Medical Students' Attachment Style, Emotional Intelligence and Communication Skills with Simulated Patients

Introduction: Research has linked attachment (an emotional bond between 2 individuals based on the mutual expectation of provision of care and protection in times of need1) and emotional intelligence (EI) (a type of social intelligence, involving the ability to monitor, discriminate between and use emotions to guide thinking and actions2) to effective patient-provider communication (PPC). Findings suggest that clinicians’ attachment style influences how they respond to and communicate patients’ needs3 and that high EI is associated with the competency of interpersonal and communication skills, with doctors’ EI being 1 explanation as to the variation in PPC.4 Research has linked attachment style to EI and related communication; including interpersonal skills, deficits in expressivity and disclosure,5 conversational regulation6 and interpersonal sensitivity.1 This study assesses these interactions in first year medical students. Research Questions: 1 Is there a relationship between attachment and EI in first year medical students? 2 Does this relationship influence coded video communication scores in an OSCE? Summary of Work: First year medical students at the University of Liverpool (n = 350) were asked to complete a measure of EI (MSCEIT7) and attachment (ECR-SF8), and were videoed in a 5minute communication skills summative OSCE. Communication was rated with the Verona VR-CoDES9 which identifies patient emotional cues/concerns and students’ associated responses. Analysis: 44.4% of students (n = 156/N = 351) participated. The 3 / 7 mean number of emotional cues/concerns elicited per OSCE was 7.16, with 65.73% of student responses allowing further disclosure of the emotion. Students reported a mean EI score of 83.6, and EI was correlated with both relationship avoidance (-0.307, P < 0.000) and relationship anxiety (-0.182, p.001). The majority of students (54.4%) reported both low relationship anxiety and avoidance, which was associated with significantly higher EI (P < 0.000), and a higher number of cues and concerns elicited (P < 0.009). Discussion and Conclusion: This study found a clear link between attachment and EI in first year medical students, which influenced students’ responding to patients’ emotive cues/concerns. This provides insight into the mechanisms by which medical students communicate with emotive patients, and offers a framework for the integration of feedback of communicative strengths and weaknesses into the curriculum using individual characteristics. The current method of assessing communication skills is largely reliant on simulated patient encounters. Previous research has suggested a relationship between EI and patient outcomes,10 therefore it would be beneficial to further explore the relationships between EI, attachment and communication found in this study during ‘real life’ PPC.