Impact of student ethnicity and patient-centredness on communication skills performance

Med Educ. 2010 Jul;44(7):653-61. doi: 10.1111/j.1365-2923.2010.03632.x.

Abstract

Objectives: The development of patient-centred attitudes by health care providers is critical to improving health care quality. A prior study showed that medical students with more patient-centred attitudes scored higher in communication skills as judged by standardised patients (SPs) than students with less patient-centred attitudes. We designed this multicentre study to examine the relationships among students' demographic characteristics, patient-centredness and communication scores on an SP examination.

Methods: Early Year 4 medical students at three US schools completed a 12-item survey during an SP examination. Survey items addressed demographics (gender, ethnicity, primary childhood language) and patient-centredness. Factor analysis on the patient-centredness items defined specific patient-centred attitudes. We used multiple regression analysis incorporating demographic characteristics, school and patient-centredness items and examined the effect of these variables on the outcome variable of communication score.

Results: A total of 351 students took the SP examination and 329 (94%) completed the patient-centredness questionnaire. Responses indicated generally high patient-centredness. Student ethnicity and medical school were significantly associated with communication scores; gender and primary childhood language were not. Two attitudinal factors were identified: patient perspective and impersonal attitude. Multiple regression analysis revealed that school and scores on the impersonal factor were associated with communication scores. The effect size was modest.

Conclusions: In a medical student SP examination, modest differences in communication scores based on ethnicity were observed and can be partially explained by student attitudes regarding patient-centredness. Curricular interventions to enhance clinical experiences, teaching and feedback are needed to address key elements of a patient-centred approach to care.

Publication types

  • Multicenter Study

MeSH terms

  • Attitude of Health Personnel
  • Clinical Competence / standards*
  • Communication*
  • Education, Medical, Undergraduate
  • Ethnic Groups*
  • Factor Analysis, Statistical
  • Female
  • Humans
  • Male
  • Patient-Centered Care / standards*
  • Students, Medical / psychology*
  • Surveys and Questionnaires