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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.

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Assessment of communication skills of undergraduate medical students

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  1. 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

  2. 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

  3. 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

  4. 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

  5. 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

  6. 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

  7. 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

  8. 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

  9. 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

  10. Results: Distribution of scores • 0 = Lack of skill, 1 = Appropriate use of skill, 2 = Over-use of skill

  11. Results: Distribution of scores • 0 = Lack of skill, 1 = Appropriate use of skill, 2 = Over-use of skill

  12. Results: Item difficulty

  13. Results: Distribution of total non-verbal scores

  14. Results: Distribution of appropriate responses

  15. Preliminary correlation with academic performance

  16. 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

  17. 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

  18. 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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