Abstract
BackgroundCommunication skills are essential for physicians to practice Medicine. Evidence for the validity and domain specificity of communication skills in physicians is equivocal and requires further research. This research was conducted to adduce evidence for content and context specificity of communication skills and to assess the usefulness of a generic instrument for assessing communication skills in International Medical Graduates (IMGs).MethodsA psychometric design was used for identifying the reliability and validity of the communication skills instruments used for high-stakes exams for IMG's. Data were collected from 39 IMGs (19 men – 48.7%; 20 women – 51.3%; Mean age = 41 years) assessed at 14 station OSCE and subsequently in supervised clinical practice with several instruments (patient surveys; ITERs; Mini-CEX).ResultsAll the instruments had adequate reliability (Cronbach's alpha: .54 – .96). There were significant correlations (r range: 0.37 – 0.70, p < .05) of communication skills assessed by examiner with standardized patients, and of mini-CEX with patient surveys, and ITERs. The intra-item reliability across all cases for the 13 items was low (Cronbach's alpha: .20 – .56). The correlations of communication skills within method (e.g., OSCE or clinical practice) were significant but were non-significant between methods (e.g., OSCE and clinical practice).ConclusionThe results provide evidence of context specificity of communication skills, as well as convergent and criterion-related validity of communication skills. Both in OSCEs and clinical practice, communication checklists need to be case specific, designed for content validity.
Highlights
Communication skills are essential for physicians to practice Medicine
Assessment occurred in two parts: 1) Step A, a 150 item multiple choice questions exam to test declarative knowledge followed by a 14 station objective structured clinical exam utilizing standardized patients for testing clinical and communication skills, and 2) Step B, direct assessments and evaluations of the International Medical Graduates (IMGs) in a three month supervised clinical practice experience
Twenty-five of 39 IMGs passed Step A and 24 (1 withdrew) moved to Step B and were assessed during supervised clinical practice. Out of these 24 IMG's, based on the assessments during supervised clinical practice 16 passed Step B and subsequently obtained a restricted license to practice in their respective provinces
Summary
Evidence for the validity and domain specificity of communication skills in physicians is equivocal and requires further research. This research was conducted to adduce evidence for content and context specificity of communication skills and to assess the usefulness of a generic instrument for assessing communication skills in International Medical Graduates (IMGs). Communication is one of the most important components of physicians' patient management skills and overall competence. Competence in a physician is a composite of clinical skills, interpersonal aspects of patient physician encounter, professionalism and communication skills [13]. Hodges, Turnbull, Cohen et al reported a significant difference in the mean score of difficult and easy OSCE stations, they concluded that communication skills are bound with content knowledge and are case or context specific [6]
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