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      Do medical students like communication? Validation of the German CSAS (Communication Skills Attitude Scale) Translated title: Mögen Medizinstudierende Kommunikation? Validierung der deutschsprachigen CSAS (Communication Skills Attitude Scale)

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          Abstract

          Objectives: Attitudes towards communication skills of medical undergraduates can be gathered using the Communication Skills Attitude Scale (CSAS). We aimed to develop a German version of the CSAS (CSAS-G) in order to explore attitudes towards communication skills in a German cohort. Additionally the potential influence of demographic factors was examined.

          Methods: We realized the CSAS-G and conducted a survey with 529 participants from 3 different years of study. We then carried out an explorative as well as confirmatory factor analysis and compared the attitudinal scores. Multiple regression analysis was performed.

          Results: The confirmatory analysis confirmed the two-subscale system revealed by the explorative factor analysis. Students indicate low levels of negative attitudes and moderate levels of positive attitudes. Attitudinal scores differ significantly in relation to gender.

          Conclusion: The CSAS-G can be used in German cohorts to evaluate attitudes towards communication skills. Medical students in our study show basically a positive approach. Further investigation is necessary to explore and understand attitudes towards communication skills of German medical students.

          Zusammenfassung

          Zielsetzung: Die Lehre ärztlicher Gesprächskompetenz schließt die Vermittlung förderlicher Einstellungen ein. Mittels der Communication Skills Attitude Scale (CSAS) werden Einstellungen Medizinstudierender zum Erwerb von kommunikativer Kompetenz erfasst. Ziel der vorliegenden Erhebung ist die Entwicklung einer deutschsprachigen CSAS-Fassung (CSAS-G), um die Einstellungen in einer deutschsprachigen Kohorte zu messen. Ergänzend untersuchten wir den Einfluss demographischer Merkmale auf die Einstellungswerte.

          Methodik: Wir erstellten die CSAS-G und befragten in unserer Untersuchung 529 Studienteilnehmer aus drei verschiedenen Studienjahren. Wir führten eine explorative wie konfirmatorische Faktorenanalyse durch und verglichen anschließend die Einstellungswerte nach Studienjahr. Ebenso wurde eine multiple Regressionsanalyse berechnet.

          Ergebnisse: Die konfirmatorische Faktorenanalyse bestätigte das zweifaktorielle System aus der explorativen Faktorenanalyse. Die Studierenden gaben wenig Zustimmung zu negativen Einstellungen und mäßige Zustimmung zu positiven Einstellungen an. Die Einstellungswerte differieren signifikant nach Geschlechtszugehörigkeit.

          Schlussfolgerung: Die CSAS-G eignet sich zur Einschätzung von Einstellungsausprägungen zu Kommunikationskompetenz in deutschsprachigen Kohorten. Die Medizinstudierenden unserer Studie zeigten grundlegend eine positive Einstellung. Weiterführende Untersuchungen sind erforderlich, um die Einstellungen deutschsprachiger Medizinstudierender zu kommunikativer Kompetenz zu erfassen und zu verstehen.

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          How does communication heal? Pathways linking clinician-patient communication to health outcomes.

          Although prior research indicates that features of clinician-patient communication can predict health outcomes weeks and months after the consultation, the mechanisms accounting for these findings are poorly understood. While talk itself can be therapeutic (e.g., lessening the patient's anxiety, providing comfort), more often clinician-patient communication influences health outcomes via a more indirect route. Proximal outcomes of the interaction include patient understanding, trust, and clinician-patient agreement. These affect intermediate outcomes (e.g., increased adherence, better self-care skills) which, in turn, affect health and well-being. Seven pathways through which communication can lead to better health include increased access to care, greater patient knowledge and shared understanding, higher quality medical decisions, enhanced therapeutic alliances, increased social support, patient agency and empowerment, and better management of emotions. Future research should hypothesize pathways connecting communication to health outcomes and select measures specific to that pathway. Clinicians and patients should maximize the therapeutic effects of communication by explicitly orienting communication to achieve intermediate outcomes (e.g., trust, mutual understanding, adherence, social support, self-efficacy) associated with improved health.
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            Medical student attitudes toward the doctor-patient relationship.

            Medical educators have emphasized the importance of teaching patient-centred care. To describe and quantify the attitudes of medical students towards patient-centred care and to examine: (a) the differences in these attitudes between students in early and later years of medical school; and (b) factors associated with patient-centred attitudes. We surveyed 673 students in the first, third, and fourth years of medical school. Our survey utilized the Patient-Practitioner Orientation Scale (PPOS), a validated instrument designed to measure individual preferences towards various aspects of the doctor-patient relationship. Total PPOS scores can range from patient-centred (egalitarian, whole person oriented) to disease- or doctor-centred (paternalistic, less attuned to psychosocial issues). Additional demographic data including gender, age, ethnicity, undergraduate coursework, family medical background and specialty choice were collected from the fourth year class. A total of 510 students (76%) completed data collection. Female gender (P < 0.001) and earlier year of medical school (P = 0.03) were significantly associated with patient-centred attitudes. Among fourth year students (n = 89), characteristics associated with more patient-centred attitudes included female gender, European-American ethnicity, and primary-care career choice (P < 0.05 for each comparison). Despite emphasis on the need for curricula that foster patient-centred attitudes among medical students, our data suggest that students in later years of medical school have attitudes that are more doctor-centred or paternalistic compared to students in earlier years. Given the emphasis placed on patient satisfaction and patient-centred care in the current medical environment, our results warrant further research and dialogue to explore the dynamics in medical education that may foster or inhibit student attitudes toward patient-centred care.
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              A preliminary study of empathy, emotional intelligence and examination performance in MBChB students.

              There is considerable interest in the attributes other than cognitive ability that medical students need in order to be professionally successful, with a particular focus on empathy and emotional intelligence (EI). Selection considerations have also motivated interest in such attributes as predictors of academic success. There are reports of declines in empathy in US medical students, but no comparative information is available for UK students. This study aimed to compare empathy levels in medical students in Years 2, 3 (pre-clinical) and 5 (clinical), to examine gender differences in empathy and EI, and to investigate whether EI and empathy are related to academic success. Questionnaires assessing EI and empathy were completed by students. Previous empathy scores for the Year 2 cohort were also available. Empathy trends were examined using anova; trends for the Year 2 group for whom Year 1 scores were available were examined using repeated-measures anova. Associations of EI and empathy with academic success were examined using Pearson correlation. A significant gender x cohort effect was found, with male empathy scores increasing between Years 1 and 2, whilst female scores declined. Peer ratings in Year 2 problem-based learning (PBL) groups were positively correlated with EI. Trends in levels of empathy differed by gender. The reasons for this require further investigation, particularly in relation to course content. Associations between academic performance and EI were sparse, and there were none between academic performance and empathy, but the effects of EI (and other characteristics) on PBL group functioning represent a promising area for future study.
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                Author and article information

                Journal
                GMS Z Med Ausbild
                GMS Z Med Ausbild
                GMS Z Med Ausbild
                GMS Zeitschrift für Medizinische Ausbildung
                German Medical Science GMS Publishing House
                1860-7446
                1860-3572
                11 February 2015
                2015
                : 32
                : 1
                : Doc11
                Affiliations
                [1 ]University Hospital Leipzig, Department of Psychic Health, Division for Medical Psychology and Medical Sociology, Leipzig, Germany
                Author notes
                *To whom correspondence should be addressed: Katrin Rockenbauch, University Hospital Leipzig, Department of Psychic Health, Division for Medical Psychology and Medical Sociology, Ph.-Rosenthal-Straße 55, D-04103 Leipzig, Germany, Phone: +49 (0)341/97-18808, Fax: +49 (0)341/97-18809, E-mail: katrin.rockenbauch@ 123456medizin.uni-leipzig.de
                Article
                zma000953 Doc11 urn:nbn:de:0183-zma0009538
                10.3205/zma000953
                4330630
                25699103
                a73b157d-2ff3-4a92-a7a2-cf7113fba37a
                Copyright © 2015 Busch et al.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License.

                History
                : 19 March 2014
                : 30 October 2014
                : 19 June 2014
                Categories
                Article

                Medicine
                communication,medical education,undergraduate,attitude of health personnel
                Medicine
                communication, medical education, undergraduate, attitude of health personnel

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