Authors

• AFSANEH YAKHFOROSHHA ¹
• MANDANA SHIRAZI ²
• NASER YOUSEFZADEH ³
• AMIN GHANBARNEJAD ⁴
• MOHAMMADALI CHERAGHI ⁵
• RITA MOJTAHEDZADEH ⁶
• BEHROOZ MAHMOODI-BAKHTIARI ⁷
• SEYED AMIR HOSSEIN EMAMI ⁸

¹ Tehran University of Medical Sciences, Tehran, Iran

² 2Educational Development Centre (EDC), Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran, 3LIME Department, Karolinska Institutet, Solnavägen, Sweden;

³ Hasheminejad Kidney Center, Iran University of Medical Sciences, Tehran, Iran

⁴ Social Determinant in Health Promotion Research Center, School of Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran

⁵ School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran

⁶ Virtual School, Tehran University of Medical Sciences, Tehran, Iran

⁷ Department of Performing Arts, Tehran University, Tehran, Iran

⁸ Faculty of Medicine, Department of Medical Education, Tehran University of Medical Sciences, Tehran, Iran

Abstract

Introduction: Communication skill (CS) has been regarded as one of thefundamental competencies for medical and other health care professionals.Student’s attitude toward learning CS is a key factor in designing educationalinterventions. The original CSAS, as positive and negative subscales, wasdeveloped in the UK; however, there is no scale to measure these attitudesin Iran. The aim of this study was to assess the psychometric characteristicof the Communication Skills Attitude Scale (CSAS), in an Iranian contextand to understand if it is a valid tool to assess attitude toward learningcommunication skills among health care professionals.Methods: Psychometric characteristics of the CSAS were assessed byusing a cross-sectional design. In the current study, 410 medical studentswere selected using stratified sampling framework. The face validity of thescale was estimated through students and experts’ opinion. Content validityof CSAS was assessed qualitatively and quantitatively. Reliability wasexamined through two methods including Chronbach’s alpha coefficient andIntra class Correlation of Coefficient (ICC). Construct validity of CSAS wasassessed using confirmatory factor analysis (CFA) and explanatory factoranalysis (PCA) followed by varimax rotation. Convergent and discriminantvalidity of the scale was measured through Spearman correlation. Statisticalanalysis was performed using SPSS 19 and EQS, 6.1.Results: The internal consistency and reproducibility of the total CSASscore were 0.84 (Cronbach’s alpha) and 0.81, which demonstrates anacceptable reliability of the questionnaire. The item-level contentvalidity index (I-CVI) and the scale-level content validity index (S-CVI/Ave) demonstrated appropriate results: 0.97 and 0.94, respectively. Anexploratory factor analysis (EFA) on the 25 items of the CSAS revealed4-factor structure that all together explained %55 of the variance. Resultsof the confirmatory factor analysis indicated an acceptable goodness-offitbetween the model and the observed data. [χ2/df=2.36, ComparativeFit Index (CFI)=0.95, the GFI=0.96, Root Mean Square Error ofApproximation (RMSEA)=0.05].Conclusion: The Persian version of CSAS is a multidimensional, validand reliable tool for assessing attitudes towards communication skillamong medical students.Keywords: Communication skills, Attitude, Psychometrics