gms | German Medical Science

Introduction: Learning and assessing communication skills has been given great importance in medical curricula. Examinations usually assess communication skills under standardized conditions. There is a lack of workplace based assessment (WPBA) if students can communicate with "real patients".

Objectives: The aim of this study was to pilot a formative testing method for WPBA of communication skills. We analysed whether or not physicians view the method as feasible and how high acceptance is among students. In addition, we assessed the reliability of the method.

Materials & methods: In their General Practitioner training, 16 students held two consultations each with chronically ill patients. Consultations were video-recorded. Mentoring physicians (n=9) rated their student's performance and provided feedback using the Berlin Global Rating scale (BGR). Videos were also evaluated by two impartial, trained raters using BGR. In order to explore feasibility of the assessment, we had physicians filled in a semi standardized 12-item questionnaire. Students were asked to indicate their experiences in open-ended responses. The latter were evaluated by inductive content analysis. To test for reliability, the test-retest reliability was calculated for both of the overall evaluations by Pearson's correlation coefficient. The inter-rater reliability was determined for the three evaluations of each individual consultation by intra-class correlation.

Results: The formative assessment method was rated positively by both physicians and students. Its significant value lies in the personal, structured and recurring feedback. Assessment can be improved by integrating more information on medical context and students' self-assessments. The two overall scores for each patient consultation correlate moderately (r=0.520 – r=0.669). The degree of uniformity among the three raters in respect to the individual consultations is low (ICC=0.301 – ICC=0.619).

Conclusion: In our study, only a small sample of physicians and students could be surveyed to a limited extent. Despite these limitations, it has become obvious that WPBA of communication skills in the clinical setting is a valuable addition to the communication curricula of medical schools. The lack of interrater-reliability could be reduced by rater trainings or check lists instead of global rating.