Communication skills are essential in a patient-centred health service and therefore in medical teaching. Although significant differences in communication behaviour of male and female students are known, gender differences in the performance of students are still under-reported. The aim of this study was to analyse gender differences in communication skills of medical students in the context of an OSCE exam (OSCE = Objective Structured Clinical Examination). In a longitudinal trend study based on seven semester-cohorts, it was analysed if there are gender differences in medical students’ communication skills. The students (self-perception) and standardized patients (SP) (external perception) were asked to rate the communication skills using uniform questionnaires. Statistical analysis was performed by using frequency analyses and t-tests in SPSS 21. Across all ratings in the self- and the external perception, there was a significant gender difference in favour of female students performing better in the dimensions of empathy, structure, verbal expression and non-verbal expression. The results of male students deteriorated across all dimensions in the external perception between 2011 and 2014. It is important to consider if gender-specific teaching should be developed, considering the reported differences between female and male students.

Patient-Centered Innovations, Education and Technology for Cancer Care and Cancer Research

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: The most frequent malignant disease in women is breast cancer. In the metastatic setting, quality of life is the primary therapeutic goal and systematic treatment has only limited effect on survival rates; therefore, the concept of Health-related Quality of Life (HRQoL) and measurement of Patient Reported Outcomes (PRO) is gaining more and more importance in the therapy setting of diseases such as breast cancer. One of the frequently used questionnaires for measuring HRQoL in breast cancer patients is the Functional Assessment of Cancer Therapy - Breast (FACT-B). Currently, paper-based surveys still predominate as only a few reliable and validated electronic-based questionnaires are available. EPRO tools of the FACT-B questionnaire with proven reliability are missing so far. Objective: The aim of this study was to analyze the reliability of tablet-based measurement of FACT-B in German language in adjuvant (curative) and metastatic breast cancer patients. Methods: Paper- and tablet-based questionnaires were completed by a total of 106 female adjuvant and metastatic breast cancer patients, recruited as part of the ePROCOM and PEPPER study. All patients were required to complete the electronically based (ePRO) and paper-based version of the FACT-B. A frequency analysis was performed to determine descriptive sociodemographic characteristics. Both dimensions of reliability [parallel forms reliability (Wilcoxon test) and test of internal consistency (Spearman’s rho)] and agreement rates for single items, Kendall’s tau for each subscale and total score were analyzed. Results: High correlations were shown for both dimensions of reliability (parallel forms reliability and internal consistency) in the patient’s response behavior between paper-based and electronically based questionnaires. Regarding the reliability test of parallel forms no significant differences were found in 35 of 37 single items, while significant correlations in the test for consistency were found in all 37 single items, in all 5 sum individual item subscale scores, as well as in total FACT B score. Conclusions: The ePRO version of the FACT-B questionnaire is reliable for breast cancer patients in both the adjuvant and metastatic setting, showing highly significant correlations with the paper-based version in almost all questions all subscales and the total score.

Introduction: When cancer patients have advanced disease and a primary cure is no longer possible, the focus is on maintaining the patientʼs quality of life. Recent therapeutic advances in breast cancer treatment mean that even patients with metastatic disease can remain stable for long periods of time. The aim of this study was to look at the health-related quality of life (HRQL) of these patients and compare it with data for the general population and to show the differences in outcomes for different survey instruments used to measure quality of life. Material and Methods: A total of 96 breast cancer patients with metastatic disesae or receiving adjuvant therapy were questioned about their quality of life. Patients were investigated using the established survey instruments EORTC QLQ-C30, EORTC QLQ-BR23, EQ-5D-5L and EQ VAS. All patients filled out questionnaires. Statistical analysis was done using MS Excel and SPSS. Results: Although the questionnaires were completed at the same time, the different questionnaires showed significant differences with regard to the level of stress experienced by the patient. When the EQ VAS questionnaire was used, the patientʼs current state of health was assessed as significantly better than with the EORTC QLQ-C30. Overall, all aspects of patientsʼ quality of life were found to be in need of optimization and HRQL of patients was significantly poorer in all areas compared to the reference population. Conclusion: To improve the quality of life of patients with metastatic disease, it is necessary to continuously monitor the success of therapy. The choice of survey tools is highly relevant as assessments differ considerably depending on the choice of questionnaire. Einleitung: Liegt bei einer Krebserkrankung bereits ein fortgeschrittenes Stadium vor und ist somit eine primäre Heilung nicht mehr möglich, steht die Erhaltung der Lebensqualität im Fokus. Gerade beim Mammakarzinom sind durch die verbesserten neuen Therapien auch im metastasierten Stadium noch längere stabile Verläufe möglich. Ziel dieser Studie war es deshalb, einerseits die Lebensqualität der Patientinnen durch einen Vergleich mit Daten der Gesamtbevölkerung darzustellen und andererseits Unterschiede zwischen den verschiedenen Erhebungsinstrumenten aufzuzeigen. Material und Methoden: Insgesamt wurden n = 96 Brustkrebspatientinnen in metastasierter oder adjuvanter Situation hinsichtlich ihrer Lebensqualität befragt. Dabei kamen die etablierten Erhebungsinstrumente EORTC QLQ-C30, EORTC QLQ-BR23, EQ-5D-5L und EQ-VAS zum Einsatz, wobei alle Patientinnen alle Bögen ausfüllten. Die statistische Analyse erfolgte mittels MS Excel und SPSS. Ergebnisse: Obwohl die Bögen zum gleichen Zeitpunkt ausgefüllt wurden, zeigten sich deutliche Unterschiede im Belastungsniveau in Abhängigkeit zum angewandten Bogen. Beim Einsatz des EQ VAS wurde der aktuelle Gesundheitsstatus signifikant besser beurteilt als beim EORTC QLQ-C30. Insgesamt gestaltete sich die Lebensqualität der Patientinnen in allen Dimensionen als optimierungsbedürftig und war in allen Bereichen signifikant schlechter als in der Referenzbevölkerung. Schlussfolgerung: Um die Lebensqualität von metastasierten Patientinnen zu verbessern, ergibt sich die die Notwendigkeit des beständigen Therapieerfolg-Monitorings. Von Relevanz ist die Wahl des Erhebungsinstruments, da in Abhängigkeit vom Erhebungsinstrument unterschiedliche Werte ermittelt wurden.

Background: As good communication skills are crucial for doctor-patient interactions, it is recommended to incorporate them in medical school programs from the very beginning. On this basis medical schools in Germany introduced the OSCE (objective structured clinical examination) to examine and by this foster learning of communication skills as assessment drives learning. The aim of the study was to examine the development of the communication skills of medical students during an OSCE to investigate how communication competence has developed between different student cohorts.Methods: This study is a longitudinal trend study based on seven semester-cohorts, examining the communication skills of medical students in the OSCE both from the perspective of students and from the viewpoint of standardized patients (SP). Altogether, 1027 students from seven semester cohorts were asked to rate their own communication skills (self-perception) before the OSCE exam started. Here, sub-analyses were performed to outline a potential influence of previous history-taking group participation. The SP evaluated the students’ communication skills in external perception during the OSCE exam at each station with history-taking or physical examinations. The communication skills in both groups were ascertained in the dimensions of empathy, content structure, verbal expression, and non-verbal expression.Results: Only in the dimension of non-verbal expression could a statistically significant change be found in students’ self-perception over the years. Notably, the rating of communication skills as self-rated by the students has risen constantly, whereas they deteriorated from the perspective of standardized patients (SP). It has also been found that previous history-taking courses have a positive influence on the structural dimension of communication skills in particular.Conclusions: The results of this study support conclusions of other studies which also suggest differences between self- and external perception of medical students’ communication skills. Nevertheless, students showed good overall communication skills in the four dimensions of empathy, content structure, verbal expression, and non-verbal expression, as demonstrated in a longitudinal trend study over seven semesters. However, we noted that externally rated empathy levels declined over the semester cohorts, suggesting the need for new priorities to be set in student teaching.