Skills in clinical communication: Are we correctly assessing them at undergraduate level?

2014 
Traditonal learning and assessment systems are overwhelmed when it comes to addressing the complex and mult-dimensional problems of clinical communicaton and professional practce. This paper shows results of a training program in clinical communicaton under Problem Based Learning (PBL) methodology and correlaton between student self-assessment and teachers assessment. This involves a qualitatve-quanttatve cross-sectonal study in usual practce in the 2nd year of the degree in Medicine. Teaching methodology is PBL, including 15 associate professors and 90 students. Educatonal tools for learning: PBL cases and seminars (video recorded, theoretcal-practcal lectures). Assessment tools: Tutorials on those cases worked on PBL (40%), knowledge test (30%), assessment of a case with PBL methodology (20%) and video recording report (10%). Communicaton skills are evidenced by CICCA-D scale (Connect-Understand-IdentfyAgree-Help-Decision). Variables: academic performance, score on CICCA-D and academic methodological assessment. The analysis is carried out using descriptve statstcs, calculatng the intra-class correlaton coefcients and weighted Kappa index with quadratc weights. 92.2% of students passed the course on the frst round. In a range between 0 and 34 points students' self-assessment scored 13 (SD ± 5) points and teachers' 16 (SD ±7). A weak (21% - 41%) or poor (< 20%) correlaton was obtained between teachers and students for all questons on CICCA-D. The authors suggest a summatve assessment using diferent instruments and techniques to assess clinical communicaton skills from the frst year onwards, and highlight the key role of self-assessment, peer assessment and the use of video recording techniques along with feedback in formatve assessment.
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