The structural model of a physician's communicative competence

Filatova Y.; Lutova N.

doi:10.14529/jpps250407

Y. S. Filatova Yaroslavl State Medical University (5 Revolutsionnaya str., Yaroslavl, 150000, Russia) https://orcid.org/0000-0003-3024-9483 y.s.filatova@mail.ru
N. B. Lutova V.M. Bekhterev National Research Medical Center for Psychiatry and Neurology (3 Bekhtereva str., St. Petersburg, 192019, Russia) https://orcid.org/0000-0002-9481-7411 lutova@mail.ru

DOI: https://doi.org/10.14529/jpps250407

Keywords: physician’s communicative competence, structural model, cognitive-behavioral component, emotional-reflexive component, ethical-deontological component, therapeutic alliance, commitment to treatment, professional communication in medicine, empathy

Abstract

Background. In scientific literature, a physician’s communicative competence is considered a complex, multi-component phenomenon that integrates knowledge, skills, and personal qualities. The analysis of various theoretical approaches reveals a lack of a unified, integrative model that accounts for the specifics of medical practice and the role of model components in achieving a therapeutic alliance. Aims. This study aims to develop a structural model of communicative competence based on a synthesis of contemporary Russian and international research. Theoretical foundations. This study consists of complementary approaches: descriptive analysis was used to systematize the characteristics of the phenomenon; an integrative approach, to conceptualize the phenomenon as a multi-component construct; and subject-activity and competence-based approaches, to analyze the phenomenon within the context of professional activity. Categorization methods were employed to identify structural elements and to facilitate a critical analysis of theoretical propositions and empirical data. Results. As a result of this research, a three-component model of a physician’s communicative competence has been developed, comprising cognitive-behavioral, emotional-reflexive, and ethical-deontological components. The model demonstrates a synergetic relationship among these components: operational skills are regulated by psychological mechanisms of self-awareness and guided by a system of professional values. A key finding is the differentiation of empathy types, which confirms the primacy of cognitive empathy and compassion in patients' assessment of care quality and clarifies the context-dependent role of reflection. Conclusion. The developed model offers a framework for modernizing educational programs and designing targeted training aimed at the holistic development of communicative competence in medical professionals. Prospects for further research involve the empirical validation of the model and an investigation into how its components vary according to medical specialization and the physician’s experience.

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Author Biographies

Y. S. Filatova , Yaroslavl State Medical University (5 Revolutsionnaya str., Yaroslavl, 150000, Russia)

Candidate of Medical Sciences, Associate Professor, Head of the Department of Clinical Psychology

N. B. Lutova , V.M. Bekhterev National Research Medical Center for Psychiatry and Neurology (3 Bekhtereva str., St. Petersburg, 192019, Russia)

Doctor of Medical Sciences, Head of the Department of Integrative Pharmaco-Psychotherapy for Patients with Mental Disorders

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