Medical students’ attitudes toward communication skills learning: comparison between two groups with and without training [Response to letter]

Dear editor

We thank von Widekind and Machin for the interest and comments on our work “Medical students’ attitudes towards communication skills learning: comparison between two groups with and without training”. On the whole, we agree with most of their remarks about the methodological limitations of the study and with the value they gave to our study for “ensuring CS is delivered in an effective format”.

Nevertheless, the majority of these comments are included in the paper, where we effectively affirm that “the findings suggest that students’ attitudes toward CS could decline as a result of CS training”, and immediately afterward too “… However, further studies using longitudinal research designs should be performed for exploring students’ attitudes changes over time”. So, we would like to highlight that, although in this letter authors comment that “the study can not validly conclude that attitudes decline due to previous exposure to CS”, the study does not really conclude that exactly.

We also take the opportunity to comment that, although the number of baseline variables compared in the two populations is indeed limited, both groups were quite homogeneous and, as other authors have pointed out, we have reason to believe in the negative influence of some aspects of the educational methods as the main hypothesis for students developing negative affective attitudes. At the same time, we have been able to explore this by a focal groups study with these students (Ruiz Moral et al, Medical students perceptions towards learning communication skills: a qualitative study after two years training program, Int J Medical Education, 2019, under review)^1–3. Having said this also in the discussion, later we recognize, however, that “This highlights the possible influence of factors not only related to the implementation of problems of experiential methodologies pointed out, but also to others (workload or study, work stress, contact with real scenarios with patients, etc.)” and as a colophon to the limitations of the study: “We have also pointed out the existence of other variables that can influence this decrease in positive and affective attitudes and that may be related to the assumption by students of new responsibilities, or be similar to those related to the decrease in students’ empathy highlighted by other authors”.

In any case, the value of this preliminary study, as von Widekind and Machin point out, is indeed in drawing attention to the importance often ignored that “Learning CS with experiential methods seems to be challenging for students at a personal level, and this should be kept in mind by educators when designing them, emphasizing personalization as much as possible”.

Thus, 4 years later our cohort of first-year students is being analyzed to corroborate or not these hypotheses.

We would like to reiterate our thanks to von Widekind and Machin for their interest in our work.

Disclosure

The authors report no conflicts of interest in this communication.