Objectives: To compare the communication skills shown by medical students during simulated patien... more Objectives: To compare the communication skills shown by medical students during simulated patient interviews between those who received training in communication during the preclinical years and those who did not. Methods: A retrospective study was conducted to analyze the communication skills of several cohorts of fourth-year medical students from Universitat Internacional de Catalunya during simulated patient interviews. Out of a total of 477 students included in the study, 229 (48%) had received training in communication skills through a 60-hour elective course during the preclinical second year, while the remaining 248 (52%) had received none. Communication skills were assessed by an evaluation team using a numerical scale (0 to 10) that included eight categories: "verbal", "non-verbal", "empathy", "concreteness", "warmth", "message content", "assertiveness", and "respect". Scores obtained by trained and non-trained students were compared using the t-test. Results: A trend towards obtaining better results was observed among students who had received communication training (mean score: 6.98/10) versus none (6.83/10, t(1,869)=-1.95, p=0.05). Non-trained male students obtained significantly lower mean scores than non-trained females in the categories of "respect" (7.48/10 vs. 7.83/10, t(968)=-2.89, p<0.01), "verbal communication" (6.87/10 vs. 7.15/10, t(968)=-2.61, p=0.01), "warmth" (6.53/10 vs. 6.95/10, t(968)=-3.40, p<0.01), and "non-verbal communication" (6.49/10 vs. 6.79/10, t(968)=-2.48, p=0.01). Trained female and male students had similar scores. Conclusions: Training in communication skills during the preclinical years may improve fourth-year students' performance in simulated interviews with patients, particularly among males. These results demonstrate the importance of introducing specific training in communication skills early in the undergraduate medical curriculum.
BackgroundEmpathy is a key aspect of the physician-patient interactions. The Jefferson Scale of E... more BackgroundEmpathy is a key aspect of the physician-patient interactions. The Jefferson Scale of Empathy (JSE) is one of the most used empathy measures of medical students. The development of cross-cultural empathy studies depends on valid and reliable translations of the JSE. This study sought to: (1) adapt and assess the psychometric properties in Spanish students of the Spanish JSE validated in Mexican students; (2) test a second order latent factor model.MethodsThe Spanish JSE was adapted from the Spanish JSE-S, resulting in a final version of the measure. A non-probabilistic sample of 1104 medical students of two Spanish medical schools completed a socio-demographic and the Spanish JSE-S. Descriptive statistics, along with a confirmatory factor analysis, the average variance extracted (AVE), Cronbach’s alphas and composite reliability (CR) coefficients were computed. An independent samples t-test was performed to access sex differences.ResultsThe Spanish JSE-S demonstrated accep...
Objective. To examine the factorial structure of the Jefferson Scale of Empathy–Medical student v... more Objective. To examine the factorial structure of the Jefferson Scale of Empathy–Medical student version (JSE-S) and assess items’ discriminatory ability at higher and lower empathy levels in medical student populations from different countries and languages.Methods. JSE-S datasets were retrieved from previous studies of 4,113 first- and/or second-year medical students from Switzerland, Portugal, Italy, Brazil, France, Spain, New Zealand, UK, Ireland, Mexico, and Peru. Parallel principal component analyses and item response theory were applied.Results. Excluding item 18, the Compassionate Care subscale emerged in five samples (Switzerland, Portugal, Italy, France and UK/Ireland), Perspective Taking in three (Switzerland, Portugal and UK/Ireland) and Walking in Patient’s Shoes in five (Switzerland, Portugal, Spain, UK/Ireland and Mexico/Peru). All subscales had items providing overlapping information. The JSE-S subscales had reliable high test performance at low empathy levels, while ...
The first wave of the COVID-19 pandemic resulted in a decreed confinement in Spain from March unt... more The first wave of the COVID-19 pandemic resulted in a decreed confinement in Spain from March until the end of term in June 2020, forcing an abrupt transition to exclusive distance learning in universities. We aimed to describe and analyze the perceptions and experiences of undergraduate medical students and faculty members as a consequence of this educational shift so as to identify the key elements for successful online medical learning. Methods A convergent mixed methods design was employed, using both quantitative and qualitative data collected successively through Phase 1: Online teaching follow-up program; Phase 2: Discussion groups (two focus groups and a nominal group with students and faculty, respectively) and a survey of students from first to fifth year; and Phase 3: Triangulation of qualitative and quantitative data. Results Thirteen strongly interconnected categories were identified. Four of them played an organizational role: course planning, coordination, communication, and pedagogical coherence. The remaining nine categories were learning outcomes, teaching methodology, online resources, evaluation, time management, workload, student motivation, participation, and teacher-student relationship. Among the key aspects of learning were those that promoted rapport between faculty and students, such as synchronous sessions, especially those based on clinical cases. Conclusions Promoting student motivation and participation at all levels were the main lessons learned for enhancing online learning and teaching experiences in undergraduate medical education. Key elements to reach this goal are, among others, planning, coordination, communication, and pedagogical coherence.
BACKGROUND The suspension of face-to-face teaching activity due to the COVID-19 pandemic forced a... more BACKGROUND The suspension of face-to-face teaching activity due to the COVID-19 pandemic forced an abrupt transition to distance learning in Spanish universities. AIM To know how medical students value distance learning in the context of COVID-19 pandemic. MATERIAL AND METHODS Undergraduate medical students from first to fifth year in Barcelona (Spain) were invited to answer an anonymous online survey about their perceptions and level of satisfaction with virtual learning. RESULTS Of 483 students invited to the survey, 244 (50.5%) answered it. Respondents from the first and second year rated distance learning as acceptable (mean 3.1) on a Likert scale from 1 to 5. Those from third to fifth years rated distance learning as unsatisfactory (mean 2.7). The best evaluated aspects were synchronous lectures (3.9) and lectures based on cases (3.4). The worst evaluated issues were motivation (2.3), interaction with faculty (2.1), and additional workload (0.7). CONCLUSIONS The perceptions exp...
Objectives: The purpose of this study was to investigate student's perceptions of Educational Cli... more Objectives: The purpose of this study was to investigate student's perceptions of Educational Climate (EC) in Spanish medical schools, comparing various aspects of EC between the 2 nd (preclinical) and the 4 th (clinical) years to detect strengths and weaknesses in the ongoing curricular reform. Methods: This study utilized a cross-sectional design and employed the Spanish version of the "Dundee Ready Education Environment Measure" (DREEM). The survey involved 894 2 nd year students and 619 4 th year students from five Spanish medical schools. Results: The global average score of 2 nd year students from the five medical schools was found to be significantly higher (116.2±24.9, 58.2% of maximum score) than that observed in 4th year students (104.8±29.5, 52.4% of maximum score). When the results in each medical school were analysed separately, the scores obtained in the 2 nd year were almost always significantly higher than in the 4 th year for all medical schools, in both the global scales and the different subscales. Conclusions: The perception of the EC by 2 nd and 4 th year students from five Spanish medical schools is more positive than negative although it is significantly lower in the 4 th year. In both years, although more evident in the 4 th year, students point out the existence of several important "problematic educational areas" associated with the persistence of traditional curricula and teaching methodologies. Our findings of this study should lead medical schools to make a serious reflection and drive the implementation of the necessary changes required to improve teaching, especially during the clinical period.
Introductionthe COVID-19 pandemic resulted in a decreed confinement in our country from March unt... more Introductionthe COVID-19 pandemic resulted in a decreed confinement in our country from March until the end of term in June 2020. This forced a transition exclusively to distance learning. The aim of this study was to broaden the understanding of fully online distance learning from the experiences of undergraduate medical students and faculty members during confinement, and identify its key elements.MethodsA convergent mixed methods study analyzing: (a) an online teaching follow- up program, (b) two focus groups and a nominal group with students and faculty, respectively, and (c) a survey with students from 1st to 5th year.ResultsThirteen strongly interconnected categories were identified. Four played an organizational role: course planning, coordination, communication and pedagogical coherence. The remaining nine categories were: learning outcomes, teaching methodology, online resources, evaluation, time management, workload, student motivation, participation, and teacher-student r...
Evaluation of clinical communication skills in medical students with simulated patients Backgroun... more Evaluation of clinical communication skills in medical students with simulated patients Background: Communication skills are not learnt innately. It is therefore necessary to both train and evaluate medical students in this area. Aim: To evaluate communication skills of fourth-year medical students with the use of a simulated patient (SP). Material and Methods: Four clinical scenarios (CS) for clinical interviews with simulated patients were designed: chronic and acute diseases, difficult and functional patients. Each student performed the four CS, and his communication skills were evaluated using our own questionnaire as agreed with the SP. The questionnaire included items on verbal and nonverbal communication, warmth, respect, specificity, assertiveness and empathy (rated from 0 to 10). The response variable was the arithmetic mean of the scores on each item. All students received a detailed evaluation report. Results: Sixty one students (32 men) performing 244 interviews, were evaluated. The overall mean score was 7.87 (4.62 to 9.03). The highest scores were for respect and specificity (7.57 and 7.15 respectively). The lowest were for empathy and nonverbal communication (6.44 and 6.84 respectively). The CS evaluations were 7.87 (chronic disease), 7.02 (difficult patient), 6.46 (acute disease) and 6.14 (functional pathology). Women had higher overall scores compared to men (7.26 and 6.51 respectively; p < 0.01) and a significantly higher score in all communication variables (p < 0.01). Conclusions: The overall assessment in clinical communication with SP is satisfactory although there is room for improvement, especially in empathy and nonverbal communication. Women had significantly higher scores than men.
Empathy is a key aspect of the physician-patient interactions. The Jefferson Scale of Empathy (JS... more Empathy is a key aspect of the physician-patient interactions. The Jefferson Scale of Empathy (JSE) is one of the most used empathy measures of medical students. The development of cross-cultural empathy studies depends on valid and reliable translations of the JSE. This study sought to: (1) adapt and assess the psychometric properties in Spanish students of the Spanish JSE validated in Mexican students; (2) test a second order latent factor model. The Spanish JSE was adapted from the Spanish JSE-S, resulting in a final version of the measure. A non-probabilistic sample of 1104 medical students of two Spanish medical schools completed a socio-demographic and the Spanish JSE-S. Descriptive statistics, along with a confirmatory factor analysis, the average variance extracted (AVE), Cronbach's alphas and composite reliability (CR) coefficients were computed. An independent samples t-test was performed to access sex differences. The Spanish JSE-S demonstrated acceptable to good sens...
Objectives: To compare the communication skills shown by medical students during simulated patien... more Objectives: To compare the communication skills shown by medical students during simulated patient interviews between those who received training in communication during the preclinical years and those who did not. Methods: A retrospective study was conducted to analyze the communication skills of several cohorts of fourth-year medical students from Universitat Internacional de Catalunya during simulated patient interviews. Out of a total of 477 students included in the study, 229 (48%) had received training in communication skills through a 60-hour elective course during the preclinical second year, while the remaining 248 (52%) had received none. Communication skills were assessed by an evaluation team using a numerical scale (0 to 10) that included eight categories: "verbal", "non-verbal", "empathy", "concreteness", "warmth", "message content", "assertiveness", and "respect". Scores obtained by trained and non-trained students were compared using the t-test. Results: A trend towards obtaining better results was observed among students who had received communication training (mean score: 6.98/10) versus none (6.83/10, t(1,869)=-1.95, p=0.05). Non-trained male students obtained significantly lower mean scores than non-trained females in the categories of "respect" (7.48/10 vs. 7.83/10, t(968)=-2.89, p<0.01), "verbal communication" (6.87/10 vs. 7.15/10, t(968)=-2.61, p=0.01), "warmth" (6.53/10 vs. 6.95/10, t(968)=-3.40, p<0.01), and "non-verbal communication" (6.49/10 vs. 6.79/10, t(968)=-2.48, p=0.01). Trained female and male students had similar scores. Conclusions: Training in communication skills during the preclinical years may improve fourth-year students' performance in simulated interviews with patients, particularly among males. These results demonstrate the importance of introducing specific training in communication skills early in the undergraduate medical curriculum.
BackgroundEmpathy is a key aspect of the physician-patient interactions. The Jefferson Scale of E... more BackgroundEmpathy is a key aspect of the physician-patient interactions. The Jefferson Scale of Empathy (JSE) is one of the most used empathy measures of medical students. The development of cross-cultural empathy studies depends on valid and reliable translations of the JSE. This study sought to: (1) adapt and assess the psychometric properties in Spanish students of the Spanish JSE validated in Mexican students; (2) test a second order latent factor model.MethodsThe Spanish JSE was adapted from the Spanish JSE-S, resulting in a final version of the measure. A non-probabilistic sample of 1104 medical students of two Spanish medical schools completed a socio-demographic and the Spanish JSE-S. Descriptive statistics, along with a confirmatory factor analysis, the average variance extracted (AVE), Cronbach’s alphas and composite reliability (CR) coefficients were computed. An independent samples t-test was performed to access sex differences.ResultsThe Spanish JSE-S demonstrated accep...
Objective. To examine the factorial structure of the Jefferson Scale of Empathy–Medical student v... more Objective. To examine the factorial structure of the Jefferson Scale of Empathy–Medical student version (JSE-S) and assess items’ discriminatory ability at higher and lower empathy levels in medical student populations from different countries and languages.Methods. JSE-S datasets were retrieved from previous studies of 4,113 first- and/or second-year medical students from Switzerland, Portugal, Italy, Brazil, France, Spain, New Zealand, UK, Ireland, Mexico, and Peru. Parallel principal component analyses and item response theory were applied.Results. Excluding item 18, the Compassionate Care subscale emerged in five samples (Switzerland, Portugal, Italy, France and UK/Ireland), Perspective Taking in three (Switzerland, Portugal and UK/Ireland) and Walking in Patient’s Shoes in five (Switzerland, Portugal, Spain, UK/Ireland and Mexico/Peru). All subscales had items providing overlapping information. The JSE-S subscales had reliable high test performance at low empathy levels, while ...
The first wave of the COVID-19 pandemic resulted in a decreed confinement in Spain from March unt... more The first wave of the COVID-19 pandemic resulted in a decreed confinement in Spain from March until the end of term in June 2020, forcing an abrupt transition to exclusive distance learning in universities. We aimed to describe and analyze the perceptions and experiences of undergraduate medical students and faculty members as a consequence of this educational shift so as to identify the key elements for successful online medical learning. Methods A convergent mixed methods design was employed, using both quantitative and qualitative data collected successively through Phase 1: Online teaching follow-up program; Phase 2: Discussion groups (two focus groups and a nominal group with students and faculty, respectively) and a survey of students from first to fifth year; and Phase 3: Triangulation of qualitative and quantitative data. Results Thirteen strongly interconnected categories were identified. Four of them played an organizational role: course planning, coordination, communication, and pedagogical coherence. The remaining nine categories were learning outcomes, teaching methodology, online resources, evaluation, time management, workload, student motivation, participation, and teacher-student relationship. Among the key aspects of learning were those that promoted rapport between faculty and students, such as synchronous sessions, especially those based on clinical cases. Conclusions Promoting student motivation and participation at all levels were the main lessons learned for enhancing online learning and teaching experiences in undergraduate medical education. Key elements to reach this goal are, among others, planning, coordination, communication, and pedagogical coherence.
BACKGROUND The suspension of face-to-face teaching activity due to the COVID-19 pandemic forced a... more BACKGROUND The suspension of face-to-face teaching activity due to the COVID-19 pandemic forced an abrupt transition to distance learning in Spanish universities. AIM To know how medical students value distance learning in the context of COVID-19 pandemic. MATERIAL AND METHODS Undergraduate medical students from first to fifth year in Barcelona (Spain) were invited to answer an anonymous online survey about their perceptions and level of satisfaction with virtual learning. RESULTS Of 483 students invited to the survey, 244 (50.5%) answered it. Respondents from the first and second year rated distance learning as acceptable (mean 3.1) on a Likert scale from 1 to 5. Those from third to fifth years rated distance learning as unsatisfactory (mean 2.7). The best evaluated aspects were synchronous lectures (3.9) and lectures based on cases (3.4). The worst evaluated issues were motivation (2.3), interaction with faculty (2.1), and additional workload (0.7). CONCLUSIONS The perceptions exp...
Objectives: The purpose of this study was to investigate student's perceptions of Educational Cli... more Objectives: The purpose of this study was to investigate student's perceptions of Educational Climate (EC) in Spanish medical schools, comparing various aspects of EC between the 2 nd (preclinical) and the 4 th (clinical) years to detect strengths and weaknesses in the ongoing curricular reform. Methods: This study utilized a cross-sectional design and employed the Spanish version of the "Dundee Ready Education Environment Measure" (DREEM). The survey involved 894 2 nd year students and 619 4 th year students from five Spanish medical schools. Results: The global average score of 2 nd year students from the five medical schools was found to be significantly higher (116.2±24.9, 58.2% of maximum score) than that observed in 4th year students (104.8±29.5, 52.4% of maximum score). When the results in each medical school were analysed separately, the scores obtained in the 2 nd year were almost always significantly higher than in the 4 th year for all medical schools, in both the global scales and the different subscales. Conclusions: The perception of the EC by 2 nd and 4 th year students from five Spanish medical schools is more positive than negative although it is significantly lower in the 4 th year. In both years, although more evident in the 4 th year, students point out the existence of several important "problematic educational areas" associated with the persistence of traditional curricula and teaching methodologies. Our findings of this study should lead medical schools to make a serious reflection and drive the implementation of the necessary changes required to improve teaching, especially during the clinical period.
Introductionthe COVID-19 pandemic resulted in a decreed confinement in our country from March unt... more Introductionthe COVID-19 pandemic resulted in a decreed confinement in our country from March until the end of term in June 2020. This forced a transition exclusively to distance learning. The aim of this study was to broaden the understanding of fully online distance learning from the experiences of undergraduate medical students and faculty members during confinement, and identify its key elements.MethodsA convergent mixed methods study analyzing: (a) an online teaching follow- up program, (b) two focus groups and a nominal group with students and faculty, respectively, and (c) a survey with students from 1st to 5th year.ResultsThirteen strongly interconnected categories were identified. Four played an organizational role: course planning, coordination, communication and pedagogical coherence. The remaining nine categories were: learning outcomes, teaching methodology, online resources, evaluation, time management, workload, student motivation, participation, and teacher-student r...
Evaluation of clinical communication skills in medical students with simulated patients Backgroun... more Evaluation of clinical communication skills in medical students with simulated patients Background: Communication skills are not learnt innately. It is therefore necessary to both train and evaluate medical students in this area. Aim: To evaluate communication skills of fourth-year medical students with the use of a simulated patient (SP). Material and Methods: Four clinical scenarios (CS) for clinical interviews with simulated patients were designed: chronic and acute diseases, difficult and functional patients. Each student performed the four CS, and his communication skills were evaluated using our own questionnaire as agreed with the SP. The questionnaire included items on verbal and nonverbal communication, warmth, respect, specificity, assertiveness and empathy (rated from 0 to 10). The response variable was the arithmetic mean of the scores on each item. All students received a detailed evaluation report. Results: Sixty one students (32 men) performing 244 interviews, were evaluated. The overall mean score was 7.87 (4.62 to 9.03). The highest scores were for respect and specificity (7.57 and 7.15 respectively). The lowest were for empathy and nonverbal communication (6.44 and 6.84 respectively). The CS evaluations were 7.87 (chronic disease), 7.02 (difficult patient), 6.46 (acute disease) and 6.14 (functional pathology). Women had higher overall scores compared to men (7.26 and 6.51 respectively; p < 0.01) and a significantly higher score in all communication variables (p < 0.01). Conclusions: The overall assessment in clinical communication with SP is satisfactory although there is room for improvement, especially in empathy and nonverbal communication. Women had significantly higher scores than men.
Empathy is a key aspect of the physician-patient interactions. The Jefferson Scale of Empathy (JS... more Empathy is a key aspect of the physician-patient interactions. The Jefferson Scale of Empathy (JSE) is one of the most used empathy measures of medical students. The development of cross-cultural empathy studies depends on valid and reliable translations of the JSE. This study sought to: (1) adapt and assess the psychometric properties in Spanish students of the Spanish JSE validated in Mexican students; (2) test a second order latent factor model. The Spanish JSE was adapted from the Spanish JSE-S, resulting in a final version of the measure. A non-probabilistic sample of 1104 medical students of two Spanish medical schools completed a socio-demographic and the Spanish JSE-S. Descriptive statistics, along with a confirmatory factor analysis, the average variance extracted (AVE), Cronbach's alphas and composite reliability (CR) coefficients were computed. An independent samples t-test was performed to access sex differences. The Spanish JSE-S demonstrated acceptable to good sens...
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