assessment of attitudes and communication skills

8/10/2019 Assessment of Attitudes and Communication Skills

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Assessment of Attitudes and

Communication Skills

dr. M. Sidhartani

Medical Faculty Diponegoro University


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Attitude

A tendency to behave in a preferential manner

Personal qualities of doctors and their attitude

toward health, patients, peers

Nature of Attitude

Constant traits of feeling, thinking, action

Guidance of behavior


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Components of Attitude

Attitudes

Cognitive

Affective

Conative

What a person knows

and his belief about

the attitude object

How he feels about

the attitude

object

Behavioral tendency

towards the object-

verbal and nonverbal


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Assessment of attitude relates to :

Patient care

Formation of attitude of peers or juniors

Acceptance of new technology Interpersonal skills

Curriculum planning

Its effect on meaningful learning and retention


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Effect of Attitudinal Bias

Premature closure and dogmatic response

Evasion

Premature reassurance Rejection

Condescension

Technical jargons : confuses patient


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Measurement of Attitudes

Difficult

Different method : simplecomplex :

1. Self report2. Attitude scales : Likert, Osgoods

3. Involuntary


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Osgoods Scale

2 (two) opposite adjectives given with

gradations.

Example :

Behavioral sciences course in undergraduate

medical curriculum is :

UsefulInformative

Interesting

Relevant

....

..

..

Not usefulNot informative

Uninteresting

Irrelevant


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Comparison Between Likert and

Osgoods Scales (Cont)

Scoring & interpretation

5 point scale

Limited interpretation on Osgood scale

Uses : in medical research

Reliability & validity

Establish before use


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Construction of Scales

Specify attitude variable that is to be measured

Collect wide variety of statement

Edit the statement Sort out the statements into (an imaginary)

scale

Calculate the scale value


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1. The statement should be brief

2.

Each statement should convey one complete thought3. The statement should belong to the attitude variable

that is to be measured

4. The statements should cover the entire range of theaffective scale of interest

5. Statements should be such that they can be endorsed orrejected (agree/disagree)

6. Acceptance and rejection should indicate somethingabout the attitude measured

7. Care should be taken on language (simple sentences,avoid double negatives, avoidall, always, none ornever, use with care only, just, merely, avoidwords with more than one meaning)

Guidelines


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Reliability and Validity

Do item validation of statement

Estimate reliability

Validity : content and constructUse standard procedures : - test retest

- split half


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The doctor-patient relationship is created and

maintained

Verbal information relevant to the clarification

and solution of the patients problem is

gathered

The solution to the problem is negotiated


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Assessment of Communication Skills

Evaluate :1. Ability to understand his patient

2. Ability to communicate his view point to the patient

and his family members3. Ability to explore and answer patients questions

(mind the patients frame of reference which

includes the psychological connotations of patients

complaints, his wishes, expectations and fears)

4. Ability to propose solutions to the problems and to

motivate patients for compliance with treatment


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Strategies of Assessment of


1. Observation in routine setting, eg. during clinicalrounds

2. Observation in a structured situation; 10-15 minutes

interview session on a preselected topic; a checklistcan be prepared to assess the various components ofcommunication used/unused by the candidate

3. Listening triad: A role play exercise in which 3

students take the role of doctor, patient and aobserver. The observer records the ensuinginterviews which from the substance for discussionand feedback


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4. Closed circuit TV monitors are used to assess the manner inwhich a student interviews the patients.

5. Communication skills have also been assessed through OSCEstations. Simulated or real patients may be used in the OSCE

stations. The assessment can be objectivised using a rating scaleor a check list

6. Students may be asked to maintain a log book, recording write-up of the various exercises and activities related tocommunication. This is constantly supervised by the teachingstaff

7. The students may view the video-tape of an interview situationand point out or answer to the specific questions, such asnonverbal behavior of the patient.

Strategies of Assessment of

Communication Skills (Cont)


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Summative Assessment

Communication skill should be in-built into clinical assessment


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assessment of attitudes and communication skills

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