Monitoring communication skills progress of medical students: Establishing a baseline has value, predicting the future is difficult

Abstract

Objective: To provide evidence for the validity of an Introductory Clinical Experience (ICE) that was implemented as a baseline assessment of medical students' clinical communication skills to support progression of skills over time.

Methods: In this longitudinal study of communication skills, medical students completed the ICE, then a Practice of Medicine (POM) Objective Structured Clinical Exam 8 months later, and the Comprehensive Clinical Skills Exam (CCSE) 25 months later. At each experience, trained Standardized Patients assessed students, using the same behaviorally anchored checklist in 3 domains: Information Gathering, Relationship Development, and Patient Education and Counseling (PEC) with good internal reliability (.70-.87). Skills development patterns were described. ICE as a predictor of later performance was explored. Students' perspectives were elicited.

Results: 140 (80%) medical students consented to include their data in this study. Overall communication scores increased over time (eta² = .17, medium effect) mostly attributable to increase in PEC skills (eta² = .48, large effect), in 4 patterns. ICE and POM scores predicted future communication skills. Most students recognized the educational value of ICE.

Conclusion: Entering medical students' clinical communication skills increase over time on average and may predict future performance.

Practice implications: Implementing an ICE is likely a valid strategy for monitoring progress and facilitating communication skills development.

Keywords: Communication skills; Competency based medical education; Medical students; Progress testing; Progressive mastery; Remediation; Validity evidence.