Abstract
The purpose of this study is toinvestigate the content-specificity ofcommunication skills. It investigates thereliability and dimensionality of standardizedpatient (SP) ratings of communication skills inan Objective Structured Clinical Examination(OSCE) for final year medical students. AnOSCE consisting of seven standardized patient(SP) encounters was administered to final-yearmedical students at four medical schools thatare members of the California Consortium forthe Assessment of Clinical Competence (N =567). For each case, SPs rated students'communication skills on the same seven items. Internal consistency coefficients werecalculated and a two-facet generalizabilitystudy was performed to investigate thereliability of the scores. An exploratoryfactor analysis was conducted to examine thedimensionality of the exam.Findings indicate that communication skillsacross the seven-case examination demonstrate areliable generic component that supportsrelative decision making, but that asignificant case-by-student interaction exists. The underlying structure further supports thecase-specific nature of students' ability tocommunicate with patients. From thesefindings, it is evident that individual'scommunication skills vary systematically withspecific cases. Implications include the needto consider the range of communication skilldemands made across the OSCE to supportgeneralization of findings, the need forinstruction to provide feedback oncommunication skills in multiple contexts, andthe need for research to further examine thestudent, patient, and presenting problem assources of variation in communication skills.
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References
Bayer-Fetzer Conference on Patient-Physician Interaction in Medical Education (2001). Essential elements of communication in medical encounters: the Kalamazoo Consensus Statement.Academic Medicine 76: 390–393.
Blue, A.V., Chessman, A.W., Gilbert, G.E. & Mainous III, A.G. (2000). Responding to patients' emotions: important for standardized patient satisfaction. Family Medicine 32: 326–330.
Cohen, D.S., Colliver, J.A., Robbs, R.S. & Swartz, M.H. (1997). A large-scale study of the reliabilities of checklist scores and ratings of communication skills evaluated on a standardized-patient examination. Advances in Health Sciences Education 1: 209–213.
Colliver, J.A. & Swartz, M.H. (1997). Assessing clinical performance with standardized patients.JAMA 278: 790–791.
Colliver, J.A., Swartz, M.H., Robbs, R.S. & Cohen, D.S. (1999). Relationship between clinical competence and communication skills in standardized-patient assessment Academic Medicine 74: 271–274.
Colliver, J.A., Willis, M.S., Robbs, R.S., Cohen, D.S. & Swartz, M.H. (1998). Assessment of empathy in a standardized-patient examination. Teaching and Learning in Medicine 10: 8–11.
Donnelly, MB., Sloan, D., Pymale,M. & Schwartz, R. (2000). Assessment of residents' interpersonal skills by faculty proctors and standardized patients: a psychometric analysis. Academic Medicine 75(October): S93–S95.
Hodges, B., Turnbull, J., Cohen, R., Bienenstock, A. & Norman, A. (1996). Evaluating communication skills in the objective structured clinical examination format: reliability and generalizability.Medical Education 30: 38–44.
Holmboe, E.S. & Hawkins, R.E. (1998). Methods for evaluating the clinical competence of residents in internal medicine: a review. Annals of Internal Medicine 129: 42–48.
Keen, A.J.A., Klein, S. & Alexander, D.A. (2003). Assess the communication skills of doctors in training: reliability and sources of error. Advances in Health Sciences Education 8: 5–16.
Maradi, A. (1981). Factor analysis as an aid in the formation and refinement of empirically useful concepts. In D. Jackson & E.F. Borgatta (eds.), Factor Analysis and Measurement in Sociological Research. Thousand Oaks, CA: Sage.
Meredith, P. & Wood, C. (1996). Aspects of patient satisfaction with communication in surgical care: confirming qualitative feedback through quantitative methods. International Journal for Quality in Health Care 8: 253–264.
Reckase, M.D. (1979). Unifactor latent trait models applied to multi-factor tests: results and implications. Journal of Educational Statistics 4: 207–230
Rose, M. & Wilkerson, L. (2001). Widening the lens on standardized patient assessment: what the encounter can reveal about the development of clinical expertise. Academic Medicine 76: 88–91.
Sloan, D.A., Donnelly, M.B., Schwartz, R. & Strodel, W.E. (1995). The objective structured clinical examination: the new gold standard for evaluating postgraduate clinical performance. American Journal of Surgery 222: 735.
Vu, N.V. & Barrows, H.S. (1994). Use of standardized patients in clinical assessments: recent developments and measurement findings. Educational Researcher 23: 23–30.
Wilkerson, L. & Rose, M. (2001). Learning from narrative comments of standardized patients during an objective structured clinical examination of final-year medical students. ERIC Clearinghouse on Assessment and Evaluation.
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Guiton, G., Hodgson, C.S., Delandshere, G. et al. Communication Skills in Standardized-Patient Assessment of Final-Year Medical Students: A Psychometric Study. Adv Health Sci Educ Theory Pract 9, 179–187 (2004). https://doi.org/10.1023/B:AHSE.0000038174.87790.7b
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DOI: https://doi.org/10.1023/B:AHSE.0000038174.87790.7b