Communication skills in value-based medical training First-semester students' perceptions and their impact on the doctor-patient relationship.

Abstract

Introduction: Value-Based Healthcare (VBHC) prioritizes outcomes that impact patients' lives and demands high-precision clinical communication. These skills are decisive for treatment adherence, shared decision-making, and system efficiency. Despite their relevance, they are often overlooked in early medical training. This study evaluates first-semester medical students' self-perceptions of their communicative competencies to identify strengths and areas for improvement necessary for a humanized and effective medical practice.

Materials and Methods: An observational, prospective, and cross-sectional study was conducted at the University of Guayaquil (July–October 2025). A 15-item Likert-scale questionnaire was administered to a probabilistic sample of 130 medical students (Cronbach’s alpha = 0.83) to evaluate five dimensions of clinical communication. To mitigate bias, expert validation and double-entry data verification were employed. Statistical analysis included weighted averages and frequencies in SPSS v.26.0, prioritizing internal consistency and methodological rigor.

Results: A total of 130 respondents participated. The analysis revealed high perceived performance in message adaptation (4.52), open-mindedness (4.38), and active listening (4.36). However, critical weaknesses were identified in deep listening management, specifically in planning responses while listening (3.56), managing difficult interlocutors (3.78), and maintaining objectivity toward others' opinions (3.72). Most students recognize the importance of communication skills but report deficiencies in their formative development. The lowest scores were related to the systematic practice of active listening and empathy in clinical settings.

Conclusions: Students have a solid self-perception of their communicative adaptability but exhibit critical deficiencies in deep listening and in managing complex situations. Under the Value-Based Healthcare model, these gaps limit the achievement of optimal outcomes. It is imperative to integrate communicative competencies as technical and transversal skills within the curriculum. Strengthening active listening and emotional management from the earliest stages will ensure that professionals are capable of leading a more effective, sustainable, and humane healthcare system.