Learning Clinical Communication

Abstract

Problem statement: Clinician-patient communication is a basic skill that medical students should learn as part of their training process. Communication skills curriculums aim to develop effective communication with patients, carers, and colleagues by working on both verbal and non-verbal skills. These include being able to take a history and share information, and particularly explaining procedures and discussing treatment options and their effects. Students taking the Communication, interview and clinical history module are asked to follow a simulated-patient clinical interview, which is recorded and then self and tutor- assessed using standardized questionnaires. Purpose of study: The aim of this study is to conduct a pilot test to compare questionnaire results for self and tutor-assessed video-recorded clinical interviews. Methods: The results of students’ self-assessment questionnaires within the Communication, interview and clinical history module (second year of the medical degree) were compared with those of their tutors. The questionnaire used was a shortened version of the 17-itemCICCA-D (Conectar-Identificar-Comprender-Acordar-Ayudar – Connect-Identify-Understand-Agree- Help) instrument (score of 2, 1 or 0 for each item), based on patient-centred interviews. The assessments were carried out independently from one another, with no previous training, after watching the clinical interview video recording. Results: A total of 47 student and tutor assessments were carried out. Differences in the global average scores were statistically significant (p-value < 0.05). The students’ mean self-assessment score was 13 (SD = 5), while the tutors’ was 15 (SD = 5). A weak direct and statistically significant correlation was observed in the global questionnaire score between both self and tutor assessment (n = 47): with an ICC of 0.41 (confidence interval [CI] 95%, (0.09 – 0.66). Conclusions: Pilot test results show that tutors consider students having better communication skills than students themselves. Lack of previous training in the use of the questionnaire could be relevant. Further research is needed to confirm these preliminary results