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Talking with patients and peers: Medical students difficulties with learning communication skills
Linköping University, Department of Medical and Health Sciences, Health and Society. Linköping University, Faculty of Health Sciences.
2009 (English)In: Medical teacher, ISSN 0142-159X, E-ISSN 1466-187X, Vol. 31, no 6, 528-534 p.Article in journal (Refereed) Published
Abstract [en]

Background: Patient-centered communication skills, such as an empathic attitude towards patients and a holistic perspective on health, are difficult to acquire. Designing effective courses requires better understanding of the difficulties that students perceive with learning to talk with patients Aims: The study aimed at exploring students common difficulties with learning patient-centered communication skills. Methods: Group discussions about student-patient interviews were videotaped and analyzed with regard to issues that students perceived as difficult and to their reflections about these difficulties. Results: The students reported feeling intrusive as they explored the patients psychosocial situation. They avoided being empathic and felt insecure about coping adequately with emotionally loaded topics. Their difficulties were mainly due to insufficient understanding of the functional relations between psychosocial issues and health conditions. Moreover, students were insecure concerning the function of affective feedback in the diagnostic process. However, the group discussions generated a language for analyzing and structuring interviews that helped develop the students professional identities. Conclusions: Students experienced moral qualms about applying major aspects of patient-centered interviewing. Instruction in communication skills should aim at filling the students knowledge gaps and fostering their awareness and expression of emotional perceptions. Long-term relationships with patients could help develop patient-centered communication.

Place, publisher, year, edition, pages
2009. Vol. 31, no 6, 528-534 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-19995DOI: 10.1080/01421590802208859OAI: oai:DiVA.org:liu-19995DiVA: diva2:232444
Available from: 2009-08-24 Created: 2009-08-24 Last updated: 2014-01-13
In thesis
1. Learning professional skills and attitudes: Medical students' attitudes towards communication skills andgroup learning
Open this publication in new window or tab >>Learning professional skills and attitudes: Medical students' attitudes towards communication skills andgroup learning
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Medical education aims at forming students’ professional identity. This includes skills and attitudes such as communication and teamwork skills. One of the thesis’ aims is to identify students’ typical difficulties with learning communication skills, and to understand how these affect their identity development. Group discussions of student-patient interviews were video-taped, and selected discussions were transcribed and analyzed. Students had difficulties in establishing trustful relationships with their patients, asking about sensitive topics, responding empathetically, and with applying formal structures to the consultation. Students’ professional identity was supported by peer students’ and teachers’ comments, which created a common language and fostered selfmonitoring abilities. Another aim was to study the relationship between students* attitude towards communication training, group learning, and their self-regulatory skills. In a survey study, established instruments were combined with a new questionnaire. Four medical schools participated – two with traditional and two with problem-based curricula – in Sweden and Germany. Statistical analyses revealed that female students were more positive towards learning communication skills than male students were. Good self-regulatory skills were related to a positive attitude towards group learning and clinical experience before academic studies. It was concluded that early clinical experience benefits students’ selfregulated learning, and promotes a positive attitude towards communication training. Awareness of typical difficulties can facilitate the acquisition of coping strategies.

Abstract [sv]

Medicinsk undervisning syftar till att forma studenternas professionella identitet. Den omfattar färdigheter och inställningar, t.ex. kommunikationsfärdigheter och förmågan att arbeta i grupp. Ett av avhandlingens syften är att identifiera studenternas typiska svårigheter med att lära sig färdighet i läkar-patient kommunikation samt att förstå hur den påverkar identitetsutvecklingen. Gruppdiskussioner av student-patient intervjuer videofilmades, utvalda diskussioner transkriberades och analyserades. Studenterna berättade om svårigheter med att etablera förtroliga relationer med patienterna, att prata om känsliga ämnen, att visa empati och att använda intervjumallen. Den professionella identiten stöttas av studenternas och lärarnas kommentarer, vilka bidrar till ett gemensamt språk och förmågan till själviakttagelse. Andra syftet är att undersöka sambandet mellan studenternas inställningar till kommunikationsfärdigheter och grupparbete, samt deras förmåga till självreglerat lärande. I en enkätundersökning kombinerades befintliga instrument med ett nytt frågeformulär. Fyra medicinska fakulteter deltog: två med traditionella och två med problembaserade undervisningsmetoder, en av varje i Sverige och i Tyskland. Statistiska analyser visade att kvinnliga studenter är, jämfört med manliga, mer positiva till att träna upp kommunikativa färdigheter. Förmågan till självreglerat lärande var relaterad till en positiv inställning till gruppinlärande och till klinisk erfarenhet innan studierna påbörjas. Slutsatsen är att tidig klinisk erfarenhet fostrar självstyrt lärande och en positiv inställning till kommunikationsträning. Medvetenhet om typiska svårigheter kan underlätta för studenter att anamma strategier att hantera dessa.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2013. 100 p.
Series
Linköping Studies in Arts and Science, ISSN 0282-9800 ; 565Linköping Dissertations on Health and Society, ISSN 1651-1646 ; 23
Keyword
Attitudes; awareness of learning strategies; communication skills; group learning; patient-centeredness, problem-based learning; self-regulation, Grupplärande; kommunikationsfärdighet; medvetenhet om inlärnings strategier; patient orientering; problembaserat lärande; självstyrt lärande
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-91722 (URN)978-91-7519-759-3 (ISBN)
Public defence
2013-05-30, Eken, ingång 65, plan 9, Campus US, Linköpings universitet, Linköping, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2013-04-30 Created: 2013-04-30 Last updated: 2013-09-04Bibliographically approved

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Lumma-Sellenthin, Antje

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