Abstract
BackgroundInterpersonal and Communication Skills (ICS) and Professionalism milestones are challenging to evaluate during medical training. Paucity in proficiency, direction and validity evidence of assessment tools of these milestones warrants further research. We validated the reliability of the previously-piloted Instrument for Communication skills and Professionalism Assessment (InCoPrA) in medical learners.MethodsThis validity approach was guided by the rigorous Kane’s Framework. Faculty-raters and standardized patients (SPs) used their respective InCoPrA sub-component to assess distinctive domains pertinent to ICS and Professionalism through multiple expert-built simulated-scenarios comparable to usual care. Evaluations included; inter-rater reliability of the faculty total score; the correlation between the total score by the SPs; and the average of the total score by two-faculty members. Participants were surveyed regarding acceptability, realism, and applicability of this experience.ResultsEighty trainees and 25 faculty-raters from five medical residency training sites participated. ICC of the total score between faculty-raters was generally moderate (ICC range 0.44–0.58). There was on average a moderate linear relationship between the SPs and faculty total scores (Pearson correlations range 0.23–0.44). Majority of participants ascertained receiving a meaningful, immediate, and comprehensive patient-faculty feedback.ConclusionsThis work substantiated that InCoPrA was a reliable, standardized, evidence-based, and user-friendly assessment tool for ICS and Professionalism milestones. Validating InCoPrA showed generally-moderate agreeability and high acceptability. Using InCoPrA also promoted engaging all stakeholders in medical education and training–faculty, learners, and SPs—using simulation-media as pathway for comprehensive feedback of milestones growth.
Highlights
Interpersonal and Communication Skills (ICS) and Professionalism milestones are challenging to evaluate during medical training
Simulation scenarios Building on our previous work [24], we have developed four scenarios which have been reviewed for content, realism, acceptability and expert validity by participating faculty members, leadership, Standardized Patients (SPs) and non-participating learners
Interrater reliability of the total score between faculty raters was generally moderate for the four simulation scenarios (ICC range 0.44 to 0.58, Table 2)
Summary
Interpersonal and Communication Skills (ICS) and Professionalism milestones are challenging to evaluate during medical training. The ACGME produced the milestones to provide a framework for assessment [5,6,7,8], they tend to be subjective with language that allows room for interpretation, which likely reduces the fidelity and reliability of the milestones from one program or even one assessor to the other [9,10,11] These competencies and milestones have created an additional burden to already-overwhelmed educators and core faculty who genuinely want to spend sufficient time to properly teach and assess their trainee’s achievement of the competencies and professional growth [9, 12,13,14]. Of the six competencies and their milestones, Interpersonal and Communication Skills (ICS) and Professionalism [15] have been challenging to evaluate since they can be influenced by numerous factors [16]
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