Medical Students’ Self-Assessment of Communication Skills During COVID-19 Pandemic at Tabriz University of Medical Sciences

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Extended Abstract
Background
The coronavirus disease 2019 (COVID-19) pandemic has changed patient care. In this regard, using personal protective device and keeping up distance may adversely influence health care provider–patient communication. Since the COVID-19 pandemic can affect the equipment and human resources of hospitals, every healthcare provider would have limited time to communicate with their patients. During the pandemic, patients become worried and emotional. So, healthcare providers should be intensely careful in choosing their wording, approach, and opportunity of communication. Maintaining the patient–centered method, shared decision-making, and expressing care targets are important conversational aspects during the pandemic. In addition to patient satisfaction and treatment compliance, appropriate health care provider–patient communication can lead to the development of a trusting relationship between physicians and patients. Therefore, this study aimed to assess medical interns and stagers of Tabriz University of Medical Sciences, Iran in communicating with the patient during COVID-19 pandemic.
Methods
The population of this descriptive cross-sectional study included all medical stagers and interns of Tabriz University of Medical Sciences from November to December, 2020. Medical stagers were in their fifth and medical students and interns were in their last year. The training programs for both groups were clinical. So, they were performed in the teaching hospitals. The study tool was a Patient Relationship Questionnaire developed by Vakili et al. (2012) to assess interpersonal communication skills. The questionnaire had two parts: the first part contained demographic characteristics of the medical stagers and interns, and the second part included 30 items, whose validity and reliability had already been confirmed. The questions were based on a 5-point Likert scale (excellent, very good, good, fair, and poor). The participants selected the option that best indicated their communication skills. For scoring, “excellent” received five points, “very good” received four points, “good” received three points, “fair” received two points, and “poor” received one point. Accordingly, the highest and lowest score was 150 and 30, respectively. According to the accessible cut points, scores between 30-50, 51-100, and 101-150 indicated low, average, and high levels of communication skills, respectively. After filling the online questionnaire by students, the mean score of self-assessment of communication skills for the medical stagers and interns were calculated and compared. Additionally, in terms of level of education, gender, wards and on duty hours during a week, the mean self-assessment score was compared. Data analysis was performed using the independent samples t-test in the Statistical Package for the Social Sciences (SPSS) version 16. A P-value <0.05 was considered as statistically significant.
Results
Totally, 226 medical stagers and interns were trained in different wards of teaching hospitals affiliated to Tabriz University of Medical Sciences. The number of medical stagers and interns was 102 and 124, respectively. Overall, 152 medical stagers and interns participated in the study. Since 67 medical stagers and 85 interns completed the questionnaire, the response rate for medical stagers and interns was 65.7% and 68.5%, respectively. More than half of the participants were female (55.92%). The mean self-assessment score (SD) of the participants was 93.83±9.78 and the median was 86. Totally, the highest and lowest scores were 141 and 64, respectively. The mean self-assessment score (SD) of medical stagers and interns was 93.15±8.13 and 94.51±12.26, respectively. Among medical stagers, the highest and lowest scores were 139 and 65, respectively. Similarly, the highest and lowest scores among interns were 141 and 64, respectively. Additionally, the mean self-assessment score (SD) of females was significantly higher than that of males [99.48 ±11.69 vs. 90.45±11.59, P=0.044]. However, there was no statistically significant difference in the self-assessment score of patient communication based on educational level and ward (surgical and non-surgical). No significant correlation existed between duty hours during a week and the mean self-assessment score separately by educational level. Furthermore, the mean self-assessment scores were compared based on training in Medical Ethics Course. This comparison demonstrated no statistically significant difference (P=0.194). Based on the accessible cut points, only 3.5% of medical stagers and 17.9 % of interns had the mean self-assessment score higher than 100. The mean self-assessment scores of medical stagers (85.9%) and interns (77.6%) ranged from 51 to 100, which indicated average level of communication skills among them.
Conclusion
Our findings showed that most of medical interns and stagers had an average self-assessment score regarding patient communication during COVID-19 pandemic. There was no statistically significant difference in self-assessment score of patient communication based on educational level and ward (surgical and non-surgical), but based on gender, the mean total score of self-assessment was significantly higher in females. Medical stagers and interns had an average self-assessment score regarding communication skills, which may be due to inadequate role modeling by attending physicians. Additionally, limited evaluation of communication skills was performed among medical stagers and interns due to the COVID-19 pandemic. However, this finding needs more investigations in the field of communication skills, especially among medical stagers and interns.