title: Has the inclusion of a longitudinally integrated communication skills program improved consultation skills in medical students? A pilot study.
abstract: BACKGROUND
  Evidence highlights a lack of communication skills in doctors leading to dysfunctional consultations. To address this deficit, a private medical college instituted curricular reforms with inclusion of a longitudinal communication skills program. A pilot study was undertaken to evaluate the effectiveness of this program by comparing the consultation skills of medical students of this college with a medical college without a communication skills program.
  
  
  METHODS
  A 4-station Objective Structured Clinical Examination (OSCE) was conducted in the third and final year. Mann-Whitney U-test was used to compare the difference in the distribution between OSCE stations total and construct scores.
  
  
  RESULTS
  At the end of the third year, 21 (31.34%), students of the study site (medical college 1 [college with integrated longitudinal communication skills program]) and 31 (46.26%) students from the comparison site (medical college 2 [comparable college without communication skills program]) consented. Medical college 1 achieved a significantly higher overall mean total station score of 68.0% (standard deviation [SD] =13.5) versus 57.2% (SD = 15.4) (P < 0.001). Significantly higher mean scores were achieved on three stations. At the end of the final year, 19 students (29.3%) from medical college 1 and 22 (34%) students from medical college 2 consented. The difference in overall mean total station score reduced from 9.2% to 7.1% (70.2) (SD = 13.7) versus 63.1 (SD = 15.2) (P = 0.004). The mean scores of both colleges decreased in "Patient presenting with Hepatitis C Report" station (P values 0.004 and 0.775) and in "Patient Request for Faith Healing Therapy in Diabetes Mellitus" station (P values 0.0046 and 0.036), respectively.
  
  
  CONCLUSIONS
  Longitudinal communication skills in an undergraduate curriculum positively impacted consultation skills. Community-based training and faculty development are required to develop effective patient-centered consultation skills.
authors.affiliation: Department of Family Medicine, Aga Khan University and Hospital, Karachi, Pakistan.
authors.forename: Sameena
authors.initials: S
authors.lastname: Shah
authors.affiliation: Department of Family Medicine, Aga Khan University and Hospital, Karachi, Pakistan.
authors.forename: Marie
authors.initials: M
authors.lastname: Andrades
authors.affiliation: Department of Medicine, Ziauddin University, Karachi, Pakistan.
authors.forename: Fasia
authors.initials: F
authors.lastname: Basir
authors.affiliation: Department of Biochemistry, Fatima Memorial College of Medicine and Dentistry, Lahore, Pakistan.
authors.forename: Anila
authors.initials: A
authors.lastname: Jaleel
authors.affiliation: Department of Community Health Sciences, Aga Khan University and Hospital, Karachi, Pakistan.
authors.forename: Iqbal
authors.initials: I
authors.lastname: Azam
authors.affiliation: Department of Community Health Sciences, Aga Khan University and Hospital, Karachi, Pakistan.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Islam
authors.affiliation: Department of Pathology, Aga Khan University and Hospital, Karachi, Pakistan.
authors.forename: Rashida
authors.initials: R
authors.lastname: Ahmed
keywords: Communication; patient-centered care; pilot project; undergraduate medical education