The CSAS was designed to measure the attitude toward communication skill learning [35], and it is most specific to teaching and learning of communication skills and is the most widely used and validated scale [44]. The CSAS comprises of a scale that is divided into two aspects, which includes positive and negative attitudes toward learning communication skills and comprises 26 items—each with 13 items. The contents of the subscale include the Positive Attitudes Scale (CSAS-PAS) that are positively worded (e.g., “In order to be a good doctor I must have good communication skills”) and the Negative Attitudes Scale (CSAS-NAS) that are negatively worded (e.g., I do not need good communication skills to be a doctor). The measurement uses a five-point Likert scale (1 = strongly disagree, 5 = strongly agree). The scores for every scale ranged from 13 to 65, with higher scores revealing stronger positive or negative attitudes toward learning communication scale.
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