Zerbini Giulia, Schneider Pia, Reicherts Miriam, Roob Nina, Jung-Can Kathrin, Kunz Miriam, Reicherts Philipp
Department of Medical Psychology and Sociology, Institute of Theoretical Medicine, Faculty of Medicine, University of Augsburg, Stenglinstrasse 2, 86156, Augsburg, Germany.
Department of Medical Education Sciences (DEMEDA), Faculty of Medicine, University of Augsburg, Stenglinstrasse 2, 86156, Augsburg, Germany.
BMC Med Educ. 2025 May 9;25(1):685. doi: 10.1186/s12909-025-07018-9.
Successful doctor-patient communication is a critical component of effective medical treatment and therefore plays a crucial role already in medical training. The aim of this cross-sectional study was to employ a multi-measure approach assessing different perspectives and variables to investigate how medical students' communication performance differs across medical training (1st vs. 5th or 7th semester).
43 medical students (1st semester: N = 23; 5th or 7th semester: N = 20) engaged in a simulated doctor-patient consultation with a standardized patient (SP) while being videorecorded. Medical students' communication quality was assessed by a communication expert and by the SP (both being blinded regarding the semester of the medical student) using standardized questionnaires (Berliner Global Rating Scale, Medical Interview Satisfaction Scale). Following our multi-measure approach, we also assessed several non-verbal parameters and variables (back-channeling, turn-taking, verbal dominance, automatic analysis of emotional facial expressions, skin conductance level).
Analysis of non-verbal measures demonstrates that advanced students used more back-channeling, displayed more facial expressions of happiness and showed elevated skin conductance levels compared to 1st semester students. These non-verbal parameters could significantly predict the expert's communication quality assessment, explaining 31% of the variance in communication quality. As expected, the expert and SP rated the communication quality of 5th /7th semester students as significantly better compared to 1st semester students.
We found that non-verbal parameters significantly differed between students of early vs. later stages of their medical training and were predictive of communication quality. Especially, sympathetic responsiveness - likely indicating the level of involvement - correlated with expert evaluations. These findings suggest that effective communication becomes evident across different channels and that sincere engagement into a conversation might be a requisite for successful doctor-patient communication.
成功的医患沟通是有效医疗治疗的关键组成部分，因此在医学培训中也起着至关重要的作用。这项横断面研究的目的是采用多测量方法，评估不同的观点和变量，以调查医学生的沟通表现如何在医学培训的不同阶段（第1学期与第5或第7学期）存在差异。
43名医学生（第1学期：N = 23；第5或第7学期：N = 20）与标准化患者（SP）进行模拟医患咨询，同时进行录像。医学生的沟通质量由一名沟通专家和标准化患者（两者均对医学生的学期不知情）使用标准化问卷（柏林全球评分量表、医学访谈满意度量表）进行评估。按照我们的多测量方法，我们还评估了几个非语言参数和变量（反馈、话轮转换、言语主导、面部表情自动分析、皮肤电导率水平）。
非语言测量分析表明，与第1学期的学生相比，高年级学生使用了更多的反馈，表现出更多的快乐面部表情，并且皮肤电导率水平升高。这些非语言参数可以显著预测专家对沟通质量的评估，解释了沟通质量差异的31%。正如预期的那样，专家和标准化患者对第5/7学期学生的沟通质量评价明显高于第1学期的学生。
我们发现，非语言参数在医学培训早期和后期的学生之间存在显著差异，并且可以预测沟通质量。特别是，交感反应——可能表明参与程度——与专家评估相关。这些发现表明，有效的沟通在不同渠道中都很明显，真诚地参与对话可能是成功的医患沟通的必要条件。
