Medical Student's Communication Ability during the Medical Interview – Perceptions of Self, Patients and Faculty

Abstract

Background: Research indicates that students struggle to transfer class room taught communication skills into the reality of clinical practice. Students have previously been shown to be poor at self assessment of communication skills with over or under estimation of ability. Patients have previously shown little correlation with faculty. Methods: This study sought to investigate medical student's actual communication skills at the bedside, during a medical interview, from the perspectives of faculty (behavioral scientists) patients and self assessment. A validated Calgary - Cambridge observation tool was utilized. Results: Patients and faculty reported clear evidence of classroom taught skills being utilized clinically. The median scores achieved were similar with faculty reporting 64.5 %, (Q1, 59.5: Q3, 70.75), Patients 64% (Q1, 56.25: Q3, 71) and students' self- assessment at 63% (Q1, 56: Q3 68), (Range 0-100%). Students underestimated their skills in "initiation of interview", "gathering information" and "building structure". Students over estimated their abilities in "understanding the patients perspective", "building a relationship" and "closing the interview". A medium correlation of 0.584 was determined between faculty and patients with a p- value of 0.00069. There was no correlation between students self assessments and faculty nor between students and patient assessments Conclusion: Medical students can transfer some classroom taught communication skills to the clinical setting, during the medical interview, to the satisfaction of faculty and patients. Students in the early years of training appear poor at self - assessment of their actual ability in some aspects of communication skills. This concurs with previous findings. However, patients had good agreement with faculty - this has been seen previously with standardized patients but not with actual hospital in-patients.