Predictors of assertive behaviors among a sample of first-year Tunisian medical students

Libyan J Med. 2022 Dec;17(1):2095727. doi: 10.1080/19932820.2022.2095727.


Assertiveness is a constructive interpersonal behavior alternative to manipulation and aggression. Medical students (MSs) have daily interpersonal interactions with colleagues, patients and families. Yet, communication deficiencies due to hesitancy to speak-up assertively lead to adverse patient outcomes. This study aimed to assess levels of assertive behaviors (ABs), and to determine its predictors within a sample of first-year Tunisian MSs. This was a cross-sectional survey including 125 first-year MSs from Tunisia. ABs were measured by the Rathus assertiveness scale. Potential independent predictors of AB were evaluated using the following questionnaires: Rosenberg self-esteem scale, interpersonal communication skills inventory short-form-36quality of life questionnaire, and general health questionnaire. In addition, some MSs' characteristics were considered (eg; age, sex, living with family, assertiveness training, community work, personal medical field choice, smoking, and alcohol use). Univariate and multivariate analyses were performed. Among the 309 MSs, 125 (40.45%) responded to the survey. AB were found in 36.8% of MSs. Multiple linear regression models revealed that self-esteem global scores, sending clear messages, anxiety/depression and male sex were accountable for 31% in AB scores variance. Targeting self-esteem and interpersonal communication skills (sending clear messages) and identifying subgroups of students with anxiety/depression state would influence ABs.

Keywords: Decisiveness; Great Arab Maghreb; North Africa; logistic models; medicine; undergraduates.

MeSH terms

  • Assertiveness*
  • Cross-Sectional Studies
  • Humans
  • Male
  • Self Concept
  • Students, Medical*
  • Surveys and Questionnaires

Grant support

The author(s) reported there is no funding associated with the work featured in this article.