Patient image semantics and its change in training skills in quasi professional medical activity

Dyachenko Elena V. Ural State Medical University

Samoylenko Nadezhda V. Ural State Medical University

Table 1. Patient’s image in the medical students of the 1st year before undergoing training in professional communication skills

Features of the “Patient” Image	Factor loads (loads with a weight coefficient ≥0, 50)
	Factor 1	Factor 2	Factor 3
Charming / Unattractive	-0.26	0.65	0.14
Weak/ Strong	0.56	-0.20	-0.20
Jovial/ Taciturn	-0.03	0.34	-0.25
Irresponsible / Conscientious	0.78	-0.25	-0.20
Stubborn / Agreeable	0.49	0.14	-0.54
Closed / Open	0.77	-0.05	0.002
Kind / Selfish	-0.22	0.58	0.25
Dependent / Independent	0.41	-0.11	-0.21
Active / Passive	-0.20	0.71	0.06
Callous / Responsive	0.85	-0.12	-0.03
Decisive / Indecisive	-0.18	0.60	0.23
Lethargic / Energetic	0.69	-0.41	0.004
Fair / unfair	-0.18	0.64	0.12
Relaxed / Stressful	0.20	0.38	0.72
Fussy / Calm	0.42	-0.23	-0.71
Hostile / Friendly	0.81	-0.03	-0.05
Confident / Unsure	-0.14	0.50	0.30
Unoccupied / Sociable	0.69	-0.04	0.09
Honest / Insincere	-0.32	0.49	-0.23
Non-Independent / Independent	0.70	-0.10	-0.15
Annoying / Imperturbable	0.53	-0.26	-0.55
Hard / soft	0.44	-0.02	-0.06
Rough / Gentle	0.70	-0.17	-0.26
Excitable / Calm	0.61	-0.22	-0.38
Stressful / Relaxed	0.41	-0.18	-0.59
Rational / Irrational	-0.15	0.68	0.20
Logical / Intuitive	0.03	0.64	0.19
Unique / Typical	0.22	0.44	0.01
Normal / Unusual	0.31	0.09	-0.19
Sociable / Reserved	-0.16	0.48	0.15
Friendly / Lonely	-0.31	0.59	0.27
Proud / Humble	0.55	0.19	-0.23
Difficult / Naive	0.15	0.17	-0.02
Predictable / Unpredictable	0.09	0.05	0.54
Defined / Amorphous	-0.52	0.31	0.12
Explained Variation	22%	15.1%	9.3%

NB: selection of factors rotation method: Varimax with Kaiser normalization.

Table 2. Patient’s image in the medical students of the 1st year after undergoing training in professional communication skills

Features of the “Patient” Image	Factor loads (loads with a weight coefficient ≥0. 50)
	Factor 1	Factor 2	Factor 3
Charming / Unattractive	-0.75	0.26	-0.12
Weak/ Strong	0.69	-0.16	0.08
Jovial/ Taciturn	-.470	0.18	0.33
Irresponsible / Conscientious	0.82	0.02	-0.10
Stubborn / Agreeable	0.35	0.51	0.05
Closed / Open	0.73	-0.12	-0.33
Kind / Selfish	-0.68	-0.05	-0.07
Dependent / Independent	0.38	-0.17	0.36
Active / Passive	-0.71	0.18	0.18
Callous / Responsive	0.76	0.11	0.07
Decisive / Indecisive	-0.75	0.20	0.19
Lethargic / Energetic	0.73	-0.19	0.04
Fair / unfair	-0.77	0.06	0.005
Relaxed / Stressful	-0.67	-0.21	0.05
Fussy / Calm	0.73	0.18	0.35
Hostile / Friendly	0.78	0.07	0.21
Confident / Unsure	-0.76	0.12	-0.02
Unoccupied / Sociable	0.72	-0.01	-0.13
Honest / Insincere	-0.76	0.10	0.22
Non-Independent / Independent	0.68	-0.02	0.27
Annoying / Imperturbable	0.71	0.23	0.31
Hard / soft	0.12	0.64	0.14
Rough / Gentle	0.62	0.25	0.19
Excitable / Calm	0.71	0.43	0.11
Stressful / Relaxed	0.69	0.41	0.18
Rational / Irrational	-0.74	0.01	0.30
Logical / Intuitive	-0.58	0.01	0.09
Unique / Typical	-0.29	0.67	-0.19
Normal / Unusual	-0.004	-0.53	0.49
Sociable / Reserved	-0.74	0.16	0.28
Friendly / Lonely	-0.77	0.01	0.26
Proud / Humble	0.45	0.48	0.22
Difficult / Naive	-0.17	0.53	-0.25
Predictable / Unpredictable	-0.02	-0.36	0.56
Defined / Amorphous	-0.63	0.16	0.08
Explained Variation	41%	9%	5.40%

NB: selection of factors rotation method: Varimax with Kaiser normalization.

Table 3. Comparative analysis using t-Student

Category	t-empirical (with t-critical 1.99) p=0.05		Category	t-empirical (with t-critical 1.99) p=0.05		Category	t-empirical (with t-critical 1.99) p=0.05
	Mean			Mean			Mean
	before	after		before	after		before	after
Stubborn / Agreeable	t-empirical 1.51		Organised	t-эмпирич. 0.33		Prudent	t-эмпирич. 1.70
	-1.1	0.24		-0.75	0.52		-1.20	-0.51
Dependent / Independent	t-empirical 1.18		Selfish	t-empirical 0.96		Disorganised	t-empirical 0.46
	1.12	0.25		-0.45	-0.92		0.86	-1.62
Annoying / Imperturbable	t-empirical 1.74		Self-critical	t-empirical 0.48		Optimistic	t-empirical 0.51
	-0.18	0.16		0.37	-0.39		-0.51	0.78
Stressful / Relaxed	t-empirical 1.37		Hardworking	t-empirical 0.28		Thin	t-empirical 1.09
	-0.45	-0.09		-0.35	0.42		-0.77	-0.58
Proud / humble	t-empirical 0.24		Experienced	t-empirical 0.69		Cold	t-empirical 1.78
	0.42	0.17		-0.62	-0.13		0.05	-0.97
Kind	t-empirical 0.12		Vile	t-empirical 1.58		Inexperienced	t-empirical 1.98
	0.73	0.54		-0.21	-2.23		1.31	-0.42
Sociable	t-empirical 1.04		Tough	t-empirical 0.16		Natural	t-empirical 0.12
	-0.75	0.73		-0.88	-0.27		0.30	0.98
Honest	t-empirical 0.50		Charming	t-empirical 1.43		Mobile	t-empirical 1.27
	-0.43	0.89		-0.62	-0.18		0.24	0.29
Active	t-empirical 0.53		Benevolent	t-empirical 0.96		Witty	t-empirical 0.17
	0.07	0.50		-0.18	0.87		0.38	-0.04
Clever	t-empirical 0.63		Flexible	t-empirical 0.21		Erudite	t-empirical 0.55
	-1.39	0.17		-0.02	0.08		-1.38	0.41
Open	t-empirical 0.06		Poetic	t-empirical 0.92		Unfriendly	t-empirical 1.97
	-1.43	0.82		-1.86	-0.79		-0.71	-1.58
Stupid	t-empirical 0.67		Saboteur	t-empirical 1.77		Nonchallant	t-empirical 0.27
	-0.01	-0.54		-1.86	-2.21		-0.98	-1.08
Strong	t-empirical 0.24		Pretty	t-empirical 0.49		Изворотливый	t-empirical 0.20
	0.70	-0.04		0.18	-0.37		-0.06	-1.05
Simple	t-empirical 0.47		Connoisseur	t-empirical 0.44		Meticulous	t-empirical 1.91
	0.63	0.59		-0.57	0.10		-0.33	-1.57

References

Aper L., Veldhuijzen W., Dornan T., van de Ridder M., Koole S., Derese A., & Reniers J., (2015). ‘‘Should I prioritize medical problem solving or attentive listening?’’: The dilemmas and challenges that medical students experience when learning to conduct consultations. Patient Education & Counseling, 98, 77–84. doi:10.1016/j.pec.2014.09.016

Artemyeva E.Yu. (1999). Bases of the psychology of subjective semantics. Moscow, Nauka, Smysl.

Artemyeva E.Yu. & Strelkov Yu.K. (1988).The professional component of the image of the world. In: [Myshlenie, obshchenie: aktivnoe vzaimodeystvie s mirom], Yaroslavl, 5–65.

Basalaeva N.V. (2006). Sense production in quasi-professional activity: Ph.D. in Psychology, Thesis. (Astafyev Krasnoyarsk State Teacher-Training University). Barnaul.

Bombeke K., van Roosbroeck S., de Winter B., Debaene L., Schol S., van Hal G., & van Royen P. (2011). Medical students trained in communication skills show a decline in patient-centred attitudes: an observational study comparing two cohorts during clinical clerkships. Patient education & counseling, 84(3), 310–318. doi:10.1016/j.pec.2011.03.007

Bottaev N.A., Gorina K.A., Gribkov D.M., Davydova N.S., Dyachenko E.V. , Kovtun O.P., Makarochkin A.G., Popov A.A., Samoilenko N.V., Sizova Zh.M., Sonkina A.A., & Teplyakova O.V. et al. (Eds.) (2018). Effective communication skills for patient-oriented medical care: a scientific and methodological publication. Moscow, ROSOMED.

Cushing A.M. (2015). Learning patient-centred communication: The journey and the territory. Patient education & counseling, 98(10), 1236–1242. doi:10.1016/j.pec.2015.07.024

Dyachenko E.V., Noskova M.V., Shikhova E.P., Kropaneva E.M., Kazaeva A.V., Samoilenko N.V., & Andrega D.S. (2017). Innovative competence-oriented forms of training: the experience of the Department of Psychology and Pedagogy, the Ural State Medical University. [Vestnik Ural’skogo gosudarstvennogo meditsinskogo universiteta], 3, 10–14.

Dyachenko E.V. & Samoilenko N.V. (2019). The patient’s image in the students of a medical university: Proceedings of the International Youth Scientific Forum LOMONOSOV-2019. Moscow, MAKS Press, 1 electronic optic disk (CD-ROM). ISBN 978-5-317-06100-5

Dyachenko E.V., Sizova Zh.M., & Davydova N.S. et al. Federal pilot: assessment of communication skills during the initial accreditation of a specialist. [Rezul’taty, itogi 9oy Mezhdunarodnoy konferentsii «ROSMEDOBR-2018: Innovatsionnye obuchayushchie tekhnologii v meditsine», Moskva, 11–12 oktyabrya 2018 g.] Retrieved from: https://rosomed.ru/conferences/40#theses/ (accessed: 11/08/2019).

Fritsko Zh.S. (2007). Design activity as a means of methodological skills in learning a foreign language in students of a teacher training college: Ph.D. in Pedagogy, Thesis. Ekaterinburg.

Ginzberg E., Ginsburg S.W., Axelrad S., & Herma J.L. (1951). Occupational choice: An approach to general theory. N.Y.: Columbia University Pressю

Hafferty F., & Franks R. (1994). The hidden curriculum, ethics teaching, and the structure of medical education. Acad. Med., 69, 861–71. doi:10.1097/00001888-199411000-00001

Harden R.M., Stevenson M., Downie W.W., & Wilson G.M. (1975). Assessment of clinical competence using objective structured examination. Br. Med. J., 1(5955), 447–451. doi:10.1136/bmj.1.5955.447

Khanina I.B. (2009). The image of the world and the professional world. [Mir psikhologii]. 4, 179–187.

Khanina I.B. (2011). The professional world as a system of relations [Mir psikhologii], 4, 218–228.

Khanina I.B. (2015). Psychological features of the doctor’s personality: proceedings of the anniversary conference. [Ot istokov k sovremennosti 130 let organizatsii psikhologicheskogo obshchestva pri Moskovskom universitete]. In 5 volumes. 206–208.

Kurtz S., Silverman J., & Draper J. (2013). Teaching and learning communication skills in medicine, CRC press, NY, 369.

Klimov E.A. (1995). The image of the world in diverse professions: Textbook. Moscow.

Leontiev A.N. (1983). Selected psychological works. In 2 volumes. Vol. 2. Moscow, Pedagogika.

Leontiev D.A. (2003). Psychology of meaning: nature, structure and dynamics of semantic reality. Moscow, Smysl.

Petrenko V.F. (1997). Bases of psychosemantics: textbook. allowance. Moscow, Izdatel’stvo Moskovskogo Universiteta.

Putnam S. S., & Lipkin M. (1995). The patient-centered interview: Research Support. The Medical Interview. New York: Springer-Verl.Resolution of the 7th All-Russian Congress of Patients (Electronic Resource). [Vserossiyskiy Soyuz patsientov. Zdorov’e dlya vsekh!]. Retrieved from: http://www.patients.ru/kongress/vii-vserossiyskiy-kongress-patsientov-rezoliutsii/rezoliutsiia-vii-kongressa-patsientov (accessed 08.25.2019).

Rosenbaum M.E. & Axelson R. (2013). Curricular disconnects in learning communication skills: what and how students learn about communication during clinical clerkships. Patient education & counseling, 91(1), 85–90.

Samoilenko N.V. & Dyachenko E.V. (2019). Simulation educational technology “Standardized Patient” for teaching clinical communication skills at a medical university: materials of the 15th International Scientific and Practical Conference. [Akmeologiya professional’nogo obrazovaniya : sbornik], 268–271.

Serkin V.P. (2004). Methods of psychosemantics: textbook for university students. Moscow, Aspekt Press.

Serkin V. P. (2008). Methods of psychology of subjective semantics and psychosemantics: a textbook for universities. Moscow, Pchela.

Silverman J., Kertz S., & Draper J. (2018). Communication skills used with patients. Moscow, GRANAT.

Silverman J. (2009). Teaching clinical communication: a mainstream activity or just a minority sport? Patient Education and Counseling, 76(3), 361–367. doi:10.1016/j.pec.2009.06.011

Silverman J., Draper J., & Kurz S. (2013). Skills for Communicating with patients. Oxford University Press, 3ed.

Smirnov S.D. (1985). Image psychology: issues of mental reflection. Moscow, MGU.

Smith S., Hanson J.L., Tewksbury L.R., Christy C., Talib N.J., Harris M.A., Beck G.L., & Wolf F.M. (2007). Teaching patient communication skills to medical students: a review of randomized controlled trials. Eval. HealthProf. 30(1), 3–21. doi:10.1177/0163278706297333

Smith S., Hanson J.L., Tewksbury L.R., Christy C., Talib N.J., Harris M.A., Beck G.L., & Wolf F.M. (2007). Teaching patient communication skills to medical students: a review of randomized controlled trials. Eval. HealthProf. 30(1), 3–21. doi:10.1177/0163278706297333

Sobchik L.N. (2016). The colour picking method is a modification of the eight-colour Luscher test: practical guide. St. Petersburg, Rech’