AAMC; 1999.
14. Tsimtsiou Z., Kerasidou O., Efstathiou N., Papaharitou S., Hatzimouratidis K., Hatzichristou D. Medical students' attitudes toward patient-centred care: a longitudinal survey. Med Educ 2007, 41:146-153.
15. Hojat M., Vergare M.J., Maxwell K., Brainard G., Herrine S.K., Isenberg G.A., et al. The devil is in the third year: a longitudinal study of erosion of empathy in medical school. Acad Med 2009, 84:1182-1191.
16. Woloschuk W., Harasym P.H., Temple W. Attitude change during medical school: a cohort study. Med Educ 2004, 38:522-534.
17. Yedidia M.J., Gillespie C.C., Kachur E., Schwartz M.D., Ockene J., Chepaitis A.E., et al. Effect of communications training on medical student performance. J Amer Med Assoc 2003, 290:1157-1165.
18. Smith S., Hanson J.L., Tewksbury L.R., Christy C., Talib N.J., Harris M.A., et al. Teaching patient communication skills to medical students: a review of randomized controlled trials. Eval Health Prof 2007, 30:3-21.
19. Noble L.M., Kubacki A., Martin J., Lloyd M. The effect of professional skills training on patient-centredness and confidence in communicating with patients. Med Educ 2007, 41:432-440.
20. Jenkins V., Fallowfield L. Can communication skills training alter physicians' beliefs and behavior in clinics?. J Clin Oncol 2002, 20:765-769.
21. Fernandez-Olano C., Montoya-Fernandez J., Salinas-Sanchez A.S. Impact of clinical interview training on the empathy level of medical students and medical residents. Med Teach 2008, 30:322-324.
22. De Vries H., Dijkstra M., Kuhlman P., Self-efficacy: the third factor besides attitude and subjective norm as predictor of behavioral intentions. Health Educ Res 1988, 3:273-282.
23. Eagly A.H., Chaiken S. The psychology of attitudes 1993, Wadsworth/Thomson, Belmont, NY, pp. 186-90.
24. Holland R.W., Verplanken B., van Knippenberg A. On the nature of attitude-behavior relations: the strong guide, the weak follow. Eur J Soc Psychol 2002, 32:869-876.
25. Kurtz S.M., Silverman J.D. The Calgary-Cambridge referenced observation guides: an aid to defining the curriculum and organizing the teaching in communication training programmes. Med Educ 1996, 30:83-89.
26. Kurtz S., Silverman J., Draper J. Teaching and learning communication skills in medicine 2005, Radcliffe Publishing, Abingdon. 2nd ed.
27. Vlaamse Interuniversitaire Raad. De onderwijsvisitatie geneeskunde. Een evaluatie van de opleidingen geneeskunde aan de Vlaamse universiteiten. VLIR 2005. Available from: http://www.vlir.be/media/docs/Visitatierapporten/2005/kv05v2-geneeskunde.pdf.
28. de Monchy C., Richardson R., Brown R.A., Harden R.M. Measuring attitudes of doctors: the doctor-patient (DP) rating. Med Educ 1988, 22:231-239.
29. Batenburg V. Do professional attitudes change during medical education?. Adv Health Sci Educ 1996, 1:153-164.
30. Thistlethwaite J.E., Raynor D.K., Knapp P. Medical students' attitudes towards concordance in medicine taking: exploring the impact of an educational intervention. Educ Health (Abingdon) 2003, 16:307-317.
31. Rees C., Sheard C., Davies S. The development of a scale to measure medical students' attitudes towards communication skills learning: the Communication Skills Attitude Scale (CSAS). Med Educ 2002, 36:141-147.
32. Batenburg V. Medical students' attitudes: attitude development in a medical school 1997, Utrecht University.
33. Hojat M., Xu G. A visitor's guide to effect sizes: statistical significance versus practical (clinical) importance of research findings. Adv Health Sci Educ Theory Pract 2004, 9:241-249.
34. Batenburg V., Smal J.A., Lodder A., de Melker R.A. Are professional attitudes related to gender and medical specialty?. Med Educ 1999, 33:489-492.
35. Hojat M., Gonnella J.S., Mangione S., Nasca T.J., Veloski J.J., Erdmann J.B., et al. Empathy in medical students as related to academic performance, clinical competence and gender. Med Educ 2002, 36:522-527.
36. Rees C., Sheard C. The relationship between medical students' attitudes towards communication skills learning and their demographic and education-related characteristics. Med Educ 2002, 36:1017-1027.
37. Haidet P., Dains J.E., Paterniti D.A., Chang T., Tseng E., Rogers J.C. Medical students' attitudes toward patient-centered care and standardized patients' perceptions of humanism: a link between attitudes and outcomes. Acad Med 2001, 76:S42-S44.
38. Rogers J.C., Coutts L. Do students' attitudes during preclinical years predict their humanism as clerkship students?. Acad Med 2000, 75:S74-S77.
39. Levinson W., Roter D. Physicians' psychosocial beliefs correlate with their patient communication skills. J Gen Intern Med 1995, 10:375-379.
40. Hojat M., Mangione S., Nasca T.J., Gonnella J.S., Magee M. Empathy scores in medical school and ratings of empathic behavior in residency training 3years later. J Soc Psychol 2005, 145:663-672.
41. Rees C.E., Knight L.V. The trouble with assessing students' professionalism: theoretical insights from sociocognitive psychology. Acad Med 2007, 82:46-50.
42. Epstein R.M., Franks P., Fiscella K., Shields C.G., Meldrum S.C., Kravitz R.L., et al. Measuring patient-centered communication in patient-physician consultations: theoretical and practical issues. Soc Sci Med 2005, 61:1516-1528.
43. Colliver J.A., Conlee M.J., Verhulst S.J., Dorsey J.K. Reports of the decline of empathy during medical education are greatly exaggerated: a reexamination of the research. Acad Med 2010, 85:588-593.
44. Bombeke K., Symons L., Debaene L., De Winter B., Schol S., Van Royen P. Help, I'm losing patient-centredness! Experiences of medical students and their teachers. Med Educ 2010, 44:662-673.
45. Bombeke K, Symons L, Vermeire E, De Winter B, Schol S, Debaene L, et al. Communication skills training: (de)motivation for patient-centredness? Experiences and attitude scores of medical students. Abstract of oral conference presentation. Zürich: EGPRN; 2010. Available from: http://meeting.egprn.org/files/prog_zurich_2010.pdf,%20p26.
46. Rees C., Sheard C. Evaluating first-year medical students' attitudes to learning communication skills before and after a communication skills course. Med Teach 2003, 25:302-307.
47. Malhotra A., Gregory I., Darvill E., Goble E., Pryce-Roberts A., Lundberg K., et al. Mind the gap: learners' perspectives on what they learn in communication compared to how they and others behave in the real world. Patient Educ Couns 2009, 76:385-390.