|Year : 2011 | Volume
| Issue : 1 | Page : 39-44
Emotional intelligence scale for medical students
Kalpana Srivastava1, Saumya Joshi2, Arkojyoti Raichaudhuri2, VSSR Ryali3, PS Bhat3, R Shashikumar3, J Prakash3, D Basannar4
1 Department of Psychiatry, Scientist 'F', Armed Forces Medical College, Pune, Maharashtra, India
2 Student, Armed Forces Medical College, Pune, Maharashtra, India
3 Department of Psychiatry, Armed Forces Medical College, Pune, Maharashtra, India
4 Department of Preventive and Social Medicine, Scientist 'E', Armed Forces Medical College, Pune, Maharashtra, India
|Date of Web Publication||12-Jul-2012|
Department of Psychiatry, Scientist 'F' AFMC, Pune, Maharashtra
Source of Support: None, Conflict of Interest: None
| Abstract|| |
Background: Emotional Intelligence has been associated with positive outcome process in varied professions. There is paucity of Indian literature on the subject; especially involving medical undergraduates; and presently there is no scale available to measure the same in the Indian scenario. Objective: To develop a scale to measure Emotional Intelligence among medical undergraduates. Materials and Methods: Four domains of Emotional intelligence were selected, viz. Self-Awareness, Self-Management, Social-Awareness & Social-Skills and these were included for the purpose of domains of the scale. On the basis of focused group discussions and in-depth deliberations with experts, undergraduate and postgraduate medical students a pool of 50 items was generated. The items were reduced to 27 based on expert consensus and on the basis of frequency of endorsement by expert reviews. It was followed by a pilot study of 50 undergraduates. This completed the preparation of the preliminary draft based on content analysis. The questionnaire was then administered in 480 students and the data was analyzed by appropriate statistical methods. For the purpose of concurrent validity, emotional intelligence scale developed by Dr. Ekta was used. Results: The Cronbach's Alpha for Internal Consistency Reliability was 0.68. The EIS had a significant correlation with social awareness domain of Emotional Intelligence Test (EIT) establishing Concurrent Validity. Conclusion: Emotional Intelligence Scale for medical undergraduates was constructed. Reliability and concurrent validity were also established for the same.
Keywords: Emotional intelligence, medical undergraduates, assessment
|How to cite this article:|
Srivastava K, Joshi S, Raichaudhuri A, Ryali V, Bhat P S, Shashikumar R, Prakash J, Basannar D. Emotional intelligence scale for medical students. Ind Psychiatry J 2011;20:39-44
Importance of Emotional Intelligence is increasingly being recognized and assessed across various professions. Managing emotions in social contexts are clearly important for success in a variety of interpersonal as well as career-related domains.  According to much recent academic work, a good deal or our successes and failures in life are not attributable to our cognitive abilities as measured by tests of IQ, but, rather are attributable to our abilities to form and maintain social relationships, portray ourselves positively, and manipulate how others perceive us. , Those who lack such understanding may be said to lack Emotional Intelligence (EI), a type of intelligence that may be more important in reaching one's goals than traditional intelligence as measured by tests of IQ. 
Goleman has defined Emotional Intelligence as "the capacity of recognizing our own feelings and those of others, for motivating ourselves, and for managing emotions both in us and in our relationships". 
The Emotional Competence Inventory (ECI) was developed by Boyatzis et al.  ECI defines emotional intelligence as, "the capacity for recognizing our own feelings, and those of others, for motivating ourselves and for managing emotions well in ourselves and our relationships". The ECI measures four aspects of emotional intelligence, Self-Awareness, Self-Management, Social-Awareness and Social-Skills. Accordingly these four domains were considered relevant for the construct of measuring emotional intelligence.
Students with higher trait EI are more likely to experience stress during unfamiliar surgical scenarios but are also more likely to recover better compared with their lower-trait-EI peers. Trait EI has implications for the design of effective stress management training tailored to individual needs and potential applications to surgical trainee selection and development.  Emotional intelligence (EI) is a type of social intelligence that involves monitoring, discriminating between and using emotions to guide thinking and actions. EI is related to interpersonal and communication skills, and is important in the assessment and training of medical undergraduates. 
The selective processing of information remains central to the concept of emotional intelligence and facilitates patient care. But since the introduction of the concept of EI, attempt has been made to measure the EI of undergraduate medical students. The most recent index which researchers have developed is the Mayer-Salovey-Caruso Emotional Intelligence Test.  This test, which provides 4 scores, is based on their revised model of EI, which includes four 'branches' or abilities that are that are described as emotional identification or perception, use of emotions to facilitate thinking, understanding emotions and managing emotions. Scores on the MSCEIT are interpreted such that high scores represent the degree to which participants answers mirror scores that are reflective of the group (or expert) consensus. Other El frameworks conceptualize and measure this construct as a combination of mental abilities and personality traits. For instance, Bar-On (current volume) conceptualizes EI as comprising multiple dispositions relevant to emotional functioning, such as optimism and empathy. The Emotional Quotient Inventory (EQ-i) is designed to assess these dispositions using self-report methods.  The base to construct this test is provided by a joint self-report/observer rating scale, the Emotional Competence Inventory better known as ECI. ECI defines emotional intelligence as, "the capacity for recognizing our own feelings, and those of others, for motivating ourselves and for managing emotions well in ourselves and our relationships".  The ECI measures four aspects of emotional intelligence, firstly self-awareness, secondly self-management, thirdly social-awareness and lastly social-skills. Presently there is no scale available to measure the EI of medical undergraduates in the Indian scenario. Some related studies are-Medical Students Stressor Questionnaire by Dr. Sathidevi VK.  Emotional Inventory Test (EIT) by Dr. Ekta Sharma.  Hence in the background of absence of standard measure among medical students, study was planned to develop the tool of assessment of emotional Intelligence among medical students and to develop a scale to measure Emotional Intelligence among medical undergraduates. The present study was planned to focus and evaluate the relevance of EI as higher mental ability in medical students. Today all over the world medical education has become sophisticated enough to encompass numerous positive and negative challenges.
| Materials and Methods|| |
The preliminary development of scale followed the stages to identify constructs based on theory of emotional intelligence, item generation around those constructs expert validation and development of questionnaire after pilot study. As this was meant for undergraduate medical students the items were generated keeping in view relevance of medical situation. Initially sample for pilot study comprised of 50 students of first term including male and female students. Sample for final administration comprised of 480 undergraduate medical students (378 male students and 102 female students) of five consecutive batches of Medical College. Informed consent was obtained and those willing, participated in the study. The items for assessment were generated centering around the construct of four domains of emotional Intelligence Scale namely Self-Awareness, Self-management, Social awareness, Social Skills. Those who did not give consent and students in irregular batches were excluded from study. The Emotional Intelligence Scale (EIS) having 30 items was Constructed. The theoretical background of the construct was derived from Emotional Competence Inventory better known as ECI. The Emotional Intelligence Scale (EIS) addressed four domain of emotional intelligence, namely, Self-Awareness, Self-Management, Social-Awareness and Social-Skills. Accordingly these four domains were selected for the construct.
Self-Awareness is considered to be having clear perception of personality, including strengths, weaknesses, thoughts, beliefs, motivation, and emotions. (1, 10, 18,19,20,22,26)
Self-Management refers to methods, skills, and strategies by which individuals can effectively direct their own activities toward the achievement and includes goal setting. Ability to handle situations which challenge interpersonal relationships (6, 8, 11, 13, 14, 16, 25)
Social-Awareness the competencies associated with being socially aware are, understanding the other person's emotions, needs and concern and the ability to understand and meet the needs of others. Ability to take decisions in situations demanding prioritization. (3, 4, 7, 24,27,28,29)
Social-Skills is any skill facilitating interaction and communication with others. Ability to tolerate differences and rejections in interpersonal situations (9, 12, 15, 17,21,23)
The basis of item generation was formed by literature review and various qualitative sources. A focused group discussion was conducted with 30 undergraduate students. In addition in-depth interviews of 10 postgraduate students in the Department of Psychiatry were taken. Respondents were requested to limit their suggestions to common situations faced by medical undergraduates in personal and professional sphere of life. Subsequently expert opinion on the matter was obtained. Pool of 50 items was thus generated. These items were in the form of questions and options were generated around that situation. On the basis of the frequency of endorsement by expert reviews; the items were reduced to 27. This was done for content validation. The experts were requested to evaluate each of the items in terms of their relevance to measure the desired dimension as a part of the concept and domain of emotional intelligence.
Suitable buffer questions were added to make a total of 30 items. Out of these 30 items, 22 were situational analysis type of questions related with the usual situations faced by students of undergraduate age group in a medical college. Out of them, 5 questions were based upon medical situations commonly faced by medical students in OPDs, wards and ICUs. The items were worded considering the reading level of the respondents avoiding ambiguity and jargons. Finally, on the basis of frequency distribution and discrimination options were selected on likert type rating scale. Each question had four options which are having scores from 1 to 4. Choosing option with score 1 is the best response and 4 is the worst. Thus lower the score better is the EI. The score was decided on the basis of expert validation. This completed the preparation of the preliminary draft. First draft including 30 items was prepared and administered to a sample of thirty students for the purpose of pilot study. The questionnaire was then administered in 480 students and analyzed using appropriate statistical methods. Buffer questions were also added but they were not included as part of the final scoring. Construct validity was established by consulting expert in the field. The items were deleted /modified as required and suggested by experts.
Content Validity was established by expert opinion. The Emotional Intelligence Test (EIT) developed by Dr. Ekta Sharma was administered on 127 students and EIS was also administered on same. The domain scores of social awareness of EIS had a significant correlation with EIT in social awareness domain. Total score did not correlate as the items defining other domains were supposedly different, so as to match the requirement of medical situation. In the statistical analysis lower score is considered to be better. However for the purpose of computing concurrent validity the EIT questionnaire by Dr. Ekta Sharma was administered on 127 students and scores of the present tool are reversed for the purpose of compatibility of correlation between the two scales. Here higher score is considered better. The data was analyzed by Bland Altman Reliability Analysis. Correlations were done domain wise for all four domains. Results are shown in [Figure 1], [Figure 2], [Figure 3], [Figure 4] and [Figure 5].
|Figure 1: Histogram showing distribution of data following a normal curve|
Click here to view
Scoring pattern: The total score ranges between 27 and 108. A score below and equal to 47 is High Emotional Intelligence, a score more than 47 but less than equal to 58 indicates Average Emotional Intelligence and a score more than 58 denotes Below Average Emotional Intelligence.
| Results|| |
Data was analyzed using SPSS version 17. Socio-demographic details are given in table [Table 1]. Mean and standard deviations were calculated [Table 2]. Here lower score was considered to be depicting good oral intelligence. Reliability statistics: Internal Consistency is estimated by Cronbach's Alpha which came to be 0.632.
Age ranged from 17 to 25 years with mean age of 20.08 years.
| Item Description|| |
| Discussion|| |
Emotional Intelligence has been considered to be playing an important role in deciding success across varied professions. High emotional Intelligence is considered to be helpful in coping with problem situation. Emotional Intelligence facilitates coping with negative emotions evoked in stressful situation. It is found that people with higher emotional intelligence tend to solve problem willingly.  Hence, authors planned to assess emotional Intelligence in the context of medical education . In the present study questionnaire was developed with the help of experts, which included situations centering on medical conditions. Total sample comprised of 480 students. Among them 102 were females and 378 were males. Mean age of the sample was 20.08 years. Reliability of these parameters is illustrated by Cronbach's Alfa [Table 3]. Mean value of four domains is given as under [Table 1]. [Figure 1] has shown normal distribution of the data. Since these questions were exclusive to medical situation, the possible correlation between two scales was not very good. Only social awareness showed good correlation between EIS and EIT [Figure 2], [Figure 3], [Figure 4] and [Figure 5]. Principal Component's analysis to identify the likely components or factors elicited loading on the 4 factors [Table 4]. There is a need to further modify the scale with added questions. The scale is needed to be administered on larger sample. The correlation social awareness and self-awareness is maximum i.e. 0.317, which is still low. This is to be expected since when one is developing a scale the correlation between variables(questions) of a component(factor) are to be high while the correlation between the components should not be high. The relevance of having evaluated the emotional Intelligence construct among medical students cannot be overemphasized. Present scale is the preliminary attempt in this direction. In fact internal consistency of the items was noted to be at moderate level. Concurrent validity was actually not possible as there is no tool available having content of medical situations, however construct was analyzed and EIT was administered which revealed moderate level of correlation between social awareness domains. The implication of emotional intelligence in medical training has been emphasized in other setting also. In fact Accreditation Council for Graduate Medical Education's Western Reserve University, Cleveland, Ohio, has identified six general competencies of professionalism. Professionalism is taught experientially through role modeling, which might have certain shortcomings. Authors proposed the model of emotional intelligence (EI) to define key elements of professionalism and as the basis for their proposed curriculum for teaching professionalism. EI is a well-developed construct and consists of four types of abilities: emotional self-awareness, self-management, social awareness, and relationship management. EI abilities may be a useful way of developing curricula for the critical professionalism competency.  However, in Indian scenario it has not been included as a part of training as an explicit module, though integral training of roles and responsibilities of a doctor might be instrumental in teaching this. Interestingly different tools have been used to assess Emotional Intelligence. However, specific tool is not available. Hence, this may be relevant in this context. Medical postgraduates (150) from tertiary care hospital were assessed on emotional quotient self-assessment checklist and Multidimensional empathy Scale and Clinical Anger Scale were also administered authors found more than 70% had poor emotional intelligence. Good control of emotions was associated with good relationship with superiors and colleagues.  The studies have used varied assessment procedures of emotional intelligence among undergraduates and post graduates. However, in particular tool to measure the same is not available.
Current work is the preliminary attempt in the direction of developing the scale for assessment of emotional intelligence among medical students. The preliminary level draft is prepared for the same; further modifications may be done to include larger sample size and elaborate details in future study.
| Acknowledgments|| |
Authors are grateful to Dr. S. L. Jadhav, Professor Department of Community Medicine, DY Patil Medical College, Pune, for his technical evaluation.
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[Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5]
[Table 1], [Table 2], [Table 3], [Table 4]