Optometry Students’ Attitudes Towards Learning Communication Skills: A CSAS-Optom Study
Round 1
Reviewer 1 Report
Comments and Suggestions for AuthorsPage 2, Line 46 – The preceding two paragraphs discuss the importance of communication; however, communication skills are neither explained nor defined. I recommend adding a paragraph here that clearly defines communication skills as they are conceptualised and operationalised in this study, particularly since communication skills constitute the central focus of the paper.
Page 2, Lines 49–56 – Problem-based learning is addressed, but the manuscript does not explain how this type of learning contributes to the development of communication skills, how communication skills are embedded within such learning approaches, or how problem-based learning may influence students’ perceptions of communication skills, which is a key focus of the present study.
Page 2, Line 58 – The phrase “numerous health disciplines” is vague. Please specify which disciplines are being referred to and provide appropriate references.
Page 2, Lines 73–78 – I suggest separating this content into a distinct section entitled Research Aims. The aims and research questions and/or hypotheses should be clearly and explicitly formulated. In particular, the rationale for conducting comparisons based on level of study, age, and gender should be clearly explained. If there is a research question that links these comparisons to the curriculum, it should be explicitly stated.
Page 3, Line 98 – After the sections Ethics and Course Structure, please add a subsection titled Research Participants, providing a detailed description of participants’ demographic characteristics. A tabular presentation is recommended for clarity. Additionally, please justify the chosen age groups (18-25 and ≥26), and explain why alternative groupings (e.g., 18-23), particularly relevant in the context of a five-year study programme, were not used.
Page 5, Line 167 – Please include the full wording of items 14 and 16 when referring to “items 14 and 16,” as this would significantly facilitate readability. Please do so throughout the text when mentioning items in the Results and Discussion sections.
Page 7, Line 198 – The term “younger students” is relative and should be replaced with a clearly defined age group. Please ensure consistent use of precise age specifications throughout the manuscript.
Page 7, Line 203 – The statement “which is reflective of the gender bias of females in optometry” requires clarification. Please specify what is meant by gender bias in this context and support this claim with an appropriate reference, as such patterns may not be universal across countries or educational systems.
Page 11, Line 245 – The sentence “While some studies have shown attitudes of healthcare students towards learning communication decline…” is unclear. Please specify whether this refers to a decline in positive attitudes, or a decline in negative attitudes, or another attitudinal shift.
Page 12, Lines 289–292 – This content should be relocated to the Methodology section, under the subsection Participants.
Page 13, Line 345 – The claim “our findings align strongly with international literature” requires explicit referencing. Please specify which studies or bodies of literature are being referred to and cite them accordingly.
Page 13 – Section 4.4. Implications for Curriculum Design requires further elaboration. Specifically, the manuscript should clarify what concrete implications the comparative analyses by age and gender have for curriculum development. Similarly, implications related to year of study are currently stated in very general terms. The authors should explain more explicitly how the findings can be applied in redesigning or improving the existing curriculum.
Page 14 – Conclusion – The authors should ensure that the conclusion clearly derives from the stated research aims and explicitly addresses the implications for curriculum redesign, which are mentioned as a practical contribution of the study but not sufficiently articulated in the conclusion. Furthermore, the overarching purpose of the study remains unclear, particularly regarding the rationale for conducting comparative analyses by age and gender. The conclusion should clarify what these comparisons contribute to the field. Finally, the limitations of the study and directions for future research should be more clearly articulated in the conclusion, even if they have been partially addressed in the Results or Discussion sections.
Author Response
We thank both reviewers for taking the time to review this manuscript. Please find detailed responses below and corresponding revisions in track changes in the re-submitted files.
Author Response File: 
Author Response.pdf
Reviewer 2 Report
Comments and Suggestions for AuthorsWe would like to thank the authors for their valuable contribution to understanding optometry students’ attitudes toward learning communication skills. This study provides important insights into how gender, age, and year level may influence these attitudes. Overall, the manuscript addresses a relevant topic, uses appropriate methodology, and presents interesting findings. However, several improvements could enhance clarity, interpretability, and impact.
1. Introduction
Clearly stating the study hypotheses in the introduction would improve clarity and strengthen the alignment between the objectives and the analyses.
2. Data Analysis
It would be helpful to report effect sizes for statistically significant differences, in order to allow readers to assess their practical significance.
Consider reporting Cronbach’s alpha for the PAS and NAS subscales in this sample to support internal reliability.
3. Results and Presentation
Minor typographical errors in bullet points and tables (alignment and spacing) should be corrected.
Some wording could be simplified to improve readability for an international audience.
Consistency in terminology is needed: use either “optometry students” or “learners” throughout the manuscript.
4. Discussion
Expand the discussion of potential causes for observed gender differences, integrating literature from other health professions.
Discuss limitations more explicitly, particularly the reliance on self-reported attitudes and the lack of correlation with clinical performance.
It would be valuable for future studies to explore potential differences between students following PBL-based curricula and those in more traditional programs. Comparing these groups could help determine whether PBL specifically contributes to the positive attitudes toward communication skills observed in this study.
Suggest future longitudinal studies to track attitude changes over time and their impact on clinical competence.
The reference list appears inconsistent in formatting. I recommend carefully reviewing and standardizing the reference list according to the journal’s style guidelines to ensure consistency and accuracy.
Conclusion
With minor revisions to clarify methodology, report effect sizes, improve readability, and expand discussion of limitations and curriculum differences, this manuscript could make a valuable contribution to the literature on communication skills training in optometry education.
Some wording could be simplified to improve readability for an international audience.
Consistency in terminology is needed: use either “optometry students” or “learners” throughout the manuscript.
Author Response
We thank both reviewers for taking the time to review this manuscript. Please find detailed responses below and corresponding revisions in track changes in the re-submitted files.
Author Response File: Author Response.pdf
