A Quasi-experimental Study to Evaluate the Attitudes of MBBS Students Towards Teaching and Learning Communication Skills at Tertiary Care Teaching Medical Institution in Uttarakhand
Keywords:
Communication Skills Attitude Scale (CSAS); Attitude, Ethics and Communication (AETCOM); positive attitude; negative attitude; undergraduate medical curriculum; doctor–patient relationship; medical students.Abstract
Background: Communication is a fundamental clinical competency expected of Indian medical graduates and underpins high-quality patient care, therapeutic relationships, and patient safety. Historically, undergraduate medical training has provided limited structured instruction in communication, contributing to deficiencies in these skills among early-career doctors. This study examined undergraduate medical students' attitudes towards communication skills training and explored the influence of the Attitude, Ethics, and Communication (AETCOM) curriculum on these perceptions.
Methods: A quasi-experimental survey was undertaken among 229 MBBS students. Attitudes towards communication skills learning were measured using the validated Communication Skills Attitude Scale (CSAS), which employs a five-point Likert response format to evaluate both favourable and unfavourable attitudes. Data were analysed using SPSS, with comparative analyses performed between students in the second and third years of the MBBS programme.
Results: Total of 229 students participated in the study. Results showed high positive attitude scores, with mean values ranging from 4.69 to 4.84 for key items such as the importance of communication skills. The overall positive attitude score slightly decreased from 53.35 ± 5.0 (pre-test) to 52.47 ± 5.7 (post-test), while the third-year score was 52.89 ± 5.2 (p > 0.05). Negative attitude scores showed minimal variation: 43.65 ± 5.7 (pre-test), 42.7 ± 7.1 (post-test), and 42.96 ± 5.5 (third-year) (p > 0.05).
Conclusion: Students demonstrated consistently positive attitudes, though no significant improvement was observed, highlighting the need for more engaging teaching approaches. Continuous reinforcement of communication skills training across all stages of undergraduate medical education, supplemented by focused educational interventions, is essential to foster an inclusive, supportive, and learner-centred educational environment.
References
REFERENCES
https://www.nmc.org.in/information-desk/for-colleges/ug-curriculum/ (last accessed on 18/01/2026)
Tan XH, Foo MA, Lim SLH, Lim MBXY, Chin AMC, Zhou J, et al. Teaching and assessing communication skills in the postgraduate medical setting: a systematic scoping review. BMC Med Educ. 2021; 21:1–19.
Talevski J, Wong Shee A, Rasmussen B, Kemp G, Beauchamp A. Teach-back: a systematic review of implementation and impacts. PLoS ONE. 2020;15(4):e0231350
Kerasidou A, Bærøe K, Berger Z, Caruso Brown AE. The need for empathetic healthcare systems. J Med Ethics. 2021;47(12):1083-90. doi:10.1136/medethics-2021-106831 [PMID:34883888].
Franceschi D. Physician-patient communication: An integrated multimodal approach for teaching medical English. Syst. 2018; 77:13-21. doi: 10.1016/j.system.2018.01.003 [PMID:29380268].
Petty RE, Wegener DT, Fabrigar LR. Attitudes and attitude change. Annu Rev Psychol. 1997; 48:609-47. doi: 10.1146/annurev.psych.48.1.609, PMID 9046570.
Langille DB, Kaufman DM, Laidlaw TA, Sargeant J, MacLeod H. Faculty attitudes towards medical communication and their perceptions of students’ communication skills training at Dalhousie University. Med Educ. 2001 Jun;35(6):548-54. doi: 10.1046/j.1365-2923.2001. 00921.x, PMID 11380857.
Rees C, Sheard C, Davies S. The development of a scale to measure medical students' attitudes towards communication skills learning: the Communication Skills Attitude Scale (CSAS). Med Educ. 2002 Feb;36(2):141-7. doi: 10.1046/j.1365-2923.2002.01072.x. PMID: 11869441.
Stewart MA. Effective physician-patient communication and health outcomes: a review. CMAJ. 1995 May 1;152(9):1423-33. PMID: 7728691; PMCID: PMC1337906.
Bombeke K, Symons L, Debaene L, De Winter B, Schol S, Van Royen P. Help, I'm losing patient-centredness! Experiences of medical students and their teachers. Med Educ. 2010 Jul;44(7):662-73. doi: 10.1111/j.1365-2923.2010.03627.x. PMID: 20636585.
Kurtz, S., Draper, J., & Silverman, J. (2005). Teaching and Learning Communication Skills in Medicine (2nd ed.). CRC Press. https://doi.org/10.1201/9781315378398
Stewart M, Brown JB, Donner A, McWhinney IR, Oates J, Weston WW, Jordan J. The impact of patient-centered care on outcomes. J Fam Pract. 2000 Sep;49(9):796-804. PMID: 11032203.
Gude T, Finset A, Anvik T, Bærheim A,Fasmer OB, Grimstad H, et al. Do medical students and young physicians assess reliably their self-efficacy regarding communication skills? A prospective study from end of medical school until end of internship. BMC Med Educ. 2017;17(1):107. doi:10.1186/s12909-017-0943-y [PMID:28175256]
Jagosh J, Donald Boudreau J, Steinert Y, Macdonald ME, Ingram L. The importance of physician listening from the patients' perspective: enhancing diagnosis, healing, and the doctor-patient relationship. Patient Educ Couns. 2011 Dec;85(3):369-74. doi: 10.1016/j.pec.2011.01.028. Epub 2011 Feb 18. PMID: 21334160.
Butow P, Devine R, Boyer M, Pendlebury S, Jackson M, Tattersall MH. Cancer consultation preparation package: changing patients but not physicians is not enough. J Clin Oncol. 2004 Nov 1;22(21):4401-9. doi: 10.1200/JCO.2004.66.155. PMID: 15514382.
Nestel D, Tierney T. Role-play for medical students learning about communication: guidelines for maximising benefits. BMC Med Educ. 2007 Mar 2;7:3. doi: 10.1186/1472-6920-7-3. PMID: 17335561; PMCID: PMC1828731.
Kinnersley P, Edwards A, Hood K, Cadbury N, Ryan R, Prout H, Owen D, Macbeth F, Butow P, Butler C. Interventions before consultations for helping patients address their information needs. Cochrane Database Syst Rev. 2007 Ju18;2007(3):CD004565. doi: 10.1002/14651858.CD004565.pub2. PMID: 17636767; PMCID: PMC903684
Anvik T, Grimstad H, Baerheim A, BerntFasmer O, Gude T, Hjortdahl P, et al. Medical students’ cognitive and affective attitudes towards learning and using communication skills - A nationwide cross-sectional study. Med Teach. 2008;30(3):272–9. Available from: https://www.tandfonline.com/doi/abs/10.1080/01421590701784356?journalCode=imte20.
Mannava P, Durrant K, Fisher J, Chersich M,Luchters S. Attitudes and behaviours of maternal health care providers in interactions with clients: A systematic review. Global Health. 2015;11(1). PubMed: https://pubmed.ncbi.nlm.nih.gov/26276053/.
Alotaibi FS, Alsaeedi A. Attitudes of medical students toward communication skills learning in Western Saudi Arabia. Saudi Med J. 2016;37(7):791-5. doi: 10.15537/smj.2016.7.14331, PMID 27381541.
Piryani S, Piryani RM, Deo GP. Medical students’ attitudes toward communication skills learning in Chitwan Medical College, Nepal. Journal of BP Koirala Institute of Health Sciences. 2020;3(1):96-104. doi: 10.3126/jbpkihs. v3i1.30333.
Cleland J, Foster K, Moffat M. Undergraduate students’ attitudes to communication skills learning differ depending on year of study and gender. Med Teach. 2005;27(3):246-51. doi: 10.1080/01421590400029541, PMID 16011948.
Prajapati HG, Oza B, Modi NY, Amaliyar JN, Patel P. From Passive to Active: A Comparative Evaluation of Flipped Classroom and Didactic Methods in Phase III Part I MBBS Student. Glob J Med Pharm Biomed Update. 2025; 20:15. doi:10.25259/GJMPBU_33_2025.
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