Communication skills of medical students: survey of self- and external perception in a longitudinally based trend study.
BACKGROUND
As good communication skills are crucial for doctor-patient interactions, it is recommended to incorporate them in medical school programs from the very beginning. On this basis medical schools in Germany introduced the OSCE (objective structured clinical examination) to examine and by this foster learning of communication skills as assessment drives learning. The aim of the study was to examine the development of the communication skills of medical students during an OSCE to investigate how communication competence has developed between different student cohorts.


METHODS
This study is a longitudinal trend study based on seven semester-cohorts, examining the communication skills of medical students in the OSCE both from the perspective of students and from the viewpoint of standardized patients (SP). Altogether, 1027 students from seven semester cohorts were asked to rate their own communication skills (self-perception) before the OSCE exam started. Here, sub-analyses were performed to outline a potential influence of previous history-taking group participation. The SP evaluated the students' communication skills in external perception during the OSCE exam at each station with history-taking or physical examinations. The communication skills in both groups were ascertained in the dimensions of empathy, content structure, verbal expression, and non-verbal expression.


RESULTS
Only in the dimension of non-verbal expression could a statistically significant change be found in students' self-perception over the years. Notably, the rating of communication skills as self-rated by the students has risen constantly, whereas they deteriorated from the perspective of standardized patients (SP). It has also been found that previous history-taking courses have a positive influence on the structural dimension of communication skills in particular.


CONCLUSIONS
The results of this study support conclusions of other studies which also suggest differences between self- and external perception of medical students' communication skills. Nevertheless, students showed good overall communication skills in the four dimensions of empathy, content structure, verbal expression, and non-verbal expression, as demonstrated in a longitudinal trend study over seven semesters. However, we noted that externally rated empathy levels declined over the semester cohorts, suggesting the need for new priorities to be set in student teaching.
['Graf|Joachim|J|', 'Loda|Teresa|T|http://orcid.org/0000-0003-1450-1757', 'Zipfel|Stephan|S|', 'Wosnik|Annette|A|', 'Mohr|Daniela|D|', 'Herrmann-Werner|Anne|A|']
D000328:Adult D002983:Clinical Competence D003142:Communication D004504:Education, Medical, Undergraduate D004521:Educational Measurement D005260:Female D006801:Humans D008137:Longitudinal Studies D008297:Male D008875:Middle Aged D016544:Patient Simulation D010817:Physician-Patient Relations D011795:Surveys and Questionnaires D055815:Young Adult
Communication skills Self- and external perception Trend study OSCE Empathy