Abstract
BackgroundThe accuracy of self-assessment has been questioned in studies comparing physicians’ self-assessments to observed assessments; however, none of these studies used self-efficacy as a method for self-assessment.The aim of the study was to investigate how medical students’ perceived self-efficacy of specific communication skills corresponds to the evaluation of simulated patients and observers.MethodsAll of the medical students who signed up for an Objective Structured Clinical Examination (OSCE) were included. As a part of the OSCE, the student performance in the “parent-physician interaction” was evaluated by a simulated patient and an observer at one of the stations. After the examination the students were asked to assess their self-efficacy according to the same specific communication skills.The Calgary Cambridge Observation Guide formed the basis for the outcome measures used in the questionnaires.A total of 12 items was rated on a Likert scale from 1–5 (strongly disagree to strongly agree).We used extended Rasch models for comparisons between the groups of responses of the questionnaires. Comparisons of groups were conducted on dichotomized responses.ResultsEighty-four students participated in the examination, 87% (73/84) of whom responded to the questionnaire. The response rate for the simulated patients and the observers was 100%.Significantly more items were scored in the highest categories (4 and 5) by the observers and simulated patients compared to the students (observers versus students: -0.23; SE:0.112; p=0.002 and patients versus students:0.177; SE:0.109; p=0.037). When analysing the items individually, a statistically significant difference only existed for two items.ConclusionThis study showed that students scored their communication skills lower compared to observers or simulated patients. The differences were driven by only 2 of 12 items.The results in this study indicate that self-efficacy based on the Calgary Cambridge Observation guide seems to be a reliable tool.
Highlights
The accuracy of self-assessment has been questioned in studies comparing physicians’ self-assessments to observed assessments; none of these studies used self-efficacy as a method for self-assessment
Comparison of student self-efficacy and observer and simulated patient evaluation scores When including all 12 items evaluated in the dichotomized analysis, significantly more items were scored in categories 4 and 5 by the observers than by the students (−0.23; SE:0.112; p=0.002)
The results indicate that by using self-efficacy scores, the students do not overestimate their skills, while such was the case in studies in which a self-assessment tool was used in comparison with external scores [24], and in other Objective Structured Clinical Examination (OSCE) scenarios in which the communication of the students was scored by simulated patients [8]
Summary
The accuracy of self-assessment has been questioned in studies comparing physicians’ self-assessments to observed assessments; none of these studies used self-efficacy as a method for self-assessment. The aim of the study was to investigate how medical students’ perceived self-efficacy of specific communication skills corresponds to the evaluation of simulated patients and observers. Communication skills training has increasingly become a part of the training of healthcare professionals and it appears to be evident and generally accepted that communication skills are core competencies essential for good patient care [1]
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