Patient-Centered Attitudes and Communication Skills in Medical Students after Clerkship

Abstract

Purpose Patient-centered communication is known to improve patient satisfaction, compliance, doctor-patient relationship, and health outcomes. The aim of this study is to evaluate medical students' patient-centered communication skills and attitudes in medical students after their clerkship. Methods To evaluate medical students' communication skills, OSCE was performed on 114 fourth-year medical students who had completed their clerkship. After OSCE, we used structured questionnaires to survey the subjects in assessing attitudes toward communication skill learning and patient-centeredness. Results The accomplished frequency of patient-centered communication items were as follows: allow patient's narrative thread (88.6%), open-to-closed-ended questions (47.4%), discuss psychosocial and emotional factors (36.0%), elicit patient's concerns and perspectives (36.0%), discuss how health problem affects patient's daily life (21.9%), express empathy (14.0%), negotiate plan of action with patient (68.4%), and ask whether patient has further issues to discuss (33.3%). The students who did medical service as extracurricular activity and were confident with their communication skills performed better patient-centered interviews. There was no significant relationship between medical students' patient-centered attitudes and patientcentered OSCE scores. Conclusion Having completed their clerkship, medical students were still unable to perform a good patient-centered interview. Current medical curriculum should teach medical students how to communicate in a patient-centered manner. The education method should focus on behavior change initiative. Keywords: Patient-centered, Communication skill, Attitude, Medical education, Evaluation.