Trained lay observers can reliably assess medical students’ communication skills (original) (raw)
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Simultaneous Evaluation of Communication Skills by Standardized Patients and Medical Evaluators
Medical University
Introduction: The present study analyzes the evaluation of communication skills by standardized patients (SPs) and medical evaluators (Es) in an OSCE setting. Methods: The OSCE involved 189 sixth-year medical students, as well as 34 SPs and 63 Es. Communications skills were evaluated in 8 stations, simultaneously by SPs and Es. The SPs were actors who had been trained in the clinical case and who acted in accordance with a standardized script in a simulated clinical situation. The evaluators, also standardized, were Resident Doctors or staff Doctors from the Hospital Services involved. Results: The global scores awarded to students for communication skills were very similar in both groups, although the score awarded by Es was significantly higher, and a direct relationship was also observed between the mean scores awarded by both groups. Evaluators awarded significantly higher scores than SPs in 7 out of the 10 items on the checklist. Female medical students also scored significantl...
BMC Medical Education, 2015
Background: In medical education, teaching methods offering intensive practice without high utilization of faculty resources are needed. We investigated whether simulated patients' (SPs') satisfaction with a consultation could predict professional observers' assessment of young doctors' communication skills. Methods: This was a comparative cross-sectional study of 62 videotaped consultations in a general practice setting with young doctors who were finishing their internship. The SPs played a female patient who had observed blood when using the toilet, which had prompted a fear of cancer. Immediately afterwards, the SP rated her level of satisfaction with the consultation, and the scores were dichotomized into satisfaction or dissatisfaction. Professional observers viewed the videotapes and assessed the doctors' communication skills using the Arizona Communication Interview Rating Scale (ACIR). Their ratings of communication skills were dichotomized into acceptable versus unacceptable levels of competence. Results: The SPs' satisfaction showed a predictive power of 0.74 for the observers' assessment of the young doctors and whether they reached an acceptable level of communication skills. The SPs' dissatisfaction had a predictive power of 0.71 for the observers' assessment of an unacceptable communication level. The two assessment methods differed in 26 % of the consultations. When SPs felt relief about their cancer concern after the consultation, they assessed the doctors' skills as satisfactory independent of the observers' assessment. Conclusions: Accordance between the dichotomized SPs' satisfaction score and communication skills assessed by observers (using the ACIR) was in the acceptable range. These findings suggest that SPs' satisfaction scores may provide a reliable source for assessing communication skills in educational programs for medical trainees (students and young doctors). Awareness of the patient's concerns seems to be of vital importance to patient satisfaction.
2012
The aim of our study was to present the structure, process and results of the objective structured video exam and One-Station standardized patient exam that have been used to assess second year medical students’ communication skills.Scores of 1137 students between the years 2007 and 2010 were analyzed. Means and standard deviations were calculated for scores and ratings. Internal consistency was assessed using Cronbach's alpha coefficient. To analyze reliability and generalizability, multivariate generalizability theory was employed.Students’ total and item scores on the objective structured video exam (60.5–68.8) were lower than on the One-Station standardized patient exam (90.4–96.6). Internal consistencies of both exams were moderate. Generalizability analysis and D-study results showed that both the objective structured video exam and the One-Station standardized patient exam need improvement.Both exams need measures to improve them, such as increasing the number of video cases or stations, and further standardization of raters.This study might encourage medical teachers to consider assessing validity and reliability of written and performance exams on the basis of generalizability theory, and to find out feasible actions to improve assessment procedures by conducting a D-study.
Journal of Medical Education
Background: Good communication skill is as crucial for the medical practitioner as medical knowledge for better patient outcome. Incorporating simulated patients for teaching communication skills and assessment can be beneficial for the learners as it gives them learning opportunities under a controlled environment. Objectives: 1. To assess the improvement in communication skills with the use of simulated patients after communication skills training. 2. To obtain feedback from simulated patients about patient satisfaction. 3. To obtain feedback from students and faculties about communication skills training intervention and simulated patients for assessment. Methods: After a thorough introduction and explanation of the study, out of total of 139 students from the fifth-semester bachelor of medicine and bachelor of surgery (MBBS), 44 students gave the willingness to participate. Students were divided into two groups of 22 students; one group acted as doctors, and the other group acte...
Who should assess medical students' communication skills: their academic teachers or their patients?
Medical Education, 1998
The objective of this study was to compare the assessment of medical students communication skills made by their academic teachers, with the assessment made by their role-playing`patients'. It was a cross-sectional study, conducted at the Department of General Practice, University of Sydney, Australia, and consisted of 519 undergraduate medical students. Teachers rated students' communication skills using ten speci®c criteria, each marked on a ®ve-point Likert scale. Teachers then rated students' overall performance using a 10-point scale. Patients rated students' overall performance on the same 10-point Likert scale. Only two of the 10 criteria, as rated by the academic teachers, correlated with the role-playing patients' overall score, and all 10 criteria accounted for only 10á1% of the variance in that score. The academic assessors' overall score accounted for only 9á7% of the variance of the patients' overall score. The communications skills emphasized by academic teachers do not re¯ect the skills considered to be important by role-playing patients.
THE EFFECT OF TRAINING IN COMMUNICATION SKILLS ON MEDICAL STUDENTS: A RANDOMIZED CONTROLLED TRIAL
Doctor-patient relationship has always played an important role in medical practice. To measure the effect of communication skills training by evaluating experience of medical students after intervention and 3 months follow up. Sixty students of Medical Sciences participated in this single-blind randomized study. The intervention was communication skills training during a three day workshop with a total of 18 hours of training. The tool for assessment was interpersonal and communication skills checklist based on standardized patient. The mean score of communication skills in the intervention group was 4.36 scores higher than the control group after intervention and 3.7 scores higher after three months follow up. Although this difference reduced in follow up, it was still statistically different (P <0.05). The results of the study showed that communication skills training program in the form of a week-long workshops enhanced skills in the intervention group in comparison with the control group. Three months after the intervention, the effects of training still remained. Considering the lack of communication skills training in the curriculum of medical students, it is recommended that this subject be included in the curriculum.
Psychiatry Investigation
Objective The conduct of a medical interview is a challenging skill, even for the most qualified physicians. Since a training is needed to acquire the necessary skills to conduct an interview with a patient, we compared role-play with standardized patients (SP) training and a conventional lecture for the acquisition of communications skills in undergraduate medical students.Methods An entire promotion of third year undergraduate medical students, who never received any lessons about communications skills, were randomized into 4 arms: 1) SP 2 months before the testing of medical communications skills (SP); 2) conventional lecture 2 months before the testing (CL); 3) two control groups (CG) without any intervention, tested either at the beginning of the study or two months later. Students were blindly assessed by trained physicians with a modified 17-items Calgary-Cambridge scale.Results 388 students (98.7%) participated. SP performed better than CL, with significant statistical diffe...
Advances in Health Sciences Education, 2000
The purpose of this study is to investigate the content-specificity of communication skills. It investigates the reliability and dimensionality of standardized patient (SP) ratings of communication skills in an Objective Structured Clinical Examination (OSCE) for final year medical students. An OSCE consisting of seven standardized patient (SP) encounters was administered to final-year medical students at four medical schools that are members of the California Consortium for the Assessment of Clinical Competence (N = 567). For each case, SPs rated students' communication skills on the same seven items. Internal consistency coefficients were calculated and a two-facet generalizability study was performed to investigate the reliability of the scores. An exploratory factor analysis was conducted to examine the dimensionality of the exam. Findings indicate that communication skills across the seven-case examination demonstrate a reliable generic component that supports relative decision making, but that a significant case-by-student interaction exists. The underlying structure further supports the case-specific nature of students' ability to communicate with patients. From these findings, it is evident that individual's communication skills vary systematically with specific cases. Implications include the need to consider the range of communication skill demands made across the OSCE to support generalization of findings, the need for instruction to provide feedback on communication skills in multiple contexts, and the need for research to further examine the student, patient, and presenting problem as sources of variation in communication skills.
Teaching Inpatient Communication Skills to Medical Students: An Innovative Strategy
Academic Medicine, 2005
At the University of Washington, a group of medical educators defined a set of communication skills, or "benchmarks," that are expected of second-year medical students conducting history and physical examinations on hospitalized patients. In order to teach the skills listed in the communication benchmarks, an educational strategy was devised that included training sessions for 30 medical teachers and the development of an innovative videotape tool used to train the teachers and their students. The benchmarks were designed in 2003 for the developmental level of the students and were based on key communication concepts and essential elements of medical communication. A set of five short videotaped scenarios was developed that illustrated various segments of a student history and physical examination. Each scenario consisted of an "OK" version of communication and a "better" version of the same scenario. The video scenarios were used in teaching sessions to help students identify effective communication techniques and to stimulate discussion about the communication benchmarks. After the training sessions, teachers and students were surveyed to assess the effectiveness of the educational methods. The majority of students felt that the educational design stimulated discussion and improved their understanding of communication skills. Faculty found the educational design useful and 95% felt that the curriculum and videotape contributed to their own education. The development of communication benchmarks illustrated with short videotaped scenarios contrasting "OK" with "better" communication skills is a useful technique that is transferable to other institutions.