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Attitudes of Portuguese medical residents’ towards clinical communication skills

https://doi.org/10.1016/j.pec.2015.04.009Get rights and content

Highlights

  • Attitudes and perceptions of residents towards communication skills (CS) are explored.

  • Positive scores correspond to attitudes towards CS in general (CSAS1).

  • Negative scores correspond to attitudes towards the teaching process of CS (CSAS2).

  • Content analysis indicates that residents’ perceptions are context-influenced.

  • Measures are needed to facilitate transfer of skills to clinical practice.

Abstract

Objective

To explore the attitudes and perceptions of Portuguese residents towards Clinical Communication Skills (CCS) and the need for complementary training.

Methods

78 medical residents responded to an on-line questionnaire which comprised demographic data, open-ended questions and a Portuguese version of the Communication Skills Attitude Scale (CSAS).

Results

Residents gave significantly higher scores (P < 0.001) on CSAS1 (attitudes towards communication skills in general, compared to CSAS2 (attitudes towards the teaching/learning process of CCS). Residents doing their residency training in other parts of the country, other than the north, reveal a higher perception of insufficient training (72.7% vs. 38.7%, P = 0.036).

Conclusion

Residents showed more positive attitudes towards communication skills than towards the teaching/learning process. They admit to need more training in CCS in their residency year and highlight that the clinical cycle of undergraduate education should integrate these topics. Content analysis indicates that residents’ perceptions are context-influenced.

Practice implications

Integration of CCS in the undergraduate education, enhanced during post-graduate training. Training of clinical faculty and supervisors/tutors and the role that stakeholders have to play in order to promote continuous training in CCS; encourage patient-centeredness and reflective practice, as to facilitate transfer of acquired skills to clinical practice.

Introduction

Evidence highlights that experiences in clinical communication skills (CCS) training may have an impact on how new doctors will perceive and interact with patients [1] and the limitations of transfer of learned skills to clinical practice [2], [3]. These findings lead us to reflect on attitudes, considered, according to Kaufman et al. [4], as one of the challenges in communication skills training.

To our knowledge, there are few studies [5], [6], [7] that focus on residents’ attitudes towards communication skills in general and to the teaching and learning process of these skills. The purpose of this study is to measure residents’ attitudes about their communication skills education, their assessment of its adequacy, and the association of communication skills attitudes to gender, practice specialty, practice location and perceived sufficiency of training.

Section snippets

Participants

A total of 115 medical residents, were contacted in 2012 to be included in this cross-sectional study. Previously, as students, they had participated in a longitudinal study [8], [9], conducted at the medical school of the university of Porto—Portugal (FMUP), where students have a total of 50 h dedicated to CCS only in Medical Psychology (2nd yr—clinical interview) and Clinical Semiotics (3rd yr—physical exam). Topics such as difficult patients, breaking bad news and team communication were not

Participant characteristics

Of the 115 residents contacted, a total of 78 (67.8%) responded to the on-line questionnaire. Table 1 summarizes their demographic characteristics.

Descriptive results

The residents gave significantly higher scores (P < 0.001) on CSAS1 (mean = 87.9, SD = 7.09), compared to CSAS2 (mean = 50.24, SD = 14.04).

Of the 78 residents, 43 (55.1%) perceive having received sufficient training during medical education (ME). Residents that considered having received sufficient training reveal a score of 89.3 (SD = 6.0) compared to those who

Discussion

At FMUP (and other medical schools in Portugal), there are more woman than men and therefore as, residents, there are similar proportions in terms of gender. As our results indicate a similar proportion, corroborated by previous studies [8], [9], [12], [13], the respondents are representative of the total cohort.

Residents’ attitudes towards communication skills are more positive than towards the teaching and learning process of these skills. This may indicate that although residents’

Funding

This research was supported by the Portuguese Foundation for Science and Technology—FCT, through the project CostProMed—PTDC/SAU-SAP/112908/2009.

Authors’ contributions

EL and MAF were the principal researchers, having been responsible for the conception and design of the study. MS has been responsible for data analysis and together with EL have interpreted data. EL has been responsible for drafting the article and MAF and MS have revised it critically. All contributed to the drafting of the article and read and approved the final manuscript.

Conflicts of interest statement

None.

Ethical approval

Ethical approval has been granted by the Comissão de Ética of Faculty of Medicine of the University of Porto and the Centro Hospitalar S. João, EPE, Porto, Portugal.

Submission declaration

We declare that this work has not been previously published and is not under consideration for publication elsewhere. Its publication is approved by all authors. If accepted it will not be published elsewhere including electronically in the same form, in English or in any other language, without the written consent of the copyright-holder.

Acknowledgements

The authors wish to thank António Soares (AS) and Madalena Abreu (MA), for their assistance in data collection (AS) and for data insertion (AS & MA). We also thank all residents who participated in this study.

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