Medical students' perspectives of patient-centered communication skills training during clinical education: A longitudinal mixed-methods survey study.

Objective: Using repeated measures, we examined third-year medical students' perceptions of communication skills training (CST) during clinical rotations, focusing on dimensions of patient-centered communication most salient in each subspecialty. Methods: 273 third-year students at a large Midwestern medical school completed a four-phase longitudinal mixed-methods survey. Results: By the end of their third year, students reported more confidence in their communication skills, particularly question asking and answering. They reported the most direct communication with patients and the most communication training satisfaction during emergency medicine, primary care, and family medicine rotations. These evaluations were lowest during general surgery rotations. Conclusion: Students would benefit from CST related to advanced patient-centered communication skills such as adapting to challenging interactions and remaining patient-centered within clinical time constraints. Future research can use these results to develop communication curricula that is discipline-specific, focuses on multiple dimensions of patient-centered communication, and reinforces the behaviors most salient during students' current or upcoming clinical tasks. Innovation: This study extends previous work by focusing on student-centered and discipline-specific aspects of CST. Centering the behaviors students consider most relevant is a novel approach to medical education that can increase students' attitudes toward the value of communication skills training, make them more confident, and improve care for their future patients.