Mastery of Communication Skills. Does Intelligence Matter? Jeroen Kuntzea,N, Henk T

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Mastery of communication skills. Does intelligence matter? Jeroen Kuntzea,n, Henk T. van der Molenb, Marise Ph. Bornc aDepartment of Psychology and Educational Sciences, Open University, The Netherlands bFaculty of Social Sciences, Erasmus University Rotterdam, The Netherlands cDepartment of Psychology, Erasmus University Rotterdam, The Netherlands Received 14 July 2016; accepted 1 August 2016

Abstract

Background: Insight in the influence of intelligence on the mastery of communication skills is important for improving the microcounselling method, an effective training programme for acquiring these skills. Method: Participants were 323 bachelor psychology students. The participants' level of verbal, spatial and numerical intelligence was determined. Participants followed either a course in basic skills or a course in advanced skills. Their level of mastery of these skills was assessed with a video test. Results: Both training programmes proved to be effective in training communication skills. As expected, numerical and spatial intelligence were no significant predictors for the mastery of these skills. Verbal intelligence did matter for the mastery of basic communication skills, but only when students are not acquainted with the use of these skills. Discussion: Students profit from training these skills, regardless of their intelligence level. & 2016 King Saud bin AbdulAziz University for Health Sciences. Production and Hosting by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Keywords: Communication skills; Assessment; Intelligence; Training; Education

1. Introduction acquisition of these skills is microcounselling.2-5 Sev- eral studies6-13 and meta-analyses14-17 found large For many psychologists professional interviewing is overall effect sizes for this method. Improving this one of the key components of their profession. There- method, however, still remains important. For instance, fore psychology curricula offer their students training the training method was adjusted to the use of new programmes in communication skills. Moreover, the computer techniques.18-19 In the context of improving mastery of these skills is one of the requirements to be this training method it is also important to gain insight considered for the diploma of a registered European into factors that might inﬂuence the acquisition of psychologist.1 A successful training method for the communication skills. One such a factor might be intelligence. nCorresponding author. Postal address: Studiecentrum Utrecht, Nowadays there is reasonable consensus that intelli- Vondellaan 202, 3521 GZ Utrecht, The Netherlands. gence is the best predictor of work performance, based þ Fax: 31 30 2518254. on the outcomes of several longitudinal studies20-27 and E-mail address: [email protected] (J. Kuntze). 28-30 Peer review under responsibility of AMEEMR: The Association meta-analyses. General intelligence predicts, apart 31 for Medical Education in the Eastern Mediterranean Region from working performance, also training success. http://dx.doi.org/10.1016/j.hpe.2016.08.002 2452-3011/& 2016 King Saud bin AbdulAziz University for Health Sciences. Production and Hosting by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Please cite this article as: Kuntze J, et al. Mastery of communication skills. Does intelligence matter? Health Professions Education (2016), http://dx.doi.org/10.1016/j.hpe.2016.08.002 2 J. Kuntze et al. / Health Professions Education ] (]]]]) ]]]–]]] Students and soldiers scoring high on general intelli- unravelled into small meaningful communication skills. gence tests learned more from the same training Following Ivey and Authier4 and Egan,39,40 Lang and programme than persons scoring low on general Van der Molen38 distinguished seven basic commu- intelligence. This finding was confirmed by other nication skills, namely minimal encouragements, ask- studies21,32 and a meta-analysis.30 Apart from being ing questions, paraphrasing, reflection of feeling, an unsurpassed predictor of work performance, general concreteness, summarizing and situation clarification intelligence also is the best predictor of training and five advanced skills, namely advanced accurate success. empathy, confrontation, positive relabelling, examples Therefore, one would expect intelligence also to of one's own and directness. predict success in communication skills training. How- These skills fit within Egan's helping model39,40 of ever, studies investigating whether intelligence predicts three stages: (1) problem clarification, (2) gaining new success in communication skills training are scarce. insights and (3) strategies for treatment. The goal of the Nonetheless, understanding the possible effect of first stage is to clarify the problem of the client. In this intelligence on the mastery of these skills could help stage helpers mainly use the basic communication improve training programmes for the acquisition of skills. During the second stage, gaining new insights, these skills. Therefore, the focus of this study is on helpers try to have clients gain new insights in their intelligence as predictor of the mastery of communica- situation, predominantly using the five advanced com- tion skills after a basic and advanced training in these munication skills. Finally, in the third stage, strategies skills. for treatment, client and helper seek strategies to solve After Spearman's distinction between general intelli- the client's problems. gence or the g-factor and specific intelligence or the s- The basic communication skills are often taught in factor,33,34 intelligence research primarily has concen- the first or second bachelor year of a psychology trated on tests for general intelligence, because this was curriculum and the advanced communication skills in thought to be the best indicator of someone's true consecutive years. Subjects of the present study were intelligence.21 However, since the second half of the psychology students who in their first bachelor year 20th century researchers also attended to more specific followed a course in basic communication skills and in abilities, for instance verbal intelligence or spatial their second bachelor year a course in advanced intelligence. Specific job demands, e.g. bookkeeping, communication skills. These courses were built up not only appeal to general intelligence, but also to according to the Cumulative Microtraining (CMT) specific abilities, e.g. numerical intelligence.21,24 method.41 In this method students first receive theore- According to Lubinski24 general intelligence can be tical instruction about one communication skill (e.g. divided into three more specific ability domains: summarizing) and its function in a professional inter- verbal, numerical and spatial intelligence. The aggrega- view. Next, video clips show examples of inadequate tion of these three separate abilities should give a good and adequate performance of the skill to the students impression of someone's general intelligence. In this (modelling). Subsequently, students exercise the skill study we will maintain Lubinski's distinction and separately (like ‘dry swimming’). For instance, with investigate verbal, numerical and spatial intelligence regard to the basic skill ‘asking questions’ students as predictors of the mastery of communication skills. have to try to change a closed question (‘Do you feel Only a few studies have investigated these relation- sad?’) into an open question (‘How do you feel?’), after ships. These studies have concentrated mostly on the which they practice the skill in a role-play with another correlation of verbal intelligence with communication student. Finally, fellow-students and the trainer give skills. For instance, verbal intelligence admission tests feedback on the student's performance in the role-play predicted medical students' mastery of communication and the student formulates learning points according to skills.35 Well-developed verbal intelligence at early age this feedback. While students practice one or two new predicts well-developed communication and social skills in each session, CMT's ultimate purpose is to skills later on in life.36 Finally, found that students integrate the communication skills that have been dealt scoring high on verbal intelligence also scored higher with up to that moment in the training programme. on behavioural tests for communication skills.37 Both courses aim at increasing the students' adequate Students in this study followed a microcounselling application of the (basic or advanced) communication training programme in communication skills, also skills. known as microskills.2-5,38 This means that the com- According to the studies that found positive relation- plex skill of professionally interviewing a client is ships between verbal intelligence and communication

2.1. Participants 2.2.4. Counselling Communication Skills Progress Test (CSPT) A total of 323 bachelor students of a psychology The counselling communication skills progress curriculum at a large Dutch university participated in test11-13 is a video based behavioural test, established this study; 182 participants were in their first year of according to the results of Smit and Van der Molen,43- the bachelor programme, 141 were in the second year 45 who investigated different methods for the assess- of that programme. The average age of the first year ment of communication skills. The CSPT assesses the students was 19.5 (SD¼2,1) and 80% of them were participants’ level of mastery of the communication female. The second year students’ average age was skills. It has forty-two items. Each item is a video clip 20.3 (SD¼1.8) and 81% were female. in which a client, played by an actor, tells something concerning his or her problem. After watching each 2.2. Instruments clip participants write down literally what they would say to the client, having received the instruction to use The participants' verbal, numerical and spatial intel- a communication skill (e.g. ‘Give a paraphrase in an ligence were measured with three tests that are part of appropriate manner’). the Drenth Test Series Higher Level,42 a Dutch The first 30 items assess the level of mastery of the intelligence test battery often used in the Netherlands. seven basic communication skills and the next twelve The participants' mastery of the basic and advanced items the level of mastery of the five advanced communication skills was assessed with the Counsel- communication skills. The number of items for the ling Communication Skills Progress Test (CSPT).11–13 assessment of the basic skills is higher than the number of items for the assessment of the advanced skills, 2.2.1. Verbal Analogies (VA) because there are more basic skills than advanced skills The VA42 is a verbal analogies test and assesses and because the assessment of an advanced skill takes verbal intelligence. It consists of 40 multiple choice more time than the assessment of a basic skill. items and measures to what extent participants can Three trained assessors using an instruction guide reason with words. They have to determine how words developed for the assessment of the application by the are related, for instance ‘… is to calf, as horse is to…’. students of every communication skill evaluated the Participants have 40 minutes for answering the 40 participants' answers. This guide is based on the skill items. The authors report a split-half reliability of .87 definitions in Lang and Van der Molen38 and on expert and a KR-20 of .77. counsellors’’ specifications for the requirements of an adequate answer, a moderately adequate answer and an 2.2.2. Numeric series (NS) inadequate answer. Students acquired two points for an Numerical series42 estimates the participants’ numer- adequate answer, one point for a moderately adequate ical intelligence. It has 26 items, each presenting a answer and zero points for an inadequate answer. In the series of numbers. The participant has to choose from end, mean scores can be calculated on the Basic Skill four numbers, which number logically follows the last Factor (BSF) and the Advanced Skill Factor (ASF), the number of the series. For instance: 1, 3, 6, 10, 15, 21, ? two underlying dimensions of the CSPT. The range of Possible answers: 26, 27, 28, 29, 30. the scores on these two dimensions is 0–2.

Table 1 in advanced communication skills the mean scores of Mean scores on the CSPT of freshmen (no training), 1st year students the first year students on the Advanced Skills Factor at (training basic skills) and second year students (training advanced T1 were compared with the mean scores of the second skills). year students on this factor at T2. The mean scores on Freshmen (T0) 1st year students (T1) 2nd year students (T2) the CSPT of all students are displayed in Table 1. n¼182 n¼182 n¼141 The results in Table 1 show that first year students score higher on both the BSF and the ASF at T1 in BSF .45 1.41 1.57 ASF .09 .19 .87 comparison with their scores on these factors when they were freshmen at T0. These within-subjects BSF Mean score on the Basic Skill Factor (range 0–2). differences on both the BSF and the ASF were – ASF Mean score on the Advanced Skill Factor (range 0 2). significant across time, respectively F (1, 181)¼ 1779.8; po.001 and F (1, 140)¼33.1; p o.001. In order to control for testing effects two comparable Having followed the basic communication skills versions of the CSPT were developed. There were no training first year students improved most on the Basic significant differences in the students' scores between Skill Factor. The effect size (d) was 4.43. This is a large these two versions. Cronbach's α for both versions was effect according to Cohen.46,47 After this course first high (.91 and .92) and interrater-reliabilities ranged year students showed moderate progress on the between .89 and .97.11,13 Finally, age and gender had Advanced Skill Factor, d¼.6, but this is still significant. no significant influence on the CSPT-scores. Furthermore, the mean scores in Table 1 reveal that second year students score higher on both factors than 2.3. Procedure first year students. These between-subjects differences on the BSF and the ASF were significant, respectively For this study we used data of 182 first year students T (327)¼5.9; po.001 and T (327)¼22.8; who took the three intelligence tests in their first year of po.001. Second year students score highest on the the bachelor psychology curriculum. They received the BSF. However, the highest mean difference between CSPT two times, first, at the start of their study first year and second year students is on the ASF, psychology as freshmen, roughly three weeks after the which leads to an effect size (d) of 2.5, which is a large start of the academic year (T0) and second, six months effect. The mean difference on the BSF between first later in their first year, just after they had followed a year and second year students is to be considered as a course in basic communication skills (T1). Furthermore, moderate effect size (d) of .6. we gathered data of 141 second year students who took Next, regression analyses were performed to inves- the three intelligence tests in their first year of the tigate whether verbal, numerical and spatial intelligence bachelor psychology curriculum. They received the CSPT could predict the mastery of the basic and advanced after six months in their second year, when they just had skills of the first year students at T0 and T1 and finished a course in advanced communication skills (T2). whether these factors could predict success in training The basic communication skills training consists of five basic communication skills. Because of the high sessions, spread over five weeks and the advanced number of regression analyses a significance level of communication skill training has four sessions, spread .01 was used. Table 2 shows the results. over four weeks. The first year and second year students As can be seen from Table 2 only the standardized took the CSPT as a formal examination after respectively regression weight of verbal intelligence on the BSF at the course in basic communication skills and the course in T0 was significant (β¼.28; p¼.001). All other stan- advanced communication skills. Minimal scores to pass dardized regression weights of verbal, numerical and the examination were determined for both groups. spatial intelligence on the BSF and the ASF at T0 and T1 were not significant. This means that from the three 3. Results specific intelligence factors only verbal intelligence influenced the mastery of communication skills, but First, the training effects of both courses in commu- this influence applied to the basic communication skills nication skills were determined. To calculate the effect alone and before the first year students received any size of the course in basic communication skills the training in these skills. Having received the course in mean scores of the first year students on the Basic Skill basic communication skills verbal intelligent students Factor at T0 and T1 were analysed using a repeated did not score higher or lower than less verbal intelligent measures analysis. To evaluate the effect of the course students. This seems to imply that less verbal

Table 2 Table 3 Regression coefﬁcients of verbal, spatial and numerical intelligence Regression coefﬁcients of verbal, spatial and numerical intelligence as predictors of 1st year students' scores on the Basic Skill Factor and as predictors of 2nd year students' scores on the Basic Skill Factor on the Advanced Skill Factor (N¼182). and on the Advanced Skill Factor (N¼141).

Verbal Intelligence Numerical Spatial Verbal Intelligence Numerical Spatial Intelligence Intelligence Intelligence or ‘g’ Intelligence or ‘g’

β p β p β p β p β p β p

BSF0 .28* .001 .17 .031 .06 .497 BSF2 .01 .964 .01 .899 .19 .036 BSF1 .18 .049 .08 .305 .01 .941 ASF2 .18 .065 .13 .122 .08 .389 ASF0 .08 .379 .08 .338 .01 .919 ASF1 .18 .055 .08 .333 .01 .921 BSF2¼Score on Basic Skill Factor at T2. BSF .06 .491 .06 .463 .05 .592 ASF2¼Score on Advanced Skill Factor at T2. T1-T0 ASF .12 .205 .10 .214 .01 .898 T1-T0 4. Discussion

BSF0¼Score on Basic Skill Factor at T0. BSF1¼Score on Basic Skill Factor at T1. The main aim of this study was to investigate ASF0¼Score on Advanced Skill Factor at T0. whether the mastery level of communication skills ASF1¼Score on Advanced Skill Factor at T1. and progress in mastery of those skills after commu- BSF T1–T0¼Contrast scores on Basic Skill Factor between T1 nication skills training could be predicted by verbal, and T0. numerical and spatial intelligence. It was expected that ASFT1–T0¼Contrast scores on Advanced Skill Factor between T1 and T0. verbal intelligence would positively, and that numerical *po.01. and spatial intelligence would not relate to the level of mastery and training success in these skills. intelligent students gained more of the course in basic First, the effect sizes of a basic communication skills communication skills than verbal intelligent students. and an advanced communication skills microcounsel- However, the results displayed in the last two rows of ling training programme were determined. A large Table 2 reveal that neither verbal intelligence nor effect size was found for the course in basic commu- numerical or spatial intelligence predicted the contrast nication skills with respect to the mastery level of these scores between T0 and T1 significantly. So, as skills. On the mastery level of the advanced skills this expected, success in communication skills training course had a moderate effect. The course in advanced was not influenced by numerical or spatial intelligence. communication skills showed a large effect on the level However, contrary to our expectation, it also was not of these skills and a moderate effect on the basic predicted by verbal intelligence. communication skills. Although in this study no con- Finally, regression analyses were performed to trol group and, with respect to the course in advanced investigate if the second year students’ scores on the skills, no pre-test was used, these findings correspond BSF and ASF could be predicted by verbal, spatial or with results found in other studies that did use such numerical intelligence after following the course in designs7,8,11-13 and with effect sizes reported by several advanced communication skills. The results are dis- meta-analyses.14-17 Therefore, it can be concluded that played in Table 3. Again, since the number of regres- the course in basic communication skills and the course sion analyses is high, a significance level of .01 in advanced communication skills have positive effects was used. on the students' mastery level of these skills. Table 3 shows that verbal, numerical and spatial Second, the relationship between verbal, numerical intelligence did neither significantly predict the scores and spatial intelligence and the mastery level of com- on the Basic Skill Factor nor on the Advanced Skill munication skills was investigated. As expected, numer- Factor. Standardized regression weights ranged from ical and spatial intelligence did neither predict the .13 (numerical intelligence on ASF2; p¼.12) to .19 mastery level of basic or advanced communication (spatial intelligence on BSF2; p¼.04). So, verbal, skills, nor progress in the mastery of these skills. Verbal numerical and spatial intelligence did not influence intelligence, however, did predict the mastery level of the mastery of basic and advanced communication basic communication skills, but only when students had skills of second year students after a course in not received any training in these skills. Yet, after the advanced communication skills. course in basic or advanced communication skills, verbal

Please cite this article as: Kuntze J, et al. Mastery of communication skills. Does intelligence matter? Health Professions Education (2016), http://dx.doi.org/10.1016/j.hpe.2016.08.002 6 J. Kuntze et al. / Health Professions Education ] (]]]]) ]]]–]]] intelligence did not influence the mastery level of basic study motivation could moderate the relationship communication skills anymore. Verbal intelligence did between intelligence and the acquisition of these skills. neither predict success in training basic or advanced communication skills, nor did it predict the mastery level Disclosure of the advanced communication skills before or after the course in basic or advanced communication skills. So, Ethical approval: Non Applicable. the results seem to imply that verbal intelligence is of Funding: None. some importance in the application of basic commu- Other disclosure: None. nication skills, but only before a professional training in these skills. 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Please cite this article as: Kuntze J, et al. Mastery of communication skills. Does intelligence matter? Health Professions Education (2016), http://dx.doi.org/10.1016/j.hpe.2016.08.002