Jagdish Prasad Agrawal




February, 2002


Dr. J. Van Dalen
Skills Lab

University of Maastricht


Communication skills are important qualities in the behaviour of a doctor and are essential to all aspect of health care, from history taking to providing information to the patients. The purpose of this study was to examine the actual level of interpersonal communication skills of the intern doctors. Ten Intern doctors comprising 25 % of the total number who were undergoing compulsory rotatory internship at T.U. Teaching Hospital, Institute of medicine, Kathmandu were included as sample population. They were required to conduct four interviews with patients coming to the out patient department of Internal Medicine. All the interviews were video-recorded. Two trained staff members scored the video recorded interviews independently using the MAAS-Global Scoring List. Inter rater correlation was established before hand and was satisfactory (p=<.05). Mean scores for different communication skills were: Introduction 3.67; management 3.5; Evaluation of consultation 2.91; exploration 3.26; emotion 0.98; Information-sharing 3.5; Summarization 2.19; ordering 3.34, and flexibility 3.74 on 0-6 Likert scale. All the mean score values are less than satisfactory. This base line study of intern doctors shows that over all our intern doctors are deficient in almost all the components of interpersonal communication skills. A communication skills training course in undergraduate medical education could improve the existing situation in Nepal.


All the intern doctors and the patients attending the medical out patient department for participation and cooperation in this study. They were the back bone of the study.

Dr. J. Van Dalen, Ph.D. (skills lab of the faculty of medicine University of Maastricht), my supervisor a special tribute for his friendly, efficient and scientific approach through at the research. His knowledge in the field of communication skills and supervision, wisdom continuous support and feed back were instrumental for the out come of this study.

Henny Boshuizen, Ph.D, the then programme Director MHPE, University or Maastricht, for her kindness, competence and help during these years of study.

Prof. H.G. Shrestha, Dean, Institute of Medicine, Prof. R.K. Adhikari, Campus Chief and Mr. C. K. Gurung, Asst. Campus Chief, Maharjgunj  campus for there kind cooperation and support.

Prof. M. K. Nepal, Executive Director, T.U. Teaching Hospital for permission to conduction the study in the hospital.

Prof. P. C. Karmacharya, Director and Dr. D. R. Pant, Assistant Director, Medical Education Department for providing audio-visual equipments and encouragement.

Mrs. Mandira Shahi, MHPE, Asst. Professor, Medical Education Department and Dr. Mahesh Dakal, MD, Faculty Member, Department of Internal Medicine for their full support and cooperation as raters of  this study.

Dr. Mahesh Maskey, MPH, D.Sc(epi), Asst. Prof. Department of Community Medicine and Family Health for his prompt assistance in the statistical analyses.

Prof. Gopal Prasad Acharya, FRCP, Head of the Department of Internal Medicine for encouragement and permission to conduct the study.

Prof. Mahesh Khakurel, Prof. Lakhan Lal Shah, Prof. Kanti Giri, Head of the Department of  surgery, Orthopaedic, Gynaecology and Obstetrics respectively for allowing the interns posted in their department to participate in the study.

Ms. A. de Vries-Spaen and Tanja van Zoeren, secretaries in the Department of Educational Research and Educational Development, University of Maastricht for constant link with the programme, kindness and tiredless cooperation.

Mr. Anil Pandey, In-charge Audio-visual section T.U. Teaching Hospital for quality video-recording and other audio-visual assistance.

Mr. Mohan Pradhan, In-charge Healthnet Nepal for his technical support.

Mr. Kumar Shrestha, Computer assistance for all his help during the preparation of this thesis.

Supportive staffs of  department of internal medicine, audio-visual  section, medical education department and Healthnet Nepal for all their help.

To all of them, I declare my deep felling of gratitude and indebt ness.

Dedicated to:   My wife Dr. Jyoti Agrawal and daughters Aditi and Divya

My  recognition for their love and sufferings throughout the study

NAME:                        Jagdish Prasad Agrawal

TITLE:                        Assessment of Interpersonal Communication Skills of Intern Doctors.


COURSE:                   Master of Health Professions Education.

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