Medical student perceptions of establishing effective clinical communication: a qualitative study

High-quality delivery of healthcare requires effective communication between patients and providers. Clinical communication has been a priority in medical education for decades, yet studies continue to show that trainees and providers struggle to communicate effectively in real and simulated clinical scenarios. Many have investigated potential methods to improve the initial acquisition, long-term retention, and holistic evaluation of clinical communication competency in medical trainees. However, there has been a lack of rigorous qualitative research investigating the medical student perspective on this process. This study aimed to identify medical student perceptions of what factors may influence effective clinical communication and how those factors evolve with time. Twenty-two medical students were interviewed between August 2021 and May 2022 at the University of Mississippi Medical Center. Their interviews were transcribed and analyzed using deductive, inductive, and categorical coding methods to construct themes. These themes identified six influencing factors (personal identity; biases and assumptions; norms and expectations; language; episodic contexts; and comfort and trust) and one impact (evolution of personal identity). The relationships between these themes enabled the researchers to establish a preliminary model that demonstrates how medical students believe effective clinical communication occurs. Medical educators may use this model to develop innovative curricular objectives, assessment methods, and teaching strategies that might improve student's acquisition and demonstration of effective clinical communication. These improvements may be most beneficial for students who face minority stress, as well as those combating oppressive systems based on the complex relationships between their multiple minority identities.