Assessing the Impact of a Prescription Communication Skills Training Module on the Attitudes and Competency of Medical Undergraduates

TL;DR

A communication skills training module improved medical students' prescription communication performance and confidence, but not their attitudes.

Contribution

A four-week training module was developed and tested to improve prescription communication skills in medical undergraduates.

Findings

Student performance above 6.5 scores improved from 47.58% to 57.26% after the intervention.

87% of males and 100% of females agreed that regular training would enhance their performance.

The ability to communicate rated as 'very good' increased from 5.34% to 9.68%.

Abstract

Introduction: Good doctor-patient communication is critical in enhancing treatment adherence. Ineffective doctor communication has been associated with high patient non-adherence, while good communication improves doctor-patient relationships and improves adherence. Communication skills have been identified by the National Medical Commission as one of the important competencies for Indian medical graduates. Ineffective communication of prescriptions is still a challenge, impacting patient outcomes. Incorporating a communication skills module as per Competency-Based Medical Education (CBME) guidelines can increase the confidence and competence of medical students in communicating prescriptions to eventually improve patient care.

Methods: This interventional mixed-method study assessed the impact of prescription communication training module in 145 second-phase MBBS students after obtaining ethical clearance. The communication skills module was first introduced to the students through a sensitization session. Questionnaire on communication skills was administered to measure baseline attitudes toward communication skills. Intervention included structured training module comprised of four sessions, each of two-hour duration with role-play. Upon completion of the sessions, a post-test utilizing the same questionnaire on attitudes was administered to measure differences in communication skills attitudes. The main outcome was assessed by change in scores of communication skills before and after the module training using objective structured practical examination (OSPE). Students' reactions towards the training module were recorded. Data were analyzed for statistical significance using t-test.

Results: The post-test was taken by 124 (85.52% response rate) out of 145 medical students in second phase. Positive attitude scores in the post-intervention phase were more favorable in male students, rural-background students, and doctor-families, whereas negative attitude scores were negatively affected in males and urban-background students. Student performance above 6.5 scores improved from 47.58% (n = 59) to 57.26% (n = 71) after intervention, which was statistically significant (p value < 0.001). Ability to communicate rated as "very good" improved to 9.68% (n =12) from 5.34% (n =7). 87% (n = 34) of the males and 100% (n = 86) of the females concurred that training done regularly would enhance their performance.

Conclusion:Students' performance and self-confidence in prescription communication skills improved as a result of the four-week training program. However, there was no appreciable shift in attitudes. Inclusion of such modules in healthcare education would make prescription communication competent and confident for students. Additional studies are needed to determine its actual effect in real-life practice on patient communication.

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