Can Distance Communication Skills Training Increase the Empathy Levels in Medical Students? An Application During the Pandemic Period

Yıl 2022, Cilt: 6 Sayı: 3, 775 - 783, 29.09.2022

Sema Ozan , Esin Ergönül , Özlem Miman , Servet Kızıldağ , Gulsah Zeybek , Ayşe Yazıcı , Cemal Hüseyin Güvercin , Meliha Diriöz , İlkay Aksu , Cem Bediz , Songül Bayram Delibaş , Nergiz Durmuş Sütpideler , Balahan Makay

https://doi.org/10.30621/jbachs.1082337

Öz

Background and Purpose: The aim is to determine the effect of the communication skills training (CST) using interactive synchronous and asynchronous methods, which was applied for the first time on medical students’ empathy levels.
Methods: This study is a cross-sectional-analytical, self-controlled intervention.
The distance CST program was applied to first-year medical students. The change in students’ empathy levels was measured with the student version of the Jefferson Empathy Scale.
Results: 241 students’ forms were included. Empathy mean score increased significantly, this increase was higher in women.
Conclusion: The distance CST produced a positive effect on empathy levels. While interactive
PowerPoint® presentations, videos, movie clips, cartoons, real-life examples, written/audio question-
answer activities, surveys, feedback and, small group work were used in live lessons; in the
asynchronous process, student-based techniques (self-assessment, homework, WhatsApp® sharing)
were used to support the online learning climate. We believe that all of them support the cognitive and
social existence of students throughout the training. We propose our program as a model that can be
used during situations where face-to-face education is not possible and to support face-to-face
education in medical education.

Anahtar Kelimeler

medical education, distance learning, distance education, communication skills training, empathy

Kaynakça

• 1. Frank JR, Snell, Linda, Sherbino J, Royal College of Physicians and Surgeons of Canada. CanMEDS 2015 Physician Competency Framework.; 2015.
• 2. Tomorrow’s Doctors 2009. :108. Accessed from: http://www.ub.edu/medicina_unitateducaciomedica/documentos/TomorrowsDoctors_2009.pdf
• 3. mezuniyet-oncesi-tip-egitimi-cekirdek-egitimi-programi.pdf. Accessed November 4, 2021. https://www.yok.gov.tr/Documents/Kurumsal/egitim_ogretim_dairesi/Ulusal-cekirdek-egitimi-programlari/mezuniyet-oncesi-tip-egitimi-cekirdek-egitimi-programi.pdf
• 4. Laidlaw A, Hart J. Communication skills: An essential component of medical curricula. Part I: Assessment of clinical communication: AMEE Guide No. 51. Med Teach. 2011;33(1):6-8. doi:10.3109/0142159X.2011.531170
• 5. Dalen J van, Bartholomeus P, Kerkhofs E, et al. Teaching and assessing communication skills in Maastricht: the first twenty years. Med Teach. 2001;23(3):245-251. doi:10.1080/01421590120042991
• 6. Dereboy Ç, Harlak H, Gürel S, Gemalmaz A, Eski̇n M. Tıp eğitiminde eşduyumu öğretmek. Türk Psikiyatri Derg. 2005;16(2):83-89.
• 7. Laidlaw TS, MacLeod H, Kaufman DM, Langille DB, Sargeant J. Implementing a communication skills programme in medical school: needs assessment and programme change. Med Educ. 2002;36(2):115-124. doi:10.1046/j.1365-2923.2002.01069.x
• 8. Lloyd M, Bor R. Communication Skills for Medicine E-Book. Elsevier Health Sciences; 2009. ISBN: 978-0-7020-3058-1 9. Maguire P, Pitceathly C. Key communication skills and how to acquire them. BMJ. 2002;325(7366):697-700. doi:10.1136/bmj.325.7366.697
• 10. program-ciktilari.pdf. Accessed November 4, 2021. https://tip.deu.edu.tr/wp-content/uploads/2020/01/program-ciktilari.pdf
• 11. Özkan H, Degirmenci B, Musal B, et al. Letters to the Editor. Med Teach. 2004;26(3):279-280. doi:10.1080/01421590310001642966
• 12. Luke K. Twelve tips for using synchronous virtual classroom technologies in medical education. MedEdPublish. Published online 2021. doi:https://doi.org/10.15694/mep.2021.000066.1
• 13. El Tarhouny S, Hassouna A, Khalifa M. Etiquette of virtual learning; tips to ensure effective learning for medical students. MedEdPublish. https://doi.org/10.15694/mep.2021.000067.1
• 14. Sun C, Zou J, Zhao L, et al. New doctor-patient communication learning software to help interns succeed in communication skills. BMC Med Educ. 2020;20(1):8. doi:10.1186/s12909-019-1917-z
• 15. Fleetwood J, Vaught W, Feldman D, Gracely E, Kassutto Z, Novack D. MedEthEx Online: A Computer-Based Learning Program in Medical Ethics and Communication Skills. Teach Learn Med. 2000;12(2):96-104. doi:10.1207/S15328015TLM1202_7
• 16. Lai CY, Chen LJ, Yen YC, Lin KY. Impact of video annotation on undergraduate nursing students’ communication performance and commenting behaviour during an online peer-assessment activity. Australas J Educ Technol. 2020;36(2):71-88. doi:10.14742/ajet.4341
• 17. Hulsman RL, van der Vloodt J. Self-evaluation and peer-feedback of medical students’ communication skills using a web-based video annotation system. Exploring content and specificity. Patient Educ Couns. 2015;98(3):356-363. doi:10.1016/j.pec.2014.11.007
• 18. Sezer B, Sezer TA. Teaching communication skills with technology: Creating a virtual patient for medical students. Australas J Educ Technol. 2019;35(5):183-198. doi:10.14742/ajet.4957
• 19. Stepien KA, Baernstein A. Educating for empathy. J Gen Intern Med. 2006;21(5):524-530. doi:10.1111/j.1525-1497.2006.00443.x
• 20. Hojat M, Mangione S, Nasca TJ, et al. The Jefferson Scale of Physician Empathy: Development and Preliminary Psychometric Data. Educ Psychol Meas. 2001;61(2):349-365. doi:10.1177/00131640121971158
• 21. Gönüllü İ, Öztuna D. Jefferson Doktor Empati Ölçeği Öğrenci Versiyonunun Türkçe Adaptasyonu. Marmara Med J. 2015;25(2):87-92.
• 22. Fragkos KC, Crampton PES. The Effectiveness of Teaching Clinical Empathy to Medical Students: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Acad Med. 2020;95(6):947-957. doi:10.1097/ACM.0000000000003058
• 23. Kelm Z, Womer J, Walter JK, Feudtner C. Interventions to cultivate physician empathy: a systematic review. BMC Med Educ. 2014;14(1):219. doi:10.1186/1472-6920-14-219
• 24. Teding van Berkhout E, van Berkhout ET, Malouff JM. The efficacy of empathy training: A meta-analysis of randomized controlled trials. J Couns Psychol. 2016;63(1):32-41. doi:10.1037/cou0000093 25. Hojat M, Gonnella JS, Mangione S, et al. Empathy in medical students as related to academic performance, clinical competence and gender. Med Educ. 2002;36(6):522-527. doi:10.1046/j.1365-2923.2002.01234.x
• 26. Hojat M, Shannon SC, DeSantis J, Speicher MR, Bragan L, Calabrese LH. Does Empathy Decline in the Clinical Phase of Medical Education? A Nationwide, Multi-Institutional, Cross-Sectional Study of Students at DO-Granting Medical Schools. Acad Med. 2020;95(6):911-918. doi:10.1097/ACM.0000000000003175
• 27. Shaheen A, Mahmood M, Miraj M, Ahmad M. Empathy Levels among Undergraduate Medical Students in Pakistan, a Cross-Sectional Study Using Jefferson Scale of Physician Empathy. J Pak Med Assoc. 2019;(0):1. doi:10.5455/JPMA.301593
• 28. Tavakol S, Dennick R, Tavakol M. Empathy in UK Medical Students: Differences by Gender, Medical Year and Specialty Interest. Educ Prim Care. 2011;22(5):297-303. doi:10.1080/14739879.2011.11494022
• 29. Bourke R. Self-assessment in professional programmes within tertiary institutions. Teach High Educ. 2014;19(8):908-918. doi:10.1080/13562517.2014.934353
• 30. Bourke R. Self-assessment to incite learning in higher education: developing ontological awareness. Assess Eval High Educ. 2018;43(5):827-839. doi:10.1080/02602938.2017.1411881
• 31. Taras M. Student self-assessment: processes and consequences. Teach High Educ. 2010;15(2):199-209. doi:10.1080/13562511003620027
• 32. Fritz GK, Poe RO. The role of a cinema seminar in psychiatric education. Am J Psychiatry. 1979;136(2):207-210. doi:10.1176/ajp.136.2.207
• 33. Jacobson L, Grant A, Hood K, et al. A literature and medicine special study module run by academics in general practice: two evaluations and the lessons learnt. Med Humanit. 2004;30(2):98-100. doi:10.1136/jmh.2004.000176
• 34. Kim DH. Evaluation of critical thinking course for premedical students using literature and film. Korean J Med Educ. 2019;31(1):19-28. doi:10.3946/kjme.2019.115
• 35. Lumlertgul N, Kijpaisalratana N, Pityaratstian N, Wangsaturaka D. Cinemeducation: A pilot student project using movies to help students learn medical professionalism. Med Teach. 2009;31(7):e327-e332. doi:10.1080/01421590802637941
• 36. Baños JE. How literature and popular movies can help in medical education: applications for teaching the doctor−patient relationship. Med Educ. 2007;41(9):918-918. doi:10.1111/j.1365-2923.2007.02829.x
• 37. Ber R, Alroy G. Twenty Years of Experience Using Trigger Films as a Teaching Tool. Acad Med. 2001;76(6):656-658.
• 38. Darbyshire D, Baker P. A systematic review and thematic analysis of cinema in medical education. Med Humanit. 2012;38(1):28-33. doi:10.1136/medhum-2011-010026
• 39. Güven B, Yılmaz GK. Tasarlanan Hizmet-İçi Eğitim Kursunun Ortaokul Matematik Öğretmenlerinin Teknoloji Kullanım Düzeylerine Etkisi. EĞİTİM VE BİLİM. 2016;41(188). doi:10.15390/EB.2016.6646 40. Salam MA us, Oyekwe GC, Ghani SA, Choudhury RI. How can WhatsApp® facilitate the future of medical education and clinical practice? BMC Med Educ. 2021;21(1):54. doi:10.1186/s12909-020-02440-7
• 41. Gurbuz T, Yildirim S, Ozden MY. A Comparison of Student-Teachers’ Attitudes Toward Computers in On-Line And Traditional Computer Literacy Courses: A Case Study. In: Association for the Advancement of Computing in Education (AACE); 2000:348-353. Accessed January 18, 2022. https://www.learntechlib.org/primary/p/15581/
• 42. Bylund CL, Banerjee SC, Bialer PA, et al. A rigorous evaluation of an institutionally-based communication skills program for post-graduate oncology trainees. Patient Educ Couns. 2018;101(11):1924-1933. doi:10.1016/j.pec.2018.05.026
• 43. Quince T, Thiemann P, Benson J, Hyde S. Undergraduate medical students’ empathy: current perspectives. Adv Med Educ Pract. 2016;7:443-455. doi:10.2147/AMEP.S76800
• 44. Spatoula V, Panagopoulou E, Montgomery A. Does empathy change during undergraduate medical education? – A meta-analysis*. Med Teach. 2019;41(8):895-904. doi:10.1080/0142159X.2019.1584275