Introduction of Module-based Training on Communication Skills among Interns in a Tertiary Care Teaching Hospital of Kolkata, India

Abstract

Introduction: Many of the problems in Indian healthcare settings resulting in mistrust, violence, allegations and litigations against doctors can be solved by effective communication between doctors and patients or their relatives. Interaction of the students as a community physician needs training in communication skills. A structured module-based training on communication skills during internship will help the interns to communicate effectively with patients and their relatives. Aim: To develop, introduce and evaluate a structured, validated module on communication skills for interns in a Tertiary Care Teaching Hospital of Kolkata, India. Materials and Methods: A quasi-experimental, prospective, non randomised educational intervention study was conducted in the Department of Community Medicine at Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India, from January 2020 to December 2020. A structured and validated module for teaching communication skills to interns was used to train one batch of interns posted (n=40) in the department, over two days. To establish the content validity of the module, the items on content validation were rated on a scale of 1-4 by 10 experts. The validators were asked about their responses favoring face validity of the module and the average of their responses were calculated. Post-training their knowledge, skills and self-reported efficacy were assessed. Feedback from the faculty (n=6), and the interns (n=40) were collected using structured survey forms with likert scale ratings and open-ended questions. The trained cohort of interns was also assessed on communication using the SEGUE (Set the stage, Elicit information, Give information, Understand the patient's perspective, and End the encounter) Framework during patient encounter. Results: Post-training knowledge score (16.68±2.5) was significantly higher than the pre-training score (15.45±2.9). Also, there was significant increase in self-assessed knowledge (11.08±3.7 and 17.23±3.3) and skills (9.60±4.6 and 16±2.9) before and after the training. All the interns had positive attitude towards communication skill on the Communication Skills Assessment Scale (CSAS). The mean score of interns on assessment using the SEGUE framework was 16.6±3.59. The satisfaction index of the items on the feedback survey obtained from interns ranged from 82.5% to 93%. There was 100% agreement by the faculty on the relevance, usefulness and use of the module by other departments for communication skill training. More faculty involvement and more such sessions were suggested by both groups as evident from thematic analysis of open-ended responses to the feedback questsions. Conclusions: The development and delivery of a structured training module on communication skills for interns improved the knowledge and skills of the interns. Both the faculty and the interns were satisfied with the module.