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Learning professional skills and attitudes: Medical students' attitudes towards communication skills andgroup learning
Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences.
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Medical education aims at forming students’ professional identity. This includes skills and attitudes such as communication and teamwork skills. One of the thesis’ aims is to identify students’ typical difficulties with learning communication skills, and to understand how these affect their identity development. Group discussions of student-patient interviews were video-taped, and selected discussions were transcribed and analyzed. Students had difficulties in establishing trustful relationships with their patients, asking about sensitive topics, responding empathetically, and with applying formal structures to the consultation. Students’ professional identity was supported by peer students’ and teachers’ comments, which created a common language and fostered selfmonitoring abilities. Another aim was to study the relationship between students* attitude towards communication training, group learning, and their self-regulatory skills. In a survey study, established instruments were combined with a new questionnaire. Four medical schools participated – two with traditional and two with problem-based curricula – in Sweden and Germany. Statistical analyses revealed that female students were more positive towards learning communication skills than male students were. Good self-regulatory skills were related to a positive attitude towards group learning and clinical experience before academic studies. It was concluded that early clinical experience benefits students’ selfregulated learning, and promotes a positive attitude towards communication training. Awareness of typical difficulties can facilitate the acquisition of coping strategies.

Abstract [sv]

Medicinsk undervisning syftar till att forma studenternas professionella identitet. Den omfattar färdigheter och inställningar, t.ex. kommunikationsfärdigheter och förmågan att arbeta i grupp. Ett av avhandlingens syften är att identifiera studenternas typiska svårigheter med att lära sig färdighet i läkar-patient kommunikation samt att förstå hur den påverkar identitetsutvecklingen. Gruppdiskussioner av student-patient intervjuer videofilmades, utvalda diskussioner transkriberades och analyserades. Studenterna berättade om svårigheter med att etablera förtroliga relationer med patienterna, att prata om känsliga ämnen, att visa empati och att använda intervjumallen. Den professionella identiten stöttas av studenternas och lärarnas kommentarer, vilka bidrar till ett gemensamt språk och förmågan till själviakttagelse. Andra syftet är att undersöka sambandet mellan studenternas inställningar till kommunikationsfärdigheter och grupparbete, samt deras förmåga till självreglerat lärande. I en enkätundersökning kombinerades befintliga instrument med ett nytt frågeformulär. Fyra medicinska fakulteter deltog: två med traditionella och två med problembaserade undervisningsmetoder, en av varje i Sverige och i Tyskland. Statistiska analyser visade att kvinnliga studenter är, jämfört med manliga, mer positiva till att träna upp kommunikativa färdigheter. Förmågan till självreglerat lärande var relaterad till en positiv inställning till gruppinlärande och till klinisk erfarenhet innan studierna påbörjas. Slutsatsen är att tidig klinisk erfarenhet fostrar självstyrt lärande och en positiv inställning till kommunikationsträning. Medvetenhet om typiska svårigheter kan underlätta för studenter att anamma strategier att hantera dessa.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2013. , 100 p.
Series
Linköping Studies in Arts and Science, ISSN 0282-9800 ; 565Linköping Dissertations on Health and Society, ISSN 1651-1646 ; 23
Keyword [en]
Attitudes; awareness of learning strategies; communication skills; group learning; patient-centeredness, problem-based learning; self-regulation
Keyword [sv]
Grupplärande; kommunikationsfärdighet; medvetenhet om inlärnings strategier; patient orientering; problembaserat lärande; självstyrt lärande
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-91722ISBN: 978-91-7519-759-3 (print)OAI: oai:DiVA.org:liu-91722DiVA: diva2:618854
Public defence
2013-05-30, Eken, ingång 65, plan 9, Campus US, Linköpings universitet, Linköping, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2013-04-30 Created: 2013-04-30 Last updated: 2013-09-04Bibliographically approved
List of papers
1. Learning to talk and talking about talk: professional identity and communicative technology
Open this publication in new window or tab >>Learning to talk and talking about talk: professional identity and communicative technology
2007 (English)In: Medical Technologies and the Life World: The Social Construction of Normality / [ed] Sonja Olin-Lauritzen & Lars-Christer Hydén, London: Routledge , 2007, 18-39 p.Chapter in book (Other academic)
Abstract [en]

Although the use of new health technologies in healthcare and medicine is generally seen as beneficial, there has been little analysis of the impact of such technologies on people's lives and understandings of health and illness. This book explores how new technologies not only provide hope for cure and well-being, but also introduce new ethical dilemmas and raise questions about the "natural" body. Focusing on the ways new health technologies intervene into our lives and affect our ideas about normalcy, the body and identity, New Health Technologies explores: how new health technologies are understood by lay people and patients how the outcomes of these technologies are communicated in various clinical settings how these technologies can alter our notions of health and illness and create "new illness." Written by authors with differing backgrounds in phenomenology, social psychology, social anthropology, communication studies and the nursing sciences, this book is essential reading for students andacademics of medical sociology, health and allied studies, and anyone with an interest in new health technologies.

Place, publisher, year, edition, pages
London: Routledge, 2007
National Category
Social Sciences Interdisciplinary
Identifiers
urn:nbn:se:liu:diva-35598 (URN)27890 (Local ID)04-1536-434-5 (ISBN)978-04-1536-434-8 (ISBN)27890 (Archive number)27890 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2013-09-04Bibliographically approved
2. Talking with patients and peers: Medical students difficulties with learning communication skills
Open this publication in new window or tab >>Talking with patients and peers: Medical students difficulties with learning communication skills
2009 (English)In: Medical teacher, ISSN 0142-159X, E-ISSN 1466-187X, Vol. 31, no 6, 528-534 p.Article in journal (Refereed) Published
Abstract [en]

Background: Patient-centered communication skills, such as an empathic attitude towards patients and a holistic perspective on health, are difficult to acquire. Designing effective courses requires better understanding of the difficulties that students perceive with learning to talk with patients Aims: The study aimed at exploring students common difficulties with learning patient-centered communication skills. Methods: Group discussions about student-patient interviews were videotaped and analyzed with regard to issues that students perceived as difficult and to their reflections about these difficulties. Results: The students reported feeling intrusive as they explored the patients psychosocial situation. They avoided being empathic and felt insecure about coping adequately with emotionally loaded topics. Their difficulties were mainly due to insufficient understanding of the functional relations between psychosocial issues and health conditions. Moreover, students were insecure concerning the function of affective feedback in the diagnostic process. However, the group discussions generated a language for analyzing and structuring interviews that helped develop the students professional identities. Conclusions: Students experienced moral qualms about applying major aspects of patient-centered interviewing. Instruction in communication skills should aim at filling the students knowledge gaps and fostering their awareness and expression of emotional perceptions. Long-term relationships with patients could help develop patient-centered communication.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-19995 (URN)10.1080/01421590802208859 (DOI)
Available from: 2009-08-24 Created: 2009-08-24 Last updated: 2017-12-13
3. Medical students' attitudes towards group and self-regulated learning
Open this publication in new window or tab >>Medical students' attitudes towards group and self-regulated learning
2012 (English)In: International Journal of Medical Education, ISSN 2042-6372, E-ISSN 2042-6372, Vol. 3, 46-56 p.Article in journal (Refereed) Published
Abstract [en]

Objectives: The study is aimed at exploring the association between beginning students' attitudes towards group learning and their awareness of learning strategies, to demographic variables and their exposure to problem-based or mixed curricula.

Methods: The descriptive cross-sectional design included students (N = 351) from two medical schools with lecture-based and two with problem-based curricula from Germany and Sweden. Gender, age, personal and parents' practice experience within health care were assessed. A questionnaire was designed for measuring attitudes towards group and individual learning, awareness of learning strategies was assessed with the Metacognitive Awareness Inventory. The t-test for independent groups was applied to compare dependent variables between personal factors, and multivariate statistics to compare medical schools.

Results: Students' personal work experience correlated with self-regulation (t(333) = -3.307; p = 0.001) and group learning experience (t(341) = -2.971; p = 0.003). Students from the German problem-based curriculum reported most experience with group learning (largest mean difference compared to the German lecture-based curriculum = 1.45 on a Likert scale from 1 to 7; SE = 0.181; p < 0.001), and were better at regulating their learning strategies than students from the Swedish lecture-based school (mean difference 0.18; SE = 0.181; p = 0.034).

Conclusions: Students' clinical experience seemed to benefit self-regulation skills. Problem-based teaching methods and early interprofessional education appear to be favorable learning conditions for the development of professional skills.

Place, publisher, year, edition, pages
IJME, 2012
Keyword
Group learning attitudes, learning strategy awareness, problem-based learning, self-regulation, student attituds
National Category
Other Health Sciences
Identifiers
urn:nbn:se:liu:diva-77929 (URN)10.5116/ijme.4f4a.0435 (DOI)
Available from: 2012-05-31 Created: 2012-05-31 Last updated: 2017-12-07Bibliographically approved
4. Students’ attitudes towards learning communication skills: correlating attitudes, demographic and metacognitive variables
Open this publication in new window or tab >>Students’ attitudes towards learning communication skills: correlating attitudes, demographic and metacognitive variables
2012 (English)In: International Journal of Medical Education, ISSN 2042-6372, E-ISSN 2042-6372, Vol. 3, 201-208 p.Article in journal (Refereed) Published
Abstract [en]

Objectives: This study aimed at exploring the relationship of students' attitudes towards learning communication skills to demographic variables, metacognitive skills, and to the appreciation of patient-oriented care.

Methods: The cross-sectional survey study involved first- and third-term students from two traditional and two problem-based curricula (N= 351). Demographic variables, attitudes towards communication skills learning, patient orientation, and awareness of learning strategies were assessed. Differences in attitude measures were assessed with t-tests and univariate comparisons. With multiple linear regressions predictor variables of students' attitudes towards communication skills learning and patient-oriented care were identified.

Results: A positive attitude towards learning communica-tion skills was predicted by a caring patient orientation, self-regulation of learning strategies, and female gender (R2= 0.23; F (9,310) = 9.72; p < 0.001). Students' caring patient orientation was predicted by their attitudes towards learning communication skills, female gender, and higher age (R2= 0.23; F (9,307) = 13.48; p < 0.001). Students from a traditional curriculum were least interested in learning communication skills (F (3, 346) = 26.75; p <0.001).

Conclusions: Students' attitudes towards learning communication skills and their caring patient orientation are interrelated. However, communication skills are considered as more positive by students with good self-regulatory skills. Early training of self-regulation and the training of communication skills in mixed-gender groups are recommended.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-91721 (URN)10.5116/ijme.5066.cef9 (DOI)
Available from: 2013-04-30 Created: 2013-04-30 Last updated: 2017-12-06Bibliographically approved

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