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Domain Based Communication Skills Assessment Pilot For EU Doctors

Domain Based Communication Skills Assessment Pilot For EU Doctors. Annie M Cushing 1 , Jean S Ker 2 , Paul Kinnersley 3 , Anthony N Warrens 1 , Olwyn M R Westwood 1 , Pascal McKeown 4. European Union Law: Article 53 of Directive 2005/36/EC.

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Domain Based Communication Skills Assessment Pilot For EU Doctors

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  1. Domain Based Communication Skills Assessment Pilot For EU Doctors Annie M Cushing1, Jean S Ker2, Paul Kinnersley3, Anthony N Warrens1, Olwyn M R Westwood1 , Pascal McKeown4

  2. European Union Law:Article 53 of Directive 2005/36/EC ‘Persons benefitting from the recognition of professional qualification shall have a knowledge of languages necessary for practicing the profession in the host Member State’

  3. Assessment is NOT a test ofClinical Knowledge Legal Framework: ‘Proportionate and necessary’ : • Applied in a non-discriminatory manner • Justified by overriding reasons based on the general interest • Suitable for securing the attainment of the objective which they pursue and • Not go beyond what is necessary to obtain that objective

  4. Mis-communication is multi-factorial • Language Issues • Cultural differences in concept of roles, systems and professionalism • Consultation style and Communication skills in doctor-patient relationship • Cultural aspects of healthcare and team relationships Pilotti LS 2007, Watt D, 2007, Woodward-Kron R 2009, Trafford P 2010 (personal communications)

  5. Development Process for Test of Applicants to the UK Foundation Programme Validity • Tasks (GMC Tomorrow’s Doctors 2009, Scottish Doctor) • Domain-based mark scheme (Communication) • Setting the Standard – Pass mark Reliability • Training: Assessors Clinicians and Simulated Patients • Information for Candidates

  6. BLUEPRINT TEMPLATE FOR POPULATING EXAM STATIONS CONTEXTS

  7. DOMAINS A = English language skills 1. Listening comprehension: understands patient/colleague 2. Spoken English comprehension: patient/colleague understands 3. Reading comprehension: demonstrates understanding of written input 4. Written comprehension: writing understood to enable appropriate action B = Clinical communication 1. Opening the consultation: establishes relationship with patient 2. Professional /humanistic quality: continues to maintain the relationship 3. Information gathering: gathers enough information to understand the problem(s) 4. Examining the patient: patient is enabled to co-operate with examination 5. Explaining/negotiating/consenting: information is understood with appropriate patient involvement 6. Communication with colleagues/team members C = Patient ratings: Patient satisfied with doctor-patient relationship and understanding

  8. OSCE Format 15 Station Exam , 10 Minutes each = 2hrs 30mins 5th year Medical Students (n= 15 at each site)

  9. Results (n = 58) Raw Percentage Mean = 81.4 Standard Deviation = 6.7 Cronbach’s alpha = 0.78 Standard Error of Measurement = 3.11 Standard Setting by the Borderline Regression Method Cut Score (pass mark) = 62.44 Cut Score + 1 SEm = 65.62 Cut Score + 2 SEm = 68.80

  10. Cumulative Marks’ Curve (integrated frequency distribution) combined sites scores

  11. Overall Marks vs no. of stations failed, overall cut score, confidence intervals and stations’ criterion

  12. Means of Domains & Variance across All Stations A1-4 = Language, B1-5 = Consultation, B6 = Team, C= Patient Rating

  13. Next Steps Pilot with Doctors qualifying from non-English Speaking Countries

  14. Acknowledgements Sam Leinster Siobhan Fitzpatrick Pascal McKeown Jonathan Silverman John Patterson Penny Trafford Lynne Rustecki Tim Swanick Katie Petty-Saphon

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