Purpose The COVID-19 (coronavirus disease 2019) pandemic led to significant changes in clinical clerkships, including reduced ward rounds. We aimed to determine how the pandemic–induced changes in the clinical practice environment affect the clinical performance of medical students.
Methods We analyzed objective structured clinical examination scores of third- and fourth-year medical students from 2019–2020 and 2020–2021 across six stations by the Seoul–Gyeonggi Consortium. Clinical, communication, and ability scores were measured and analyzed using repeated-measures multivariate analysis of variance.
Results The interaction between clinical practice progress and pandemic-induced changes significantly affected physical examination and medical history scores, though the differences were not substantial. Patient-physician interaction significance varied by measurement period. Clinical communication ability also showed significant differences based on the measurement period and practical experience.
Conclusion During the pandemic, alternative learning methods, including self–learning, simulation/practice, and peer role–play, helped improve medical competency in areas such as history–taking and physical examination. However, these were less effective in improving patient–physician interactions or clinical communication efficacy. Alternative learning methods have limitations, and they cannot replace direct patient encounters in clinical practice.
Purpose Empathy is an important trait in physicians and a key element in the physician-patient relationship. Accordingly, one of the goals in medical education is developing empathy in students. We attempted to practically assess medical students’ empathy through their direct verbal expressions.
Methods The medical students’ empathy was measured using the modified Pencil-and-Paper Empathy Rating Test by Winefield and Chur-Hansen (2001). The students took 15 minutes or so to complete the scale, and it was then scored by one of two trained evaluators (0 to 4 points for each item, for a total score of 40). The subjects were 605 medical students, and the data were analyzed using descriptive analysis, independent t-test, and one-way analysis of variance in SPSS version 21.0.
Results The students’ empathy scores were low (mean, 12.13; standard deviation, 2.55); their most common responses (78.6%) registered as non-empathetic. Differences in empathy were observed by gender (female students>male students; t=-5.068, p<0.001), school system (medical school>medical college; t=-1.935, p=0.053), and academic level (pre-medical 1 year < other years; t=-4.050, p<0.001).
Conclusion Our findings lead us to the significant conclusion that there is the need for empathy enhancement training programs with practical content.
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Purpose Identifying patients’ agendas is important; however, the extent of Korean medical students’ agenda-setting abilities is unknown. The study aim was to investigate the patterns of Korean medical students’ agenda solicitation.
Methods A total of 94 third-year medical students participated. One scenario involving a female patient with abdominal pain was created. Students were video-recorded as they interviewed the patient. To analyze whether students identify patients’ reasons for visiting, a checklist was developed based on a modified version of the Calgary-Cambridge Guide to the Medical Interview: Communication Process checklist. The duration of the patient’s initial statement of concerns was measured in seconds. The total number of patient concerns expressed before interruption and the types of interruption effected by the medical students were determined.
Results The medical students did not explore the patients’ concerns and did not negotiate an agenda. Interruption of the patient’s opening statement occurred in 4.62±2.20 seconds. The most common type of initial interruption was a recompleter (79.8%). Closed-ended questions were the most common question type in the second and third interruptions.
Conclusion Agenda setting should be emphasized in the communication skills curriculum of medical students. The Korean Clinical Skills Exam must assess medical students’ ability to set an agenda.
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RESULTS Ego-state was related to communication skills. In particular, adapted child ego-state was negatively associated with each sphere of communication skills.
CONCLUSION Our results suggested that ego-state types should be considered in developing a communication skills education program for medical students.
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METHODS Forty-three students interviewed SPs. The students were asked to complete a communication skills questionnaire that comprised 2 measures (empathy and interpersonal communication) before the interview. After each student's interview with the SP, the latter completed the same questionnaire as the students.
RESULTS Based on Lin's concordance coefficient, there was strong disconcordance between students' self-ratings and the SPs' ratings. With regard to empathic communication, more than 50% of students who considered themselves higher than middle level were regarded by SP as low level. On interpersonal communication, 39% of students who assessed themselves as higher than middle level were scored low level by SPs.
CONCLUSION There was strong disconcordance between students' self-ratings and the SPs' ratings-students tended to overevaluate themselves regarding their communication skills. These differences might result in patient dissatisfaction and noncompliance. Further, it could become a serious hindrance to the development of a good doctor-patient relationship. Medical educators should make sincere efforts to reduce this gap by teaching medical students the importance of the patients' perception of his doctors' communication skills.
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PURPOSE The purposes of this study were to describe a viable communication skills course for medical students and to discuss how to improve it for better teaching.
METHODS The subjects were a communication skills course and one hundred thirty three third-year medical students who participated in the course in 2006. Program evaluation by students was conducted using questionnaire at the end of each session and the entire course.
RESULTS The communication course was named as "Medical Communication Skills". Basic communication skills and interview skills for specific clinical situations were taught. We used experiential leaning methods such as standardized patient (SP) interviews with feedback. Students rated the course highly especially for SP-based practice sessions and student group projects. The course evaluation indicated that the students considered communication skills to be significantly more important as a clinical competency after the completion of the course.
CONCLUSION We confirmed that the communication skills course was well perceived by medical students and they preferred experiential learning methods more than didactic methods.
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PURPOSE We specifically investigated the young doctor (residents) patient doctor-patient relationship in Korea. A society built on Confucianism, age is expected to affect even the doctor-patient relationship.
METHODS 57 residents participated and answered 6 open-ended questions. 90 patients of various age participated and answered 3 open-ended and 6 close-ended questions.
RESULTS It seems that the general problem of the doctor-patient relationships was related to attitudes and communication skills. Over 80% of the residents felt uncomfortable and received inappropriate verbal expressions and attitudes from their patients simply because they were young or younger than the patients. This negative experience resulted mostly from the residents' self-perceived lack of experience and clinical competence and the patients' distrust of young doctors. As for the patients, over 80% preferred middle-aged doctors to young doctors. Middleaged doctors were thought to be easier to understand, better mannered, more humane, and clinically competent. Most residents expected professional respect from their patients, while patients expected kindness and humility from the young doctors. This shows a gap in the reciprocal expectations between residents and patients.
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RESULTS Students were satisfied with the education program and 12 students showed increased confidence levels. However, there was no difference in clinical performance between eduated and non-educated group, even after categorization of the exam.
CONCLUSION Self-confidence for delivering bad news increased but there was no evidence of improvement in clinical performance. Communication skills training should be repeatedly performed in each medical educational curriculum.
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