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ORIGINAL ARTICLE
Year : 2016  |  Volume : 14  |  Issue : 3  |  Page : 327-331

Dental students' attitude toward learning communication skills in Bengaluru city, India


1 Department of Public Health Dentistry, Mahatma Gandhi Dental College and Hospital, Jaipur, Rajasthan, India
2 Department of Public Health Dentistry, Government Dental College and Research Institute, Bengaluru, Karnataka, India

Date of Web Publication28-Jul-2016

Correspondence Address:
Richa
Department of Public Health Dentistry, Mahatma Gandhi Dental College and Hospital, RIICO Industrial Area, Sitapura, Jaipur, Rajasthan
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2319-5932.187174

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  Abstract 

Introduction: Good communication skills can increase the health-care providers' diagnostic efficiency and decision-making ability, as well as lead to improved patient satisfaction. Aim: The aim of this study is to determine the attitude and factors associated with learning communication skills among dental students. Materials and Methods: A cross-sectional descriptive study was conducted among 400 students, studying in various dental colleges in Bengaluru, using a standardized pro forma which consisted of questions on general information, self-assessment of communication using validated Dental Communication Skills Attitude Scale. For statistical analysis, descriptive analysis, ANOVA, post hoc, and Spearman's correlation were applied. Results: Mean positive and negative attitude scores (PAS and NAS) were 50.44 ± 5.83 and 29.72 ± 4.32, respectively. There was a significant correlation of NAS with participant's poor performance in the past examination (r = 0.144, P = 0.004) and self-rating as poor communicators (r = 0.164, P = 0.001). Their consideration regarding teaching communication in dental education was significantly correlated with PAS (r = 0.257, P = 0.00) and NAS (r = −0.308, P = 0.00). Conclusion: Participant's poor performance in the past examination and self-rating as poor communicator had the negative attitude toward learning communication skills. There is a need for integrating communication skills course in the dental curriculum.

Keywords: Attitude, communication skills, dental students, India


How to cite this article:
Richa, Yashoda R, Puranik MP. Dental students' attitude toward learning communication skills in Bengaluru city, India. J Indian Assoc Public Health Dent 2016;14:327-31

How to cite this URL:
Richa, Yashoda R, Puranik MP. Dental students' attitude toward learning communication skills in Bengaluru city, India. J Indian Assoc Public Health Dent [serial online] 2016 [cited 2019 Jul 22];14:327-31. Available from: http://www.jiaphd.org/text.asp?2016/14/3/327/187174


  Introduction Top


The world of communication has transformed greatly over the centuries of humankind from sign languages, sounds, speech, development of language and in currently using machines such as the computer, mobile, and the internet. The change in communication is significant for the past five decades. Similarly, positive patient communication is always essential to build confidence, increased rapport and cooperation, and minimizes misunderstanding.[1]

According to Rollo May - “Communication leads to the community that is, to understanding, intimacy and mutual valuing. Good interpersonal communication between medical professionals and patients leads to better therapeutic outcomes, a better doctor–patient relationship, a higher patient adherence to medical advice, a higher satisfaction among patients and doctors, less burnout of medical professionals and fewer errors in treatment and fewer regresses.”[2] In dentistry, communication skills can be defined as the ability to communicate effectively with patients, use active listening skills, gather and convey information effectively, handle patients' emotions sympathetically, and demonstrate empathy, rapport, ethical awareness, and professionalism.

Evidence from the literature has shown that effective dentist-patient communication not only improves dentist-patient relationships and promotes positive health consequences, but also enhances a patient's satisfaction with the profession.[3] A fundamental idea of this framework on communication skills is that patients have better health outcomes when the provider is a good communicator; thus, the major thrust of the patient-centered principle is to encourage the development of caring oral health-care providers able to communicate their concern successfully.[4]

Dental schools in the developed and developing nations argue that communication is a core clinical skill rather than an optional curricular element and thus must be an integral part of the dental curriculum.[5] Yet, in spite of the documented advantages of having good communication skills and a call to action to improve these skills among dental students, communication skill training is not a standard in dental colleges.[6] The Dental Council of India has no specific recommendations for teaching communication skills in the undergraduate curriculum. Proficiency in communication skills, team-building skills, and global knowledge is slowly becoming an essential part of dental education in India.[7] Despite a substantial amount of literature relating to communication skills of medical students, there is a scarcity of evidence on the attitudes toward communication skills learning among dental students and especially in India.

Hence, the objectives of this study were to assess the attitude of dental students toward learning communication skills, to identify factors that may influence attitude toward learning communication skills and to suggest the inclusion of appropriate communication skill course in the dental curriculum.


  Materials and Methods Top


A cross-sectional descriptive study was conducted among dental students in Bengaluru city for the duration of 2 months from July 2013 to August 2013. Ethical approval was obtained by the Institutional Ethic Committee before commencing the study. Permission for the study was obtained from the head of the institution and informed consent was obtained from the study participants.

A pilot study was conducted among fifty dental students to assess the feasibility of the study and to determine sample size. The students who participated in the pilot were not included in the main study, and no modification was required in the questionnaire. To determine the test-retest reliability of the questions, twenty students who completed the questionnaire during the initial administration completed the questionnaire 2 weeks later and Cronbach's alpha coefficient was used to test the reliability.

The sample size was calculated as 400 dental students; 100 students, each was recruited from 3rd year, 4th year, interns, and postgraduates. Data were collected from various dental colleges of Bengaluru. Six colleges were randomly selected among all the dental colleges in Bengaluru. Students who were present on the day of study and subjects who were willing to participate were included in the study.

Before administering the questionnaire, the students were informed about the objectives of the study. They were informed that their participation was voluntary with no incentives provided. The questionnaire had two parts. The first part included demographic details and self-assessment of communication. The second part included validated Dental Communication Skills, Attitude Scale (DCSAS) questionnaire consisting 24 questions on positive and negative attitudes. DCSAS is derived from Communication Skills Attitudes Scale published by Rees and Sheard, Davies in 2002,[8],[9] which measures students' attitudes toward learning communication skills during medical school and further validated by Laurence et al. in 2012 among dental students as DCSAS.[6] Responses were rated on a 5-point Likert scale from strongly disagree, disagree, neutral, and agree to strongly agree. The questionnaire forms were kept anonymous.

The data collected was classified and tabulated in Microsoft Excel and further analyzed using Statistical Package for Social Sciences (SPSS Inc. SPSS for Windows, Version 16.0. Chicago, IL, USA) was used. The value of P value was kept at <0.05. The results were analyzed by descriptive analysis, ANOVA, post hoc, and Spearman's correlation test.


  Results Top


A total of 400 students participated in the study. For reliability analysis, Cronbach's alpha coefficient was calculated as 0.81, signifying good internal consistency. Age of the participants ranged between 18 and 39 years with 46.5% in the age range of 23–26 years. Among them, 66% were females and 34% were males. According to the Kuppuswamy socioeconomic scale,[10] most of the participants belonged to upper-middle (58.2) class followed by upper socioeconomic class (39.2%) [Table 1].
Table 1: Descriptive characteristics of the participants of the study

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Six questions were asked for self-assessment on communication. About 71.5% of the participants had the first grade in the past examination, 55.5% of the participants rated themselves good as the students and 57% of participants rated themselves good as the communicators. The importance of teaching communication in dental education was considered high by most of the participants (57.5%) and very high by 39.3% of the participants. Approximately 63% followed by 33.8% of the participants considered the importance of communication in the study of dentistry high and very high, respectively. Nearly 55% followed by 43% of participants considered the importance of communication in dental practice very high and high, respectively [Table 2].
Table 2: Distribution of participants according to self-assessment on communication

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The means of the total positive attitude score (PAS) for PG, Intern, 3rd year and 4th year were 50.77, 49.59, 50.64, and 50.76, respectively. The means of the total PAS for PG, Intern, 3rd year and 4th year were 29.51, 30.83, 29.79, and 28.74, respectively. A significant difference between the groups were found for negative attitude scale score. The post hoc test showed that negative attitude scale score for interns were significantly more than postgraduates and final year students [Table 3].
Table 3: Mean positive and negative attitude of the participants toward communication skills

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The significant positive correlation was observed for PAS with self-assessment questions as: How important do you consider teaching communication in dental education? How important do you consider communication in the study of dentistry? and How important do you consider communication in dental practice? Significant negative correlation was observed between negative attitude score (NAS) with all the self-assessment questions except how will you rate yourself as the student [Table 4].
Table 4: Correlation of positive and negative attitude scale score with self-assessment of communication

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  Discussion Top


Good dentist-patient communication is important and has multiple impacts on various aspects of oral health outcomes. The impacts include better oral health outcomes, higher compliance to therapeutic regimens in patients, higher patient and clinician satisfaction and a decline in malpractice risk. Although dental education has started to highlight the importance of communication between dentist and patient and start to include the communication skills teaching in many undergraduate and postgraduate programs, research is in its infancy in the India.[11] To the best of our knowledge, this is the first study identifying factors that may influence attitude toward learning communication skills in dental schools in India.

In this study, 96.8% of the students considered the importance of including aspects of communication into the curriculum as “high” or “very high.” This is in agreement with the study by Woelber et al. where 84% of the students considered it highly and very highly important.[2]

Mean PAS was higher and mean NAS was slightly lesser in this study than a study carried out in Malaysian dental students.[3] The present study showed that interns had a more negative attitude toward learning communication skills compared to other groups, whereas Woelber et al. reported that student's opinion was not changing between the different clinical semesters.[2] The reason could be the adoption of the biomedical model of illness during the dental training course in India which does not place much emphasis on communication skill during student training and evaluation. In this model, the emphasis is principally on disease and its management as opposed to managing the illness of the individual.[12] Hence, learning context could have a negative impact on students' attitude towards learning communication skills.

Earlier studies reported that medical students seemed to have realized the importance of communication skills training for the practice of medicine; students overall had a positive attitude toward learning communication skills, but negative attitudes were also noted. Senior students had high positive and less negative attitudes toward communication skills than junior students.[12],[13],[14]

There was the significant correlation of NAS with participant's poor performance in the past examination and self-rating as the poor communicator. Their consideration regarding teaching communication in dental education was significantly correlated with positive and negative attitude scale both. This corresponds to the study conducted by Nor NA.[3] Possible explanation of these findings is that students who had good performance in examinations and able to communicate well would be more confident and more willing to participate in the several activities and express their talent in communication. Students who have exceptional doctor–patient communication skills may regard communication skills learning as easy, common sense, and not critical as there was no examination on the subject. They have the feeling that it is “soft skill” – Can be learned easily. However, students with poor communication skills are more likely to value the opportunities offered by communication skills courses.[3]

In further studies, focus group discussions exploring the factors perceived to negative attitude can be used to reinforce the conclusions. Overall, there has been an emphasis on the need for teaching communication skills in dentistry, there is also a need for educational research evaluating the effectiveness of communication skills-based teaching programs.[5]


  Conclusions Top


Positive attitude toward learning communication skills suggests that students would agree with the affirmation that communication skills should be an integral part of the curricula. A significant number of students showed negative attitude also. Hence, efforts should be made to change this attitude. Participant's poor performance in the last examination and self-rating as poor communicator had the negative attitude toward learning communication skills. Their consideration regarding teaching communication in dental education was significantly correlated with both negative and positive attitudes.

The outcomes of this study can be used as a valuable guide in integrating the communication skill course in dental curriculum related to the dentist-patient relationship, information gathering, diagnosis, treatment, and patient education. Opportunities should be provided to learn communication skills throughout the dental course and training enhanced by conducting continuing dental education and workshops.

Acknowledgments

The authors would like to thank the principals and students of the dental schools for participating in the research project. We are grateful to them for contributing their valuable time and support to the research work.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Anbuselvan GJ, Raja S, Vilvanathan P, Megabob N, Prabhakar K. Changing concepts of positive patient communication in dentistry and orthodontics: South Indian perspective. J Pharm Bioallied Sci 2013;5 Suppl 1:S109-12.  Back to cited text no. 1
    
2.
Woelber JP, Deimling D, Langenbach D, Ratka-Krüger P. The importance of teaching communication in dental education. A survey amongst dentists, students and patients. Eur J Dent Educ 2012;16:e200-4.  Back to cited text no. 2
    
3.
Nor NA, Yusof ZY, Shahidan MN. University of Malaya dental students' attitudes towards communication skills learning: Implications for dental education. J Dent Educ 2011;75:1611-9.  Back to cited text no. 3
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Hannah A, Millichamp CJ, Ayers KM. A communication skills course for undergraduate dental students. J Dent Educ 2004;68:970-7.  Back to cited text no. 5
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Laurence B, Bertera EM, Feimster T, Hollander R, Stroman C. Adaptation of the communication skills attitude scale (CSAS) to dental students. J Dent Educ 2012;76:1629-38.  Back to cited text no. 6
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Sangappa SB, Tekian A. Communication skills course in an Indian undergraduate dental curriculum: A randomized controlled trial. J Dent Educ 2013;77:1092-8.  Back to cited text no. 7
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Rees C, Sheard C. The relationship between medical students' attitudes towards communication skills learning and their demographic and education-related characteristics. Med Educ 2002;36:1017-27.  Back to cited text no. 8
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Rees C, Sheard C, Davies S. The development of a scale to measure medical students' attitudes towards communication skills learning: the Communication Skills Attitude Scale (CSAS). Med Educ 2002;36:141-7.  Back to cited text no. 9
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Patro BK, Jeyashree K, Gupta PK. Kuppuswamy's socioeconomic status scale 2010 – The need for periodic revision. Indian J Pediatr 2012;79:395-6.  Back to cited text no. 10
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Wong SY, Lee A. Communication skills and doctor patient relationship. Med Bull 2006;11:7-9.  Back to cited text no. 11
    
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Marambe KN, Edussuriya DH, Dayaratne KM. Attitudes of Sri Lankan medical students toward learning communication skills. Educ Health (Abingdon) 2012;25:165-71.  Back to cited text no. 12
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Ihmeideh FM, Al-Omari AA, Al-Dababneh KA. Attitudes toward communication skills among Students'-Teachers' in Jordanian Public Universities. Aust J Teach Educ 2010;35:1-11.  Back to cited text no. 13
    
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Shankar P, Dubey A, Balasubramanium R, Dwivedi N. Student attitude towards communication skills learning in a Caribbean medical school. Australas Med J 2013;6:466-75.  Back to cited text no. 14
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