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A tool for the assessment of communication skills.

Article Excerpt
Abstract

While the effectiveness of standardized patients (SPs) used for evaluation and teaching communication skills has repeatedly been demonstrated, there are significant drawbacks to the use of this technique, including lack of standardization across multiple sites and both cost and time at individual sites. This article describes the initial validation study of the Patient Video Interview, an instrument created to serve as a measure of medical student communication skills that overcomes some of the drawbacks of SP-based assessments and that can be used to supplement such assessments.

Introduction

The ability to communicate effectively is crucial to many endeavors, perhaps none more than the relationship between a physician and a patient. Effective communication skills have been shown to be associated with such patient outcomes as (a) medical knowledge, including recall of information, [1] (b) satisfaction, [2] which may lead to better patient compliance, [3] and (c) physiologic outcomes, including regulation of blood sugar and blood pressure. [4] Since the late 1960s, researchers have studied the natural course of communication skill development in medical students and the effects of various programs designed to increase those skills. Today virtually every medical school in the United States and abroad includes interviewing and communication skills as part of its curriculum. Beginning in June, 2004, Step 2 of the United States Medical Licensing Exam (USMLE) will include a Clinical Skills examination. [5] Foreign medical graduates seeking licensure in the U. S. have had to pass such an exam since 1998. [6]

In their attempts to study communication skills, researchers have used a variety of techniques and measurement instruments. The effectiveness of standardized patients (SPs) used for evaluation and teaching has repeatedly been demonstrated. [7] There are, however, significant drawbacks to the use of this technique. These drawbacks include lack of standardization across multiple sites and both cost and time at individual sites. The development and use of multi-institution objective structured clinical exams (OSCEs) utilizing SPs has shown promising early results. [8] Cost, however, remains a significant factor in all assessments employing SPs. The practical significance of this cost is that students are unlikely to experience more than a handful of these valuable experiences during the course of their medical education.

This article describes the development and initial validation study of the Patient Video Interview (PVI), an instrument created to serve as a measure of medical student communication skills that overcomes some of the drawbacks of SP-based assessments and that can be used to supplement such assessments.

The Patient Video Interview

Designed to assess issue recognition and communication process skills, the PVI is a videotape presentation of the cases of two different SPs, each presented in three vignettes. After each vignette, the tape contains timed still screens during which...

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