IDENTIFICATION OF COMMUNICATION APPREHENSION IN MEDICAL-STUDENTS STARTING A SURGERY ROTATION

BACKGROUND: Most methods used to critically evaluate young surgeons fo r advancement or certification in surgery require oral communication s kills, eg, case and research presentations, rounds, morbidity and mort ality conferences, interviews, journal clubs and oral examinations. Th e irony, though, is that much of surgery training focuses on technical skill lists, and the rhetorical aspects are often neglected until the surgeon encounters failure in an oral examination or is sued for not ''talking'' appropriately. Early identification of those at risk for d ifficulty with oral skills would provide programs with time needed to arrange for the appropriate types of;interventions. Therefore, the pur pose of this study was to identify those medical students with high co mmunication apprehension scores in dyadic, group, or public speaking s ituations before they encountered failure and caused problems, not onl y for themselves, but also for their programs and practices. METHODS: TWO scales, Willingness to Communicate (WTC) and the Personal Report o f Communication Apprehension (PRCA-24), were administered to medical s tudents at two large university medical centers during new student ori entation to the surgery rotation. The WTC is a 20-item probability-est imate scale designed to measure one's predisposition toward approachin g or avoiding the initiation of communication. The PRCA-24 is a scale designed to measure one's fear associated with either real or anticipa ted communication in four different contexts. In addition to the 44 it ems, a lengthy list of demographic items was added for possible correl ations. These items were based on the student's perception of the comm unication or language environment in which he was raised. Therefore, a student ranked past and future socioeconomic status (eg, blue collar or white collar) according to his or her own criteria. The chairman wa s provided with a list of individual scores. Those students who were b elow the group means on skills required during a surgery rotation were identified for immediate intervention. RESULTS: The published data sh ow a norm mean of 65.6 for PRCA-24 and 65.2 for WTC for college studen ts. The current study found medical students to be more willing to com municate (WTC) and less anxious about communication (PRCA-24) than col lege students (mean 70.7 versus 65.2, P = 0.003, and 61.6 versus 65.6, P = 0.01, respectively). This difference was accentuated for blue-col lar medical students compared with college students and persisted when blue-collar medical students were compared with white-collar medical students (73.9 blue-collar versus 70.9 college students, P = 0.15 for WTC, and 58.5 blue-collar versus 63.6 white-collar, P = 0.002 for PRCA -24). Male medical students were found to be less anxious about commun ication than female medical students. CONCLUSIONS: These instruments a re easily administered at orientation and produce simple class lists w ith individual scores. They can be used to identify students who are b elow the mean for specific forms of communication before they encounte r failure. (C) 1998 by Excerpta Medica, Inc.