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Assessing Communication Skills of Medical Students in Objective Structured Clinical Examinations (OSCE)--A Systematic Review of Rating Scales.

Cömert M, Zill JM, Christalle E, Dirmaier J, Härter M, Scholl I - PLoS ONE (2016)

Bottom Line: The Objective Structured Clinical Examination (OSCE) has been found as an appropriate means to assess communication skills within medical education.The methodological quality of studies was mainly poor.This is especially important given that most OSCE rating scales are used for summative assessment, and thus have an impact on medical students' academic success.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

ABSTRACT

Background: Teaching and assessment of communication skills have become essential in medical education. The Objective Structured Clinical Examination (OSCE) has been found as an appropriate means to assess communication skills within medical education. Studies have demonstrated the importance of a valid assessment of medical students' communication skills. Yet, the validity of the performance scores depends fundamentally on the quality of the rating scales used in an OSCE. Thus, this systematic review aimed at providing an overview of existing rating scales, describing their underlying definition of communication skills, determining the methodological quality of psychometric studies and the quality of psychometric properties of the identified rating scales.

Methods: We conducted a systematic review to identify psychometrically tested rating scales, which have been applied in OSCE settings to assess communication skills of medical students. Our search strategy comprised three databases (EMBASE, PsycINFO, and PubMed), reference tracking and consultation of experts. We included studies that reported psychometric properties of communication skills assessment rating scales used in OSCEs by examiners only. The methodological quality of included studies was assessed using the COnsensus based Standards for the selection of health status Measurement INstruments (COSMIN) checklist. The quality of psychometric properties was evaluated using the quality criteria of Terwee and colleagues.

Results: Data of twelve studies reporting on eight rating scales on communication skills assessment in OSCEs were included. Five of eight rating scales were explicitly developed based on a specific definition of communication skills. The methodological quality of studies was mainly poor. The psychometric quality of the eight rating scales was mainly intermediate.

Discussion: Our results reveal that future psychometric evaluation studies focusing on improving the methodological quality are needed in order to yield psychometrically sound results of the OSCEs assessing communication skills. This is especially important given that most OSCE rating scales are used for summative assessment, and thus have an impact on medical students' academic success.

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Flow diagram of study selection.
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pone.0152717.g001: Flow diagram of study selection.

Mentions: The electronic data base search yielded 540 records. In addition, 28 records were identified through secondary search of which 25 were from reference tracking and three from consultation of experts in the field of communication in health care. In a next step, 191 duplicates were removed. We then excluded another 316 records based on title and abstract screening. The full texts of the remaining 61 records were assessed for eligibility. Of the 61 records, 49 were excluded by applying the inclusion and exclusion criteria (see Table 1). As a result, twelve studies were included in this review. Most of the full texts were excluded either because the measured construct was not communication skills (n = 16) or the aim of the study was not to test the psychometric properties (n = 12). The study selection procedure is shown in Fig 1.


Assessing Communication Skills of Medical Students in Objective Structured Clinical Examinations (OSCE)--A Systematic Review of Rating Scales.

Cömert M, Zill JM, Christalle E, Dirmaier J, Härter M, Scholl I - PLoS ONE (2016)

Flow diagram of study selection.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4816391&req=5

pone.0152717.g001: Flow diagram of study selection.
Mentions: The electronic data base search yielded 540 records. In addition, 28 records were identified through secondary search of which 25 were from reference tracking and three from consultation of experts in the field of communication in health care. In a next step, 191 duplicates were removed. We then excluded another 316 records based on title and abstract screening. The full texts of the remaining 61 records were assessed for eligibility. Of the 61 records, 49 were excluded by applying the inclusion and exclusion criteria (see Table 1). As a result, twelve studies were included in this review. Most of the full texts were excluded either because the measured construct was not communication skills (n = 16) or the aim of the study was not to test the psychometric properties (n = 12). The study selection procedure is shown in Fig 1.

Bottom Line: The Objective Structured Clinical Examination (OSCE) has been found as an appropriate means to assess communication skills within medical education.The methodological quality of studies was mainly poor.This is especially important given that most OSCE rating scales are used for summative assessment, and thus have an impact on medical students' academic success.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

ABSTRACT

Background: Teaching and assessment of communication skills have become essential in medical education. The Objective Structured Clinical Examination (OSCE) has been found as an appropriate means to assess communication skills within medical education. Studies have demonstrated the importance of a valid assessment of medical students' communication skills. Yet, the validity of the performance scores depends fundamentally on the quality of the rating scales used in an OSCE. Thus, this systematic review aimed at providing an overview of existing rating scales, describing their underlying definition of communication skills, determining the methodological quality of psychometric studies and the quality of psychometric properties of the identified rating scales.

Methods: We conducted a systematic review to identify psychometrically tested rating scales, which have been applied in OSCE settings to assess communication skills of medical students. Our search strategy comprised three databases (EMBASE, PsycINFO, and PubMed), reference tracking and consultation of experts. We included studies that reported psychometric properties of communication skills assessment rating scales used in OSCEs by examiners only. The methodological quality of included studies was assessed using the COnsensus based Standards for the selection of health status Measurement INstruments (COSMIN) checklist. The quality of psychometric properties was evaluated using the quality criteria of Terwee and colleagues.

Results: Data of twelve studies reporting on eight rating scales on communication skills assessment in OSCEs were included. Five of eight rating scales were explicitly developed based on a specific definition of communication skills. The methodological quality of studies was mainly poor. The psychometric quality of the eight rating scales was mainly intermediate.

Discussion: Our results reveal that future psychometric evaluation studies focusing on improving the methodological quality are needed in order to yield psychometrically sound results of the OSCEs assessing communication skills. This is especially important given that most OSCE rating scales are used for summative assessment, and thus have an impact on medical students' academic success.

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