Is emotional intelligence related to objective parameters of academic performance in medical, dental, and nursing students: A systematic review

Nikhilesh Singh; Sweta Kulkarni; Richa Gupta

doi:10.4103/efh.EfH_208_17

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Year : 2020 | Volume : 33 | Issue : 1 | Page : 8-12

Is emotional intelligence related to objective parameters of academic performance in medical, dental, and nursing students: A systematic review

Nikhilesh Singh¹, Sweta Kulkarni², Richa Gupta¹
¹ Department of Physiology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Pondicherry, India
² Department of Biochemistry, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Pondicherry, India

Date of Submission	08-Apr-2017
Date of Decision	04-Jun-2020
Date of Acceptance	17-Jun-2020
Date of Web Publication	25-Aug-2020

Correspondence Address:
Richa Gupta
Department of Physiology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Pondicherry - 607 402
India

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/efh.EfH_208_17

Abstract

Background: Current research in medical education is increasingly exploring the relevance of emotional intelligence (EI) in the successful performance of health-care people. As assessments of core domains are markers of actual performance of the student when he or she is not observed, this systematic review was aimed to answer the question “what is the influence of EI on objective parameters of academic performance in undergraduate medical, dental, and nursing students aged 18–30 years?” Methods: Databases were systematically searched for empirical studies which measured EI of medical, nursing, or dental undergraduate students and compared it with academic performance during graduation years from January 1, 2000, to August 30, 2016. Quality appraisal and data abstraction was done by two independent authors. Results: Six hundred and twenty-three articles were retrieved from systematic search. Of these, 25 articles were selected. Quality appraisal further led to exclusion of two studies which did not meet ethical criterion. Medical undergraduates were included in 12, dental in 4, and nursing in 7 studies. Four studies examined the relationship of EI with clinical skills, 8 with communication skills, and 18 with overall academic performance. Discussion: The findings of review show that EI has a greater role in academic success of clinical year medical and dental students. Although the review has addressed different rungs of the health-care profession separately, it preludes that better EI skills of health-care team will have a holistic impact on health-care improvement.

Keywords: Dental, emotional intelligence, interprofessional education, medical, nursing, systematic review

How to cite this article:
Singh N, Kulkarni S, Gupta R. Is emotional intelligence related to objective parameters of academic performance in medical, dental, and nursing students: A systematic review. Educ Health 2020;33:8-12

How to cite this URL:
Singh N, Kulkarni S, Gupta R. Is emotional intelligence related to objective parameters of academic performance in medical, dental, and nursing students: A systematic review. Educ Health [serial online] 2020 [cited 2023 Jun 2];33:8-12. Available from: https://educationforhealth.net//text.asp?2020/33/1/8/293332

Background

Clinical competence among prelicensure health professionals is shaped by technical and communication skills that are underpinned by sound knowledge base. At the same time, the development of competence by students depends on many underlying domains such as cognitive ability and personality traits. One of these attributes, emotional intelligence (EI), has been increasingly linked to academic success in various professions.^[1] EI is understood as the ability to monitor one's own emotions and others' emotions, to discriminate among them, and to use this information to guide one's thinking and actions.^[2] This construct of EI is analyzed using either trait-based, ability-based, or mixed (involving trait as well as ability based) measures.^[3] Despite existing debates about the various models of EI, current research in medical education is increasingly exploring the relevance of EI in the successful performance of and practice by health-care people using different EI measures.^[4] Academic success and professional competence of an undergraduate student is defined by assessments based on individuals' competencies.^[5] As these assessments are markers of actual performance of the student when he or she is not observed,^[6] this systematic review was done with the primary aim to explore whether this underlying trait has any relationship with performance and clinical competence as measured by academic performance in undergraduate medical, dental, and nursing students.

Methods

The review process followed standard systematic review guidelines.^[7]

Data source

Databases of Medline, PsycINFO, ERIC, and Cochrane Library were searched. The search strategy included the terms (emotional intelligence AND student$) AND (medical OR dental OR nursing) AND (performance OR skills OR competence). Various synonyms were combined using OR for profession (such as surgeon, surgical, dentistry, and nurses) and performance (such as psychomotor, success, and marks) to increase the sensitivity of our search. Reference list of selected articles was hand searched for relevant studies and conference proceedings. We limited our search to English language studies conducted in young human adults aged 18–30 years published between January 1, 2000, and August 30, 2016. The starting year was chosen because the articles relevant to our review were mostly published from that period onwards.

Study selection

The titles and abstracts of hits of our search criteria (n = 623) were scanned for selection of the study based on standardized inclusion criteria which required empirical studies in which EI of medical, nursing, or dental undergraduate students was measured and compared with academic performance during undergraduate years. Reviews, general opinions, commentaries, and letter to the editors were removed. Articles related to other professions, postgraduates, preadmission scores, selection measures, self-assessment scores, and perception of performance were also removed. The flow and selection of studies is presented in [Figure 1]. In total, 23 articles were selected for data abstraction.

Figure 1: PRISMA flowchart showing flow of studies

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Data abstraction

A data abstraction form was prepared which included information about authors, year of publication, and study design; study population, profession, and year or semester of graduation; measure of EI; domain assessed and outcome measure; and main findings related to academic performance.

Results

The study characteristics and the main findings are summarized in [Table 1]. The details of findings are provided in [Supplement Table 1].

Table 1: Study wise design, target group, emotional intelligence scale used and correlation of emotional intelligence with the domain/outcome measures

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EI and communication skills

Out of eight studies which evaluated the relationship between EI and communication skills, six studies found a positive correlation between EI and communication skills^{[8],[9],[10],[11],[12],[13]} while two found no correlation.^[14],[15] Cherry et al. examined the relationship between Mayer–Salovey–Caruso Emotional Intelligence Test (MSCEIT) scores and communication skills of 2^nd-year medical students^[11] using standardized patients assessed by an examiner. Stratton et al.^[8] did subscale analysis and found a significant correlation between “attention to feelings” component of Trait Meta-Mood Scale scores and communication skills in 3^rd-year medical students. Similarly, in the study by Libbrecht et al.,^[9] ability to regulate emotions explained unique variance in interpersonal performance over and above cognitive ability. Two studies^[14],[15] used MSCEIT scores and assessed communication skills of students who were followed longitudinally. There was no correlation between EI and communication skills for any of the years. However, they did not analyze the correlation between subscales of MSCEIT and communication Objective Structured Clinical Examination (OSCE) scores. As subscales of EI tools assess different aspects of EI, subscale comparison may have thrown more light on the relationship.

Emotional intelligence and overall academic performance

The relationship between EI and overall academic performance of medical students was evaluated by nine studies. It is notable that studies that used grade point average (GPA) or mean scores across different examinations in clinical years found a significant relationship between EI and academic performance^{[15],[16],[17],[18]} while those which used preclinical year scores did not find any relationship between EI and academic performance.^{[19],[20],[21]} This is further evidenced by one study^[16] which found correlation of EI with continuous assessment and final examination marks for 1^st year and final year combined, but when subgroup analysis of each year was done, correlation existed only for final-year students. Similar results were seen in studies which included dental students^[22],[23] and nursing students^{[24],[25],[26],[27],[28]} except that by Rankin^[29] and Fernandez et al.^[30] who found a significant correlation between year 1 nursing students' EI and academic performance. However, one of the studies^[22] also found a negative relationship between EI and preclinical weighted GPA. This finding is in contradiction to other studies. In the study, EI scores were calculated by ratings from others. This approach may have problems of its own as judgment of how people perceive and manage emotions may depend on EI of the rater.

Emotional intelligence and clinical skills

Three studies that assessed clinical skills of medical students^{[8],[14],[15]} used standardized patients' OSCE scores and found no relationship between EI and OSCE scores. Clinical practice by nursing students was positively predicted by total EI scores in a study done by Rankin B.^[29]

Discussion

To our knowledge, this is the first systematic review analyzing the influence of EI on objective academic performance of medical, dental, and nursing students. The findings of review show that EI has a greater role in academic success of clinical year medical and dental students. This is especially true for their performance in communication skills as is evidenced by a significant positive relationship between communication skills and EI or its subscale in different studies. In addition, relationship between EI and holistic academic performance in clinical years also indirectly suggests the role of EI in acquisition of communication skills since the studies have not found any relationship between EI and cognitive domain assessed by written assessment only. It may also explain the absence of relationship between EI and holistic academic performance in preclinical years. However, since none of the studies were interventional, causal relationship cannot be drawn from the comparisons. On the other hand, the studies on nursing students could not provide any conclusive evidence of effect of EI on their overall performance.

Although these findings establish a relationship between EI and academic performance, especially in clinical years of both dental and medical students, they should be seen in context with limitations of the review. First, the use of various scales for determination of EI in the studies selected for review makes the comparisons unreliable^[31] because of the inherent variability of tools. Although studies have suggested and advised the use of certain EI tools such as MSCEIT or Trait Emotional Intelligence Questionnaire, it will not be apt to exclude studies that have used other tools having proven psychometric robustness. Furthermore, adaptability of various EI tools varies across countries and cultures.^[32] Notwithstanding that, studies should report justification for the use of particular EI tool so that the reader can draw the conclusions in context.

Second, although we had analyzed the relationship of EI with objective tools of assessment, it was unfortunate to find that many studies had not elaborated on the details of assessment such as domain assessed, types of questions, weightage, and frequency of examinations.

Finally, the review has considered only college grades whether in the form of end-of-year marks, GPA, Clinical Practice Examination(CPX)/OSCE scores, or CPX-communication scores. These objective tools of assessment capture conventional learning outcomes only. Research in the field of assessment brings to the fore the new measures to address competencies such as professionalism, ethical behavior, the ability to build a therapeutic relationship with the patient, and satisfaction of the patient or the family, which have all been linked to professional success of a doctor.^[33]

The findings of review have shown links between EI and various learning outcomes, especially communication skills, in different health-care professionals. Although the review has addressed different health-care professions separately, it suggests that better EI skills of health-care team members will have a holistic impact on health-care improvement. EI correlates with communication skills and hence also correlates with mean performance scores of clinical years of medical and dental students. The preclinical year could serve as a baseline year for identifying EI of individuals and training them to make them better equipped to provide holistic health care in subsequent years.

Acknowledgments

We thank Dr. B V Adkoli, Professor and Head, Department of Health Professions Education, Mahatma Gandhi Medical College & Research Institute, SBV, for his valuable suggestions on improving the manuscript.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

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