Abstract
BACKGROUND: Successful doctor-patient communication is a critical component of effective medical treatment and therefore plays a crucial role already in medical training. The aim of this cross-sectional study was to employ a multi-measure approach assessing different perspectives and variables to investigate how medical students' communication performance differs across medical training (1st vs. 5th or 7th semester). METHODS: 43 medical students (1st semester: N = 23; 5th or 7th semester: N = 20) engaged in a simulated doctor-patient consultation with a standardized patient (SP) while being videorecorded. Medical students' communication quality was assessed by a communication expert and by the SP (both being blinded regarding the semester of the medical student) using standardized questionnaires (Berliner Global Rating Scale, Medical Interview Satisfaction Scale). Following our multi-measure approach, we also assessed several non-verbal parameters and variables (back-channeling, turn-taking, verbal dominance, automatic analysis of emotional facial expressions, skin conductance level). RESULTS: Analysis of non-verbal measures demonstrates that advanced students used more back-channeling, displayed more facial expressions of happiness and showed elevated skin conductance levels compared to 1st semester students. These non-verbal parameters could significantly predict the expert's communication quality assessment, explaining 31% of the variance in communication quality. As expected, the expert and SP rated the communication quality of 5th /7th semester students as significantly better compared to 1st semester students. CONCLUSIONS: We found that non-verbal parameters significantly differed between students of early vs. later stages of their medical training and were predictive of communication quality. Especially, sympathetic responsiveness - likely indicating the level of involvement - correlated with expert evaluations. These findings suggest that effective communication becomes evident across different channels and that sincere engagement into a conversation might be a requisite for successful doctor-patient communication.