A novel multi-measure approach to study medical students' communication performance and predictors of their
Giulia Zerbini1, Pia Schneider1, Miriam Reicherts1,2
1Department of Medical Psychology and Sociology, Institute of Theoretical Medicine, Faculty of Medicine, University of Augsburg, Stenglinstrasse 2, 86156, Augsburg, Germany.
Background:
Successful doctor-patient communication is a critical component of effective medical treatment and therefore plays a crucial role already in medical training. The aim of this cross-sectional study was to employ a multi-measure approach assessing different perspectives and variables to investigate how medical students' communication performance differs across medical training (1st vs. 5th or 7th semester).
Methods:
43 medical students (1st semester: N = 23; 5th or 7th semester: N = 20) engaged in a simulated doctor-patient consultation with a standardized patient (SP) while being videorecorded. Medical students' communication quality was assessed by a communication expert and by the SP (both being blinded regarding the semester of the medical student) using standardized questionnaires (Berliner Global Rating Scale, Medical Interview Satisfaction Scale). Following our multi-measure approach, we also assessed several non-verbal parameters and variables (back-channeling, turn-taking, verbal dominance, automatic analysis of emotional facial expressions, skin conductance level).
Results:
Analysis of non-verbal measures demonstrates that advanced students used more back-channeling, displayed more facial expressions of happiness and showed elevated skin conductance levels compared to 1st semester students. These non-verbal parameters could significantly predict the expert's communication quality assessment, explaining 31% of the variance in communication quality. As expected, the expert and SP rated the communication quality of 5th /7th semester students as significantly better compared to 1st semester students.
Conclusions:
We found that non-verbal parameters significantly differed between students of early vs. later stages of their medical training and were predictive of communication quality. Especially, sympathetic responsiveness - likely indicating the level of involvement - correlated with expert evaluations. These findings suggest that effective communication becomes evident across different channels and that sincere engagement into a conversation might be a requisite for successful doctor-patient communication.
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