FACTORS AFFECTING THE COMMUNICATION SKILLS OF MEDICAL STUDENTS IN THE PRIMARY CARE SETTING

Abstract

Introduction Effective communication is an essential skill in a patient-centred doctor-patient-relationship. Although medical graduates acquire communication skills during undergraduate training, these have been shown to be inadequate for their careers. The aim of this study was to close the gap in preparing medical students with patient-centred communication skills in readiness for the workplace for improved patient satisfaction and health outcomes. Methods A phenomenological study design using in-depth individual interviews was conducted on Semester 6 medical students and patients to study their experience in an outpatient department at a primary care clinic over two weeks. Data was transcribed verbatim, analysed, and triangulated with patients’ views on cross-cultural communication with students. Thematic analysis of Braun and Clark was used to analyse data. Results Three themes emerged namely, factors that play a role in communication skills of medical students, and perceived enablers and challenges of communication skills of medical students and patients in the primary care setting. Factors affecting communication skills were language, cultural beliefs, level of maturity and stage in students’ training, and patients’ socio-economic status. Enablers in communications skills includes adopting a biopsychosocial approach by establishing rapport, building trust, showing empathy, ensuring patient’s comfort and respecting their privacy, as well as, engaging in early and continuous experiential learning, using non-verbal communication, and engaging in self-reflection. Challenges faced by both students and patients were patient’s lack of trust in western medicine, students’ difficulty in eliciting sexual history, students’ emphasis on taskorientation, cultural insensitivity, student’s speech anxiety, and patients’ emotional state. Conclusion Results of the study identified the factors, and the enablers and challenges that influenced patient-centred communication skills of medical students in undergraduate training which could close the gap for patient satisfaction and improved health outcomes at the workplace. The study also reiterated the importance of early and continuous experiential in authentic work-based settings.