The influence of medical student’s attachment orientation on their ability to respond to simulated patient and patient emotional distress.

Introduction: Attachment theory has been widely advocated as an important and influential theory providing insight into important aspects of interpersonal relationships and clinical communication. Despite this little research has explicitly explored the relationship between medical student’s attachment orientation and specific clinical communication skills with simulated patients and patients. The aim of this presentation is to explore the relationship between medical students attachment orientation (anxious & avoidant) and their ability (or willingness) to respond to simulated patient & patient distress (VR-CoDES). Methods: A cohort of consenting 4th year medical students (n=37) were videoed in a final summative 10 minute communication skills examination with a simulated patient (OSCE). The students also completed a self reported attachment questionnaire before the OSCE (Relationship Styles questionnaire). In the following year (5th year) the students were also videoed conducting consultations with several patients each (2 to 6) in Primary care. 138 consultations were video recorded. All OSCE & Primary care consultations videos were viewed and rated with the Verona Consensus Coding Scheme. Results: Descriptive and inferential analysis will be presented. Preliminary analysis has revealed a significant relationship between medical student’s attachment avoidance and their ability to respond to patient emotional distress. Upon verification and further analysis these results will be presented in more detail. 3 / 7 Discussion The interpretation and discussion of the findings will pay particular attention to the context of teaching and assessing communication, emphasising the transition from medical school to Primary care. The presentation will also critically examine the usefulness of attachment theory as a construct for the teaching and learning of medical students clinical communication skills. This is especially relevant given the lack of research exploring the relationship between attachment theory and medical student responsiveness to patient distress. 1. Ciechanowski PS, Walker EA, Katon WJ, Russo JE: Attachment theory: a model for health care utilization and somatization. Psychosom Med 2002, 64(4):660-7. PubMed Abstract | Publisher Full Text Return to text 2. Hunter JJ, Maunder RG: Using attachment theory to understand illness behavior. Gen Hosp Psychiatry 2001, 23(4):177-82. PubMed Abstract | Publisher Full Text Return to text 3. Eells TD: Attachment theory and psychotherapy research. J Psychother Pract Res 2001, 10(2):1325. PubMed Abstract | Publisher Full Text Return to text 4. Ciechanowski PS, Katon WJ, Russo JE, Walker EA: The patient-provider relationship: attachment theory and adherence to treatment in diabetes. Am J Psychiatry 2001, 158(1):29-35. PubMed Abstract | Publisher Full Text