The associations between reflective ability and communication skills among medical students. Issue 1 (January 2021)

• Record Type: Journal Article
• Authors: Karnieli-Miller, Orit; Michael, Keren; Gothelf, Ayelet Brand; Palombo, Michal; Meitar, Dafna
• Is Part Of: Patient education and counseling. Volume 104:Issue 1(2021)
• Page Start: 92
• Page End: 98
• Publication Date: 2021-01
• Subjects: Reflective practice -- Communication skills -- Breaking bad news -- Reflective ability; Patient education -- Periodicals; Health counseling -- Periodicals; Health education -- Periodicals; Counseling -- Periodicals; Patient Education -- Periodicals; Éducation des patients -- Périodiques; Counseling -- Périodiques; Éducation sanitaire -- Périodiques; 615.5071
• DOI: 10.1016/j.pec.2020.06.028
• Languages: English
• ISSNs: 0738-3991

Abstract

Highlights: Reflective ability in narrative is associated with global communication skills. Noticing physicians' explanations is associated with later tailored information provision. Noticing physicians' explanations is associated with later addressing of patients' emotions. Students' gender or age was not associated with communication skills. Abstract: Objectives: Assess associations between medical students' reflective ability demonstrated in written narratives, and communication skills demonstrated later in simulated-patient breaking bad news interactions. Methods: We analyzed 66 medical students' reflective ability, using 'REFLECT' rubric and four newly developed parameters: Noticing Explanations provided to patients, Noticing Emotions, Remoteness/Connectedness in their writing, and mentioning Self-Emotions. 'BAS' and 'SPIKES' questionnaires measured students' communication skills. Spearman and Chi-square tests examined correlations among all variables. Multiple regressions examined associations between reflective ability and demographic variables with communication skills. Results: Significant positive correlations between students' reflective ability, measured by REFLECT and three of the new parameters, and global communication skill scores. Reflective ability of Noticing Explanations in writing was associated with ability to tailoring information to patients' needs and address emotions. Conclusions: High reflective ability may improve communication skills. Specifically, ability to notice explanations to patients may enhance later capability to tailor information to patients and address emotions empathically. Practice implications: Encourage educational interventions enhancing reflective ability; specifically observation and detailed writing about how explanations are given to patients and patients' reactions to them. This process may help students develop competency to share and tailor difficult information sensitively—a critical skill when communicating bad news.