Communication skills training: effects on attitudes toward communication skills and empathic tendency.

OBJECTIVE: This study explored and compared medical students' attitudes toward communication skills and empathic tendency before and after communication skills training. METHODS: Fifty-nine first-year students voluntarily completed a questionnaire consisting of the Communication Skills Attitudes Scale and the Empathic Tendency Scale before and after training. K-means cluster analysis and Student's t-test were used for statistical analysis. RESULTS: In the pre-test, 49% of the students had positive attitudes toward communication skills learning and 59% had higher empathic tendencies. In post-test, the mean score in the positive attitude group decreased significantly, whereas there was no change in the negative attitude group. In the high empathy group, empathy scores did not change significantly after training; however, in the low empathy group, empathic tendency significantly increased. DISCUSSION: As students' low empathic tendency level became higher and positive attitudes toward communication skills learning significantly changed in a negative direction after training, we observed that our training programme seems to have an effect that makes students similar to each other in terms of their empathic tendency and attitudes toward communication skills learning. Women had more positive attitudes toward communication skills and their empathic tendencies were higher than men's. CONCLUSIONS: Our findings suggest that our curriculum is in need of further examination and modification. Future studies with larger samples are needed to investigate the effects of communication skills training on students' attitudes.

Effect of extracorporeal shockwave lithotripsy on plasma and urine endothelin concentrations.

Since the first reports of extracorporeal shockwave lithotripsy (SWL), there have been increasing numbers of articles in the literature documenting renal blood flow impairment and blood pressure elevation as complications. However, little is known about the pathophysiology and prevention of these complications. In this prospective study, the influence of high-energy shockwaves on plasma and urine endothelin concentrations was investigated in 20 patients with renal stones. The patients were randomly assigned to receive a calcium channel blocker, 10 mg of nitrendipine (Bypress; Bayer) (N = 10) 2 hours before SWL or no medication (control group; N = 10). Blood samples were taken just before and 1 minute after application of 3000 shocks. Urine samples were collected by ureteral catheters. The plasma endothelin-1 concentrations were significantly elevated after SWL in the control group (P = 0.003). On the other hand, nitrendipine significantly reduced plasma endothelin concentrations after SWL (P = 0.003). No significant change was observed in urine samples and blood pressure measurements. These results suggest that endothelin release after SWL may be a cause for lithotripsy-induced hemodynamic changes. Medical prevention with calcium channel blockers warrants further investigation.