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Article
Tracing the evolution of chiropractic students’ confidence in clinical and patient communication skills during a clinical internship: a multi-methods study
BMC Medical Education
  • Mark Hecimovich, Murdoch University
  • Simone Volet, Murdoch University
Document Type
Article
Abstract

Background: Anecdotal evidence points to variations in individual students’ evolving confidence in clinical and patient communication skills during a clinical internship. A better understanding of the specific aspects of internships that contribute to increasing or decreasing confidence is needed to best support students during the clinical component of their study.

Methods: A multi-method approach, combining two large-scale surveys with 269 students and three in-depth individual interviews with a sub-sample of 29 students, was used to investigate the evolution of change in student confidence during a 10-month long internship. Change in levels of confidence in patient communication and clinical skills was measured and relationship to demographic factors were explored. The interviews elicited students’ accounts and reflections on what affected the evolution of their confidence during the internship.

Results: At the start of their internship, students were more confident in their patient communication skills than their clinical skills but prior experience was significantly related to confidence in both. Initial confidence in patient communication skills was also related to age and prior qualification but not gender whilst confidence in clinical skills was related to gender but not age or prior qualification. These influences were maintained over time. Overall, students’ levels of confidence in patient communication and clinical skills confidence increased significantly over the duration of the internship with evidence that change over time in these two aspects were inter-related. To explore how specific aspects of the internship contributed to changing levels of confidence, two extreme subgroups of interviewees were identified, those with the least increase and those with the highest increase in professional confidence over time. A number of key factors affecting the development of confidence were identified, including among others, interactions with clinicians and patients, personal agency and maturing as a student clinician.

Conclusion: This study provides insight into the factors perceived by students as affecting the development of professional confidence during internships. One particularly promising area for educational intervention may be the promotion of a pro-active approach to professional learning.

Department
School of Kinesiology, Allied Health, and Human Services
Comments

First published in BMC Medical Education, v. 12 n. 42 (2012), published by BioMed Central. DOI: 10.1186/1472-6920-12-42

Original Publication Date
1-1-2012
DOI of published version
10.1186/1472-6920-12-42
Repository
UNI ScholarWorks, University of Northern Iowa, Rod Library
Date Digital
2012
Copyright
©2012 Mark Hecimovich and Simone Volet
Creative Commons License
Creative Commons Attribution 4.0
Language
EN
File Format
application/pdf
Citation Information
Hecimovich and Volet: Tracing the evolution of chiropractic students’ confidence in clinical and patient communication skills during a clinical internship: a multi-methods study. BMC Medical Education 2012 12:42.