RESEARCH ARTICLE: Pharmacy students’ self-reported attitudes, beliefs and behaviours about communicating with patients, measured over time




Communication, Communication Accommodation Theory (CAT), Patient-centred communication tool, Pharmacy student


Background: Pharmacy students receive training to effectively communicate with patients about their medications.

Objectives: A theory-based approach (Communication Accommodation Theory [CAT]) was used to investigate the impact of communication skills’ tutorials on Pharmacy students’ self-reported attitudes, beliefs and behaviours in patient communication.

Methods: Final year Pharmacy students completed an online, 30-item, patient-centred communication survey at three points in time, before and after attending three CAT-based tutorials (Survey #1 and Survey #2). Survey #3 was distributed six to twelve months into students’ intern training year (post-graduation). Differences between participants’ responses over time were measured and analysed.

Results: Response rates were 78% for Survey #1, 84% for Survey #2, and 28% for Survey #3. Further analysis indicated that Survey #3 respondents were not statistically different from the larger sample size. Key areas changed from baseline (Survey #1) to post tutorials (Survey #2) and were sustained well into Pharmacy students’ intern year (Survey #3).

Conclusions: This novel research indicated growing awareness and retention of key communication behaviours over time.

Author Biographies

Bernadette A M Chevalier, The University of Queensland

School of Pharmacy

Bernadette M Watson, The Hong Kong Polytechnic University

Department of English

William Neil Cottrell, The University of Queensland

Associate Professor, Faculty of Health and Behavioural Sciences


Adrian, J.A.L., Zeszotarski, P., & Ma, C. (2015). Developing pharmacy student communication skills through role-playing and active learning. American Journal of Pharmaceutical Education, 79(3), Art.44. doi: https://

Babinec, P.M., Rock, M.J., Lorenzetti, D.L., & Johnson, J.A. (2010). Do researchers use pharmacists' communication as an outcome measure? A scoping review of pharmacist involvement in diabetes care. International Journal of Pharmacy Practice, 18(4), 183-193. doi: https://

Berger, B. (2009). Communication skills for pharmacists: building relationships, improving patient care (3rd ed.). Washington, DC, US: American Pharmacists Association

Blom, L., Wolters, M., ten Hoor-Suykerbuyk, M., van Paassen, J., & van Oyen, A. (2011). Pharmaceutical education in patient counseling: 20h spread over 6 years? Patient Education and Counseling, 83(3), 465-471. doi:

Braaf, S., Rixon, S., Williams, A., Lieu, D., & Manias, E. (2015). Pharmacist-patient medication communication during admission and discharge in specialty hospital settings: implications for person centered healthcare. International Journal of Person Centered Medicine, 4(2), 90-105. doi:

Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3, 77-101

Buring, S.M., Kirby, J., & Conrad, W.F. (2007). A structured approach for teaching students to counsel self- care patients. American Journal of Pharmaceutical Education, 71, Art.8. doi: aj710108

Campbell, D.T., & Cook, T.D. (1979). Quasi- experimentation: Design & analysis issues for field settings. Chicago: Rand McNally College Publishing Company

Canadian Pharmacists' Association. (2018). Pharmacists’ Expanded Scope of Practice (online) Available at: https:// practice-canada/. Accessed 15, April, 2020

Checkbox6 (Version 2017Q2). (2017). Watertown, MA, USA: Checkbox Survey, Inc. (online). Available at:

Chevalier, B.A., Watson, B.M., Barras, M.A., & Cottrell, W.N. (2017a). Investigating Strategies Used by Hospital Pharmacists to Effectively Communicate with Patients during Medication Counselling. Health Expectations, 20, 1121-1132. doi: hex.12558

Chevalier, B. (2017b). Investigating the effectiveness of communication taking place between hospital pharmacists and patients during medication counselling. Doctoral dissertation, The University of Queensland, Brisbane, Australia. Available at: https://espace.library. Accessed 15 April, 2020

Chevalier, B.A., Watson, B.M., Barras, M.A., & Cottrell, W.N. (2018). Hospital pharmacists’ and patients’ views about what constitutes effective communication between pharmacists and patients. International Journal of Pharmacy Practice, 26, 450-457. doi:

Coupland, N., Coupland, J., Giles, H., & Henwood, K. (1988). Accommodating the elderly: Invoking and extending a theory. Language in Society, 17(1), 1-41. _tab_contents

Dragojevic, M., Giles, H., & Gasiorek, J. (2015). Communication accommodation theory. In The international encyclopedia of interpersonal communication, (eds. C. Berger & M. Roloff), Hoboken, New Jersey, US: John Wiley & Sons, Inc. pp. 1-21. doi: 10.1002/9781118540190.wbeic006

Gasiorek, J., & Giles, H. (2012). Effects of Inferred Motive on Evaluations of Nonaccommodative Communication. Human Communication Research, 38, 309-331. doi: 2012.01426.x

Giles H. (2008). Communication accommodation theory. In Engaging theories in interpersonal communication: Multiple perspectives, (eds. L.A. Baxter, D.O. Braithewaite). Thousand Oaks, CA, US: Sage Publications, Inc. pp. 161-173

Greenhill, N., Anderson, C., Avery, A., & Pilnick, A. (2011). Analysis of pharmacist–patient communication using the Calgary-Cambridge guide. Patient Education and Counseling, 83(3), 423-431. doi: 10.1016/j.pec.2011.04.036

Grice, G.R., Gattas, N.M., Prosser, T., Voorhees, M., Kebodeaux, C., Tiemeier, A., Berry, T.M., Wilson, A.G., Mann, J., & Juang, P. (2017). Design and validation of patient-centered communication tools (PaCT) to measure students’ communication skills. American Journal of Pharmaceutical Education, 81(8), 5927. doi: https://

Hardin, H.C., Hall, A.M., Roane, T.E., & Mistry, R. (2012). An advanced pharmacy practice experience in a student-staffed medication therapy management call center. American Journal of Pharmaceutical Education, 76(6), Art.110.

Horn, J.L. (1965). A rationale and test for the number of factors in factor analysis. Psychometrika, 30, 179-185. doi:

Hubbard, R., & Allen, S.J. (1987). An empirical comparison of alternative methods for principal component extraction. Journal of Business Research, 15(2), 173-190. doi: 10.1016/0148-2963(84)90047-X

Hyvärinen, M.-L., Tanskanen, P., Katajavuori, N., & Isotalus, P. (2008). Feedback in patient counselling training—Pharmacy students’ opinions. Patient Education and Counseling, 70(3), 363-369. doi: https://

IBM, C. (2017). IBM SPSS Statistics for Windows (Version Version 25.0). Armonk, NY: IBM Corp.

Jin, H.K., Choi, J.H., Kang, J.E., & Rhie, S.J. (2018). The effect of communication skills training on patient- pharmacist communication in pharmacy education: a meta-analysis. Advances in Health Sciences Education, 23, 633-652. doi: s10459-017-9791-0

Jones, L., Woodhouse, D., & Rowe, J. (2007). Effective nurse parent communication: A study of parents' perceptions in the NICU environment. Patient Education and Counseling, 69(1-3), 206-212. doi: 10.1016/j.pec.2007.08.014

Kaddoura, M. (2013). Think pair share: A teaching learning strategy to enhance students' critical thinking. Educational Research Quarterly, 36(4), 3-24

Kairuz, T., Noble, C., & Shaw, J. (2010). Preceptors, interns, and newly registered pharmacists' perceptions of new zealand pharmacy graduates' preparedness to practice. American Journal of Pharmaceutical Education, 74(6), Art.108. doi: aj7406108

Katoue, M.G., & Al Haqan, A. (2013). Implementation and evaluation of a workshop on patient counseling about antidiabetic medications for final-year pharmacy students. Medical Principles and Practice, 22(5), 489-494. doi:

Kimberlin, C.L. (2006). Communicating with patients: skills assessment in US colleges of pharmacy. American Journal of Pharmaceutical Education, 70(3), Art.67. doi:

Lancman B., Jorm C., Iedema R., Piper D., & Manidis M. (2015). Taking the heat in critical situations: being aware, assertive and heard. In Communicating quality and safety in health care, (eds. R. Iedema, D. Piper, & M. Manidis). Melbourne, Australia: Cambridge University Press. pp, 268-279

Law, M.R., Ma, T., Fisher, J., & Sketris, I.S. (2012). Independent pharmacist prescribing in Canada. Canadian Pharmacists Journal, 145(1), 17-23. e11. doi: https://

Lonie, J.M., Alemam, R., Dhing, C., & Mihm, D. (2005). Assessing Pharmacy Student Self-Reported Empathic Tendencies. American Journal of Pharmaceutical Education, 69(2). doi:

Morecroft, C., Thornton, D., & Caldwell, N. (2015). Inpatients' expectations and experiences of hospital pharmacy services: Qualitative study. Health Expectations, 18(5), 1009-1017. doi: 10.1111/hex.12074

Muller M., Jurgens J., Redaelli M., Klingberg K., Hautz W.E. & Stock S. (2018). Impact of the communication and patient hand-off tool SBAR on patient safety: a systematic review. British Medical Journal Open, 8(8), e022202. doi: bmjopen-2018-022202

Murad, M.S., Chatterley, T., & Guirguis, L.M. (2014). A meta-narrative review of recorded patient-pharmacist interactions: exploring biomedical or patient-centered communication? Research in Social and Adminstrative Pharmacy, 10(1), 1-20. doi: j.sapharm.2013.03.002

Nunes, P., Williams, S., Sa, B., & Stevenson, K. (2011). A study of empathy decline in students from five health disciplines during their first year of training. International Journal of Medical Education, 2, 12-17. doi:

O’Brien, C.E., Flowers, S.K., & Stowe, C.D. (2017). Desirable Skills in New Pharmacists: A Comparison of Opinions From Practitioners and Senior Student Pharmacists. Journal of Pharmacy Practice, 30(1), 94-98. doi:

Pharmaceutical Society of Australia. (2017). Professional Practice Standards – Version 5. Pharmaceutical Society of Australia (online). Available at: https:// Professional-Practice-Standards-v5.pdf. Accessed 15 April, 2020

Rogers, E.R., & King, S.R. (2012). The influence of a patient-counseling course on the communication apprehension, outcome expectations, and self-efficacy of first-year pharmacy students. American Journal of Pharmaceutical Education, 76(8), Art.152. doi: https://

Svensberg, K., Sporrong, S. K., Lupattelli, A., Olsson, E., Wallman, A., & Björnsdottir, I. (2018). Nordic Pharmacy Students’ Opinions of their Patient Communication Skills Training. American Journal of Pharmaceutical Education, 82(2), 6208. doi: ajpe6208

Tavakol, M., & Dennick, R. (2011). Making sense of Cronbach's alpha. International Journal of Medical Education, 2, 53-55. doi: 4dfb.8dfd

Tonna, A.P., Stewart, D., West, B., & McCaig, D. (2007). Pharmacist prescribing in the UK - a literature review of current practice and research. Journal of Clinical Pharmacy and Therapeutics, 32(6), 545-556. doi: https://

Trujillo, J.M., McNair, C.D., Linnebur, S.A., Valdez, C., & Trujillo, T.C. (2016). The Impact of a

Standalone, Patient-centered Communication Course Series on Student Achievement, Preparedness, and Attitudes. American Journal of Pharmaceutical Education, 80(10), 174. doi:

Tsingos, C., Bosnic-Anticevich, S., & Smith, L. (2014). Reflective practice and its implications for pharmacy education. American Journal of Pharmaceutical Education, 78(1), Art.18: ajpe78118

Watkins, M.W. (2006). Determining Parallel Analysis Criteria. Journal of Modern Applied Statistical Methods, 5(2), 344-346. doi: 1162354020

Watson, B.M., & Gallois, C. (1999). Communication accommodation between patients and health professionals: themes and strategies in satisfying and unsatisfying encounters. International Journal of Applied Linguistics, 9(2), 167-180. doi:

World Health Organisation. (2003). Adherence to Long- Term Therapies - Evidence for action (online). Available at: adherence_report/en/. Accessed 12 February, 2020

Zolnierek, K.B., & Dimatteo, M.R. (2009). Physician communication and patient adherence to treatment: a meta-analysis. Medical Care, 47(8), 826-834. doi: https://

Zwick, W.R., & Velicer, W.F. (1986). Comparison of five rules for determining the number of components to retain. Psychological Bulletin, 99(3), 432-442. doi:





Research Article