The CSAS in context: a commentary on its application and cultural challenges

Abstract Background The Communication Skills Attitude Scale (CSAS) is a key tool for assessing medical students’ attitudes toward learning communication skills, which significantly influence their clinical communication behaviors. Methods We reviewed literature on the development, cross-cultural adaptation, and application of the CSAS across different countries. Results The CSAS demonstrates good reliability and validity as the most widely used instrument in this field. Its two-factor structure has been adapted into multidimensional models in various contexts. However, its application is influenced by linguistic, pedagogical, and participant-related factors. Conclusions Despite its widespread use, careful attention to cross-cultural validation and methodological limitations is essential. Future longitudinal and qualitative studies will help optimize its application in medical education.