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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

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
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
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
introduction1
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
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
slide6
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
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
methods1
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
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
Results: Distribution of scores
  • 0 = Lack of skill, 1 = Appropriate use of skill, 2 = Over-use of skill
results distribution of scores1
Results: Distribution of scores
  • 0 = Lack of skill, 1 = Appropriate use of skill, 2 = Over-use of skill
discussion
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
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
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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