Monitoring communication skills progress of medical students: Establishing a baseline has value, predicting the future is difficult.

Abstract

To provide evidence for the validity of an Introductory Clinical Experience (ICE) that was implemented as a baseline assessment of medical students' clinical communication skills to support progression of skills over time. In this longitudinal study of communication skills, medical students completed the ICE, then a Practice of Medicine (POM) Objective Structured Clinical Exam 8 months later, and the Comprehensive Clinical Skills Exam (CCSE) 25 months later. At each experience, trained Standardized Patients assessed students, using the same behaviorally anchored checklist in 3 domains: Information Gathering, Relationship Development, and Patient Education and Counseling (PEC) with good internal reliability (.70-.87). Skills development patterns were described. ICE as a predictor of later performance was explored. Students' perspectives were elicited. 140 (80%) medical students consented to include their data in this study. Overall communication scores increased over time (eta² = .17, medium effect) mostly attributable to increase in PEC skills (eta² = .48, large effect), in 4 patterns. ICE and POM scores predicted future communication skills. Most students recognized the educational value of ICE. Entering medical students' clinical communication skills increase over time on average and may predict future performance. Implementing an ICE is likely a valid strategy for monitoring progress and facilitating communication skills development.