Assessment of communication skills of undergraduate medical students
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Assessment of communication skills of undergraduate medical students. J Voges E Jordaan * L Koen DJH Niehaus Servier Student Training Centre Department of Psychiatry, University of Stellenbosch and Stikland Hospital * Biostatistics Unit: Medical Research Council, Bellville.

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Assessment of communication skills of undergraduate medical students

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Assessment of communication skills of undergraduate medical students

J Voges

E Jordaan *

L Koen

DJH Niehaus

Servier Student Training Centre

Department of Psychiatry, University of Stellenbosch and Stikland Hospital

* Biostatistics Unit: Medical Research Council, Bellville


Positioning of study

  • Correlation of communication skills of undergraduate medical students with academic performance

  • Substudies

    • Facial affect recognition

    • Performance in oral examinations in Psychiatry

    • Communication skills: Verbal and non-verbal


Introduction

  • Effective medical practitioners require communication competency

  • Successful communication

    • Improved satisfaction

    • Treatment compliance

    • Strong predictor of medical school success

  • Ineffective communication

    • Malpractice claims

    • Medication errors

  • Interpersonal communication includes content and relational components


Introduction

  • Non-verbal communication

    • Conveys and acknowledges information

    • Contextualises meaning of verbal information

  • Doctors and patients gain information about medical encounter

  • Greater focus on verbal communication

    • medical education

    • communication research


Assessment of communication skills

  • Complex

  • Close to real-life encounter

  • Verbal communication skills

    • Adapted Liverpool communication skills assessment scale

  • Non-verbal communication skills

    • Focus of presentation


Aim

First phase:

  • To develop a psychometrically sound non-verbal assessment tool

    • Comprehensive

    • Valid within study population

    • User-friendly

      Second phase:

  • Determine whether there is a correlation between non-verbal communication skills and academic performance


Methods

  • Subjects:

    • Medical students completing late rotation

    • 5 min. semi-structured interview with patient that was videotaped

    • Permission granted by Faculty of Health Sciences and Ethics committee of SU

    • Total of 301 video interviews

  • Venue:

    • 5-week Psychiatry rotation at Stikland hospital


Methods

  • Assessment tool:

    • Development of rating scale

    • Previous scales

    • Items retained

    • 5-point rating results

    • 3-point rating

  • Statistical evaluation

    • Item response model

    • Parameter estimation


Non-verbal scale

  • Body orientation (Lean)

  • Body posture

  • Attitude

  • Facial expressivity

  • Hand movement

  • Frequency of smiling

  • Frequency of nodding

  • Eye-contact

    Ordinal measurement scale:

    • 0: Displayed lack of skill

    • 1: Appropriate use of skill

    • 2: Over-use of skill


Results: Distribution of scores

  • 0 = Lack of skill, 1 = Appropriate use of skill, 2 = Over-use of skill


Results: Distribution of scores

  • 0 = Lack of skill, 1 = Appropriate use of skill, 2 = Over-use of skill


Results: Item difficulty


Results: Distribution of total non-verbal scores


Results: Distribution of appropriate responses


Preliminary correlation with academic performance


Discussion

  • Composite non-verbal communication scale

  • 3-point ordinal rating scale

  • Acceptable scale for measuring latent variable Non-verbal communication

  • Suggestions for using total score and individual items


Limitations and recommendations

  • More difficult items

  • High number of maximum scores

    • Skill

    • Raters

    • Type of patient

    • Rating scale

  • Patient population

  • Sample size

    • Correlation with academic performance


Selected references

  • Epstein, R.M., Campbell, T.L., Cohen-Cole, S.A., McWhinney, I.R. & Smilkstein, G. (1993). Perspectives on patient-doctor communication. Journal of Family Practice 37(4): 377–388.

  • Griffith, C., Wilson, J., Lanfer, S. & Haist, S. (2003). House staff nonverbal communication skills and standardized patient satisfaction. Journal of General Internal Medicine18: 170–174.

  • Ishikawa, H., Hashimoto, H., Kinoshita, M., Fujimori, S., Shimizu, T. & Yano, E. (2006). Evaluating medical students’ non-verbal communication during the objective structured clinical examination. Medical education40: 1180–1187.

  • Parker, G. (1993). On our selection: predictors of medical school success. Medical Journal of Australia 158(11): 747–751.

    Project supported by funding from FINLO

    Faculty of Health Sciences


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