Theses (Master Of Health Professions Education)

Introduction Effective communication is an essential skill in a patient-centred doctor-patient-relationship. Although medical graduates acquire communication skills during undergraduate training, these have been shown to be inadequate for their careers. The aim of this study was to close the gap in preparing medical students with patient-centred communication skills in readiness for the workplace for improved patient satisfaction and health outcomes. Methods A phenomenological study design using in-depth individual interviews was conducted on Semester 6 medical students and patients to study their experience in an outpatient department at a primary care clinic over two weeks. Data was transcribed verbatim, analysed, and triangulated with patients’ views on cross-cultural communication with students. Thematic analysis of Braun and Clark was used to analyse data. Results Three themes emerged namely, factors that play a role in communication skills of medical students, and perceived enablers and challenges of communication skills of medical students and patients in the primary care setting. Factors affecting communication skills were language, cultural beliefs, level of maturity and stage in students’ training, and patients’ socio-economic status. Enablers in communications skills includes adopting a biopsychosocial approach by establishing rapport, building trust, showing empathy, ensuring patient’s comfort and respecting their privacy, as well as, engaging in early and continuous experiential learning, using non-verbal communication, and engaging in self-reflection. Challenges faced by both students and patients were patient’s lack of trust in western medicine, students’ difficulty in eliciting sexual history, students’ emphasis on taskorientation, cultural insensitivity, student’s speech anxiety, and patients’ emotional state. Conclusion Results of the study identified the factors, and the enablers and challenges that influenced patient-centred communication skills of medical students in undergraduate training which could close the gap for patient satisfaction and improved health outcomes at the workplace. The study also reiterated the importance of early and continuous experiential in authentic work-based settings.

Language, as a form of communication, is crucial for healthcare professionals as they communicate with various stakeholders including patients, patients' families, other healthcare professionals, administrators and students. Hence, it is important for them to have good communication skills, particularly proficiency in English, as English language is widely used in the field of medicine. While literature emphasises the importance of communication and language skills for medical students, there is a gap of knowledge on medical students’ perception on the importance of the English language skills during their medical education, and subsequently to the medical profession. Hence this study intends to explore medical students’ perception of the importance of English language. A qualitative study via focus group method was conducted where medical students were interviewed on their perspectives. A total of 6 sessions of focus groups were conducted, with 24 students. Data obtained were analysed by themes using the Braun and Clarke (2006) thematic analysis framework. Three main areas of the study include the use of English language in medical education, the influence of university culture in English language mastery and the impact of English language proficiency on medical students. Themes coded from the data indicate that medical students perceive English language to be important in 3 aspects, namely English language as a learning tool, a professional language and as a communication tool. Students discussed the availability of university and peer support in their mastery of English language. The study also found that English language proficiency impacts students’ academic progression, communication and personal and professional development. The study concludes that language awareness is important for medical students to deliver high quality patient care as language barriers during patient communication impedes patient care quality.