Effects of Education and Clinical-Training on the Recognition of Communication Skills for Physical a

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International Journal of Modern Education Forum (IJMEF) Volume 3 Issue 3, August 2014 DOI: 10.14355/ijmef.2014.0303.04

Effects of Education and Clinical-Training on the Recognition of Communication Skills for Physical and Occupational Therapists Hiroki Okuda Faculty of Health Sciences, Kinjo University, Japan okuda@kinjo.ac.jp Abstract The purpose of this investigation is to examine the effects of university education and clinical-training experience on the recognition of communication skills for medical service workers (physical therapists, occupational therapists and nurses, etc.). The participants were 90 Japanese university students. 50 of them were freshmen and the remaining 40 were seniors majoring in physical therapy. They were asked to evaluate the necessity of 144 items of communication skills for medical service workers (necessity score) on a 7-point scale (1-7). They were also asked to evaluate the degree of adequateness and skillfulness of their performance of the skills (ability score) on a 7-point scale. The items were divided into 4 groups: the basic skill item group, the specific patient item group, the difficult situation item group and the general item group. The mean ability scores of all the 4 item groups in the senior group were significantly higher than those in the freshman group (p<0.01). Various factors which influence the recognition of communication skills and the improvement of research methods were discussed.

Keywords Communication Skills; Physical Therapy; Self Evaluation

Introduction It seems that acquisition of communication skills and formation of interpersonal relations are very important for those people with much human interaction that is, medical service workers like psychological therapists, childcare workers, etc. There have been considerable researches on skills for medical service workers (e.g. physical therapists, occupational therapists and nurses etc.) to communicate with the patients receiving their therapy (the users of hospitals, social welfare facilities, etc.). However, many unclear points are still left behind.

Okuda (2011) picked up some communication skills from some papers for medical service workers to deal with their patients (Jette and Portney 2003, Kikuchi 1988, Yamada and Amano 1988, Uenura et al. 2008,).

Some items relevant to basic communication skills for

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general purpose are modified for medical service workers. The communication skill item group concerning patients who have a specific disease or a certain kind disability is also included in those items.

Moreover, the item group about communication skills in difficult situations for medical service workers is included in those items.

The purpose of this research is to investigate the effects on the recognition of communication skills after several years of education in the department of physical therapy at a private university and the effects on the same one after twenty-some weeks of clinical-training in a hospital or in a social facility, etc. for the purpose of this research, the recognition of each communication skills was compared between the freshmen and the seniors of the university.

The participants of the two groups were asked to evaluate the necessity of some communication skills for medical service workers. They were also asked to evaluate how much adequately and skillfully they would be able to perform the skills. Moreover, in order to investigate change of actual communication skills, the mean scores of the middle evaluation in the clinical training of the senior group were compared with those of the final evaluation.

Method Participants The participants were 90 Japanese private university students. 50 of them were freshmen and the remaining 40 were seniors majoring in physical therapy.

Hereinafter, the two participant groups are called freshman group and senior group. The seniors studied various kinds of expertise and technology about medical science and physical therapy at the university.

Moreover, they received clinical training in hospitals, health care facilities for the elderly and the like 20 weeks or more. The freshmen just began studying

International Journal of Modern Education Forum (IJMEF) Volume 3 Issue 3, August 2014

some fundamental subjects, like physiology and anatomy.

The purpose of this research was explained to all the participants. Moreover, they received explanations that their anonymity and their personal information would be protected, and that the collected data would be used only for the research purpose. Then the consent of the research participations was obtained.

Evaluation Item Group A total of 144 communication skill items were used in this research. The skills are used when medical service workers communicate with their patients. 18 of the items are modified for basic skills that are used in communication universally.

However, some communication skill items were somewhat changed so that medical circumstances can be reflected. Some of them are the following: "You (Medical service workers) can talk to patients fluently without silence" ,“You (Medical service workers) can tell patients what you want them to do.”, “You (Medical service workers) can join a conversation between patients friendly.” , “You (Medical service workers) can express your feelings and thoughts frankly to patients.” Hereinafter, these items are called basic skill item group.

Eight of the items are about patients with a specific disease or some kind of disability. Some of them are the following: “You (Medical service workers) can explain the location of things to visually disabled people clearly”, “You (Medical service workers) can talk slowly and clearly to people who have difficulty in hearing without raising your voice unnecessarily”.

Hereinafter, these items are called specific patient item group. 18 of the items are about situations which are very difficult for medical service workers to deal with.

Some of them are the following: “You can respond appropriately to patients who complain about doctors or other workers”, “When patients express their romantic feelings to you, you can respond appropriately”. Hereinafter, these items are called difficult situation item group.

The remaining 99 items are about various communication skills for medical service workers.

Some of them are the following: “You can greet patients in a way appropriate to the situation”, “You can behave friendly so that patients can say frankly what they think”, “You can explain disease and treatment in understandable terms for patients”.

Hereinafter, these items are called general item group.

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Evaluation Method The participants were asked to evaluate the degree of necessity of 144 items of communication skills for medical service workers. The items were evaluated on a 7-point scale (1 = entirely unnecessary, 2 = mostly unnecessary, 3 = somewhat unnecessary, 4 = neither, 5 = somewhat necessary, 6 = mostly necessary, 7 = entirely necessary).

The subjects were also asked to evaluate the degree of adequateness and skillfulness of their performance of the skills on a 7-point scale (1 = entirely impossible 2 = mostly impossible, 3 = somewhat impossible, 4 = neither, 5 = somewhat possible, 6 = mostly possible, 7 = entirely possible).

Evaluation of Clinical-training In order to investigate the change of actual communication skills, the mean scores of the middle evaluation and the one of the final evaluation about communication skills in the clinical training of the senior group were compared. The evaluation categories about the communication skills in the clinical-training were the following seven: observance of rules, action with responsibility, appropriate attire, establishment of good rapport, suitable environmental management, effective information gathering, and explanation of medical inspection and measurement.

These seven categories were evaluated on a three-grade scale by hospital clinical training supervisors (physical therapists). The top grade was converted into 7 points, the middle grade 3 points, and the bottom grade 0 points. Then the mean scores of the categories were calculated.

Result and Discussion Mean Necessity Scores of the Four Item Groups in the freshman and Senior Groups The mean scores of the degree of necessity (i.e. necessity score) of the four item groups in the two student groups were calculated (Fig. 1). A two-way ANOVA [different student group (2) x item group (4)] was conducted on the evaluation scores (1 to 7). The ANOVA revealed a significant main effect for item group, F (3, 264) = 24.49, p<0.01. However, the main effects for different student groups F(1, 88) = 1.55, and the interaction between the different student groups and the item groups, F(3, 264) = 0.87, are not significant.

The mean scores of the necessity of the four item groups descended in the following order: specific

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International Journal of Modern Education Forum (IJMEF) Volume 3 Issue 3, August 2014

patient, difficult situation, general, and basic skill.

The specific patient item group is about communication skills required only for some limited patients. The mean necessity score of this item group was expected to be low. However, it was actually highest in the four item groups. This result suggests that the participants recognize that the skills to communicate with specific patients are indispensable attributes for medical service workers.

[different student group (2) x item group (4)] was conducted on the evaluation scores (1 to 7). The ANOVA revealed a significant main effect for different student groups, F(1, 88) = 29.14 p<0.01 and the main effect for item group, F(3, 264) = 23.83, as well as significant interaction between the different student groups and the item groups, F(3, 264) = 6.48, p<0.01. A further analysis revealed a significant simple effect of the different student groups and the item groups (p<0.01).

The mean ability scores of all the four item groups in the senior group were significantly higher than those in the freshman group. This result shows that the self-evaluation of communication skills in the senior group is higher than that in the freshman group. The evaluation result of the senior group suggests that they improved their communication skills for medical service workers through some years of education in university and clinical-training in hospitals. The result must be interpreted carefully because it might result from the change of self-evaluation in the senior group.

FIG. 1 MEAN NECESSITY SCORE OF THE FOUR ITEM GROUPS IN THE FRESHMAN AND SENIOR GROUPS

The difficult situation item group showed the second highest average score. It is shows that the participants recognize that the necessity of these skills is also high even if these skills are very difficult for medical service workers. The basic skill item group showed the lowest mean score of necessity in the four item groups. The skills included in the basic skill item group are regarded as general communication skills. However, some of the skills in the basic skill item group might be inappropriate as skills for medical service workers to communicate with their patients.

In this research, the participants were asked to evaluate the necessity of the communication skills in the four item group which have different characteristics. The statistically significant differences were shown among the mean ability scores of these four item groups. However, the mean scores of the evaluation were 6.0 or more in all of the four item groups. It is necessary to reconsider the choice of skill items so that the item groups include various skills with different degrees of necessity.

Mean Ability Scores of the Four Item Groups in the Fresh and Senior Groups The mean scores of the degree of ability (i.e. ability score) of the four item groups in the two student groups were calculated (Fig. 2). A two-way ANOVA

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In both of the freshman and senior groups, the mean scores of the four item groups descend in the following order: general, specific patient, basic skill, and difficult situation. The difficult situation item group is about skills for medical service workers to deal with difficult situations. Therefore, it seems to be logically valid that the mean score of the difficult situation item group is the lowest in the four item groups.

FIG. 2 MEAN ABILITY SCORE OF THE FOUR ITEM GROUPS IN THE FRESHMAN AND SENIOR GROUPS

Mean Scores of the Middle Evaluation and the Final Evaluation in Clinical-training In order to find the actual change of the seniorsâ&#x20AC;&#x2122; communication skills, the mean scores of the middle evaluation and of the final evaluation about the seniorsâ&#x20AC;&#x2122; communication skills estimated by hospital clinical training supervisors (physical therapists) were

International Journal of Modern Education Forum (IJMEF) Volume 3 Issue 3, August 2014

compared (Fig. 3).

The mean score of the final evaluation of the six communication skill categories in clinical-training was higher than that of the middle evaluation. The appropriate attire category appears to be an exception.

This is because its score is almost full in the middle evaluation, and is difficult to improve.

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clinical-training supervisors in the middle and the end of their clinical-training.

The mean scores of all the four item groups in the senior group are significantly higher than those in the freshman group. The mean scores of the final evaluation of the six actual communication skill categories in clinical-training were higher than those of the middle evaluation.

These results show that the senior group’s communication skills required for medical service workers improved as an outcome of university education and hospital clinical training.

REFERENCES

Jette, U. Dian., Portney, G. Leslie. “Construct validation a model for professional behavior in physical therapist students. Physical Therapy 83(5), 2003: 437-443.

FIG.3 MEAN SCORE OF THE MIDDLE EVALUATION AND THE FINAL EVALUATION OF ACTUAL COMMUNICATION SKILLS

A similar kind of improvement in the evaluation scores of the communication skill categories was observed in the scores of self-evaluation of the senior group as well.

These results show that in the senior group, communication skills required for medical service workers improved as an outcome of university education and hospital clinical training.

Conclusions The freshmen and seniors majoring in physical therapy at a university were asked to evaluate the necessity and ability of 144 items of communication skills required for medical service workers.

The seniors’ actual communication skills for medical service workers were evaluated by hospital

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Okuda, Hiroki. “Desirable interpersonal skill items of physical therapists and occupational therapists (In Japanese).”Proceedings of 16th workshop of evaluation on heart and mind, (2012): 31-36.

Yamada, Yukari, Amano, Hiroshi. “Medical staffs’ cognition of difficult communication situation. –Examination for physical

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