The story beneath the scores: A mixed methods study of communication skills self-assessment.

Abstract

Communication skills are universally recognised as a core competency in clinical education. This study aimed to investigate the impact of self-assessment on the development of communication skills and to understand the underlying meanings of self-assessment scores at the Faculty of Dental Medicine, Damascus University, Syria. Based on the well-established Calgary-Cambridge Guide, an assessment instrument was developed, translated, and cross-culturally validated for the Syrian Arabic context. The assessment approach comprised one consultation with each of six patients in a clinical setting. After each consultation, the student and patient completed an assessment form. Fifty-four final-year dental students completed all six sessions. A mixed-methods design was employed, beginning with a quantitative phase that investigated the psychometric properties of the assessment instrument and tested for change in communication performance. In the qualitative phase, semi-structured interviews were conducted with a purposive subsample (n = 12) based on quantitative findings. Thematic analysis explored the educational impact and factors influencing self-assessment. There was a significant improvement in patient assessments over time, with a large effect size (P < 0.001, Partial η² = 0.184). Qualitative results supported these findings, revealing increased self-awareness and self-control due to self-assessment. Subjective self-assessment practices, patient - dentist dynamics, and self-reflection all influenced self-assessment scoring. This rigorous mixed-methods research makes an original and substantive contribution through in-depth exploration of meanings and intentions underlying self-assessment results. Although the findings warrants cautious generalisation, this research provides valuable recommendations for students, clinical educators, and curriculum developers to optimise self-assessment and use its data to improve communication performance. This study highlights that using structured self-assessment can be an effective educational practice to improve communication skills and provides insight for educators into what self-assessment scores could mean.