Assessment of Communication Skills in Medical Education

From the 1/29/2021 newsletter

 

 

Assessment of Communication Skills in Medical Education

 

 

Mary Ann Gilligan, MD MPH

 

 

Dr. Gilligan, who has an interest in communication in medical settings, shares how she and colleagues are developing teaching methodologies and measurements of effective communication skills for medical students …

 

 

Expertise in communication skills is one of the essential components of clinical competence for doctors. Medical schools are required to include training in communication skills in their curricula. Historically, training has primarily occurred in the early years of medical school and the skills have not been consistently reinforced later in the clinical environment. Fortunately, we now have decades of research to help guide development of a successful program in communication skills training.

 

Assessment of communication skills is one key component of a successful program and is the focus of this article. However, in order to appreciate the role assessment plays, it is important to understand the other components. Core communication skills have been identified and models developed to facilitate teaching of the skills (e.g., Calgary-Cambridge, Three-Function, Smith). There is not one best model but, rather, each one has strengths and weaknesses. For a given program, it is important to choose a model on which to base the program that will provide a common language for both teaching and assessment of skills. There should be progressive building of skills across the curriculum, beginning with core skills in the early years with introduction of advanced skills (e.g., breaking bad news, motivational interviewing) in the later years when learners will be more likely have a chance to use them. The final component to a successful program is the “how” or methods used to teach: communication is a behavior and is best learned using active strategies with opportunities for practice and feedback.

 

 

Communication skills training at MCW

 

Improving communication skills training at MCW begins with changes in assessment, because assessment can drive curriculum change. A robust assessment program will provide the data needed to inform what and how communication skills are taught. Currently at MCW, one important method of assessment of communication skills has been the Objective Structured Clinical Examinations (OSCEs). In the last year, we used a validated communication skills checklist for M3s based on the Three-Function Model for the OSCEs with plans to expand usage to all OSCEs in the near future. Use of the checklist across all years of the curriculum will allow students to track their progress on skills over time. I have been working with Dr. Tavinder Ark and the Kern Institute Data Lab on expanding use of the checklist, analysis of data, and generation of reports for students. 

 

Assessment of communication skills on clinical rotations could serve as another important source of data on competence in communication skills but will require investment of time and effort, especially for faculty development.

 

We are on our way to developing a program that achieves the goals of assessment in medical education as defined by Kalet and Pusic: 1) to motivate and guide [learners] to continually aspire to higher levels of expertise, 2) to identify [learners] who are not competent to practice safely, and 3) to provide evidence that the [learner] is ready for…unsupervised practice.

 

 

For further reading: 

 

Kalet A, Pusic M. Defining and assessing competence. In Remediation in Medical Education: A Mid-Course Correction, Kalet and Chou, eds. Springer. 2014.

 

 

 

Mary Ann Gilligan, MD MPH is a Professor in the Department of Medicine (General Internal Medicine) at MCW. She is a member of the Curriculum and Faculty Pillars of the Robert D. and Patricia E. Kern Foundation for the Transformation of Medical Education.