Face, hierarchy, and autonomy in Uzbek clinical communication: A Situational Judgement Test study

Abstract

Effective clinical communication requires not only bioethical knowledge but sociopragmatic competence, the capacity to navigate competing professional, cultural, and relational expectations in medical encounters. This exploratory, cross-sectional study asked which domains elicited the greatest sociopragmatic tension among Uzbek medical students and how their appropriateness judgements varied across year groups. A scenario-based survey was administered in Uzbek to 100 undergraduate students at seven institutions. Participants completed a six-scenario Situational Judgement Test (SJT): five scenarios used a five-point Likert-type appropriateness scale (Cronbach’s alpha = .785, reported only as a descriptive indicator of interrelatedness for a deliberately multidimensional instrument), and one used a three-option forced-choice format. Non-parametric analyses (Spearman correlations, Kruskal-Wallis tests, Fisher’s Exact Test) were applied, and results are interpreted as sample-level patterns rather than population estimates. Mean ratings ranged from 1.86 to 2.20, below the neutral midpoint, indicating that target actions were more often rated inappropriate than appropriate. The patient-consent scenario showed the widest dispersion (M = 2.15, SD = 1.24). Gift-giving responses were divided among professional refusal (30%), acceptance explicitly framed in the instrument as cultural reciprocity (37%), and collective departmental acceptance (33%). Year group was associated with response choice, although the result was borderline and exploratory (simulated p = .038, Cramér’s V = .304). After Holm adjustment across the five scenario-level tests, year-group differences remained significant for S3, S4, and S5. The exploratory total score, which was not included in the adjustment family, also differed across year groups (H(5) = 35.01, unadjusted p < .001); given the cross-sectional design and small, uneven groups, these differences cannot be interpreted developmentally. These findings provide initial evidence from an underrepresented setting and a basis for validated, longitudinal research on culturally responsive communication training.

More by Gulnoza Salimova

• Gold-set and Probe for LLM Interpretation of Contested Images in Classical Uzbek PoetryFigshare · 2026
• A Pilot Annotation Dataset for Five-Line Takhmis Stanzas in Classical Uzbek Poetry (Ogahiy)Figshare · 2026
• A Lexicon and Detector for Folklorism in Uzbek Poetry (Iqbol Mirzo)Figshare · 2026
• Bioethical-Communicative Judgments Across Training Years: Cross-Year Evidence from Uzbek Medical EducationJournal on Efficiency and Responsibility in Education and Science · 2026 · Citations: 1