The Fall and Rise of Medical Students’ Attitudes to Communication Skills Learning in Ireland: A Longitudinal Approach

Many studies have explored attitudes to communication skills learning before and after a teaching intervention but there remains a dearth of published longitudinal studies. An area currently unexplored is medical student’s attitudes to communication skills teaching and learning over the entirety of the undergraduate programme. A longitudinal approach was utilized in this study involving all medical students (n= 128) entering a Medicine Under Graduate Degree Programme in 2007 in a Dublin Medical School. Participants completed a previously validated Communication Skills Attitudinal Scale (CSAS) on Day 1 of the second medical year prior to clinical exposure. Once baseline attitudes were established, the tool was completed sequentially at the end of the 2nd, 3rd, 4th and 5th (final) medical years. Results indicated a mean Positive Attitude Score (PAS) of 51.9 (range 13-65) at the beginning of 2nd year declining to 45.5 at the end of this year. This decline in positivity was statistically significant with p < 0.035. Results indicated a mean Negative Attitude Score (NAS) of 29.8 (range 13-65) at the beginning of 2nd year rising to 33.8 at the end of this year. However, the longitudinal approach taken highlighted that attitudes rose again by the end of the 3rd year -mean PAS 48.7, and 4th - 49.3 and attitudes almost returned to baseline by the end of the 5th Year - mean PAS 49.3. The NAS score remained constant at 31.4 at the end of 3rd year, 31.4 at the end of 4th and 29.6 at the end of the 5th year .These changes in NAS were not statistically significant. A qualitative study is indicated to investigate the causation of the fall in positive attitude scores and rise in negative attitudes at the end of the second year. As communication skills are a core requirement for practicing in a professional discipline further research into these findings is warranted.