Assessment of communication skills of undergraduate medical students J Voges E Jordaan * L Koen DJH Niehaus Servier Student Training Centre Department of Psychiatry, University of Stellenbosch and Stikland Hospital * Biostatistics Unit: Medical Research Council, Bellville

Positioning of study Correlation of communication skills of undergraduate medical students with academic performance Substudies  Facial affect recognition  Performance in oral examinations in Psychiatry  Communication skills: Verbal and non-verbal

Introduction Effective medical practitioners require communication competency Successful communication  Improved satisfaction  Treatment compliance  Strong predictor of medical school success Ineffective communication  Malpractice claims  Medication errors Interpersonal communication includes content and relational components

Introduction Non-verbal communication  Conveys and acknowledges information  Contextualises meaning of verbal information Doctors and patients gain information about medical encounter Greater focus on verbal communication  medical education  communication research

Assessment of communication skills Complex Close to real-life encounter Verbal communication skills  Adapted Liverpool communication skills assessment scale Non-verbal communication skills  Focus of presentation

Aim First phase: To develop a psychometrically sound non-verbal assessment tool  Comprehensive  Valid within study population  User-friendly Second phase: Determine whether there is a correlation between non-verbal communication skills and academic performance

Methods Subjects:  Medical students completing late rotation  5 min. semi-structured interview with patient that was videotaped  Permission granted by Faculty of Health Sciences and Ethics committee of SU  Total of 301 video interviews Venue:  5-week Psychiatry rotation at Stikland hospital

Methods Assessment tool:  Development of rating scale  Previous scales  Items retained  5-point rating results  3-point rating Statistical evaluation  Item response model  Parameter estimation

Non-verbal scale Body orientation (Lean) Body posture Attitude Facial expressivity Hand movement Frequency of smiling Frequency of nodding Eye-contact Ordinal measurement scale:  0: Displayed lack of skill  1: Appropriate use of skill  2: Over-use of skill

Results: Distribution of scores 0 = Lack of skill, 1 = Appropriate use of skill, 2 = Over-use of skill

Results: Distribution of scores 0 = Lack of skill, 1 = Appropriate use of skill, 2 = Over-use of skill

Results: Item difficulty

Results: Distribution of total non- verbal scores

Results: Distribution of appropriate responses

Preliminary correlation with academic performance

Discussion Composite non-verbal communication scale 3-point ordinal rating scale Acceptable scale for measuring latent variable Non-verbal communication Suggestions for using total score and individual items

Limitations and recommendations More difficult items High number of maximum scores  Skill  Raters  Type of patient  Rating scale Patient population Sample size  Correlation with academic performance

Selected references  Epstein, R.M., Campbell, T.L., Cohen-Cole, S.A., McWhinney, I.R. & Smilkstein, G. (1993). Perspectives on patient-doctor communication. Journal of Family Practice 37(4): 377–388.  Griffith, C., Wilson, J., Lanfer, S. & Haist, S. (2003). House staff nonverbal communication skills and standardized patient satisfaction. Journal of General Internal Medicine 18: 170–174.  Ishikawa, H., Hashimoto, H., Kinoshita, M., Fujimori, S., Shimizu, T. & Yano, E. (2006). Evaluating medical students’ non-verbal communication during the objective structured clinical examination. Medical education 40: 1180–1187.  Parker, G. (1993). On our selection: predictors of medical school success. Medical Journal of Australia 158(11): 747–751. Project supported by funding from FINLO Faculty of Health Sciences