Assessment of communication skills

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Highlights

  • Communication is best learned in the most authentic setting.

  • Assessment of communication is based on direct observation.

  • Individual assessment moments are geared to giving feedback, not to take pass/fail decisions.

  • Skilled communication is promoted by regular feedback and role modeling.

  • Pass/fail high stake decisions are based on a rich set of information on the longitudinal development of a learner.

Abstract

Objective

This paper addresses how communication skills can best be assessed. Since assessment and learning are strongly connected, the way communication skills are best learned is also described.

Results

Communication skills are best learned in a longitudinal fashion with ample practice in an authentic setting. Confrontation of behavior initiates the learning process and should be supported by meaningful feedback through direct observation. When done appropriately a set of (learned) communication skills become integrated skilled communication, being versatilely used in purposeful goal-oriented clinical communication. The assessment of communication skills should follow a modern approach to assessment where the learning function of assessment is considered a priority. Individual assessments are feedback-oriented to promote further learning and development. The resulting rich information may be used to make progression decisions, usually in a group or committee decision.

Conclusion

This modern programmatic approach to assessment fits the learning of skilled communication well.

Practice implications

Implementation of a programmatic assessment approach to communication will entail a major innovation to education.

Section snippets

Background

Communication skills are a firm part of training programs of most health professionals. Communication skills has been included as a main competency in all major competency frameworks used in medical education, like Can-Meds [1], ACGM outcomes project [2] and Good Medical Practice [3]. When training programs teach communication skills, then there is often a need to assess these skills as well. Have certain communication outcomes and skills been reached? Has the training program been effective?

Learning communication skills from an educational perspective

Modern training programs are outcome-based. Outcomes are usually defined in a set of competencies. A competency is the integration of knowledge, skills and attitudes to be able to perform a complex professional challenge [5]. Competency frameworks have been developed in all parts of the world with a purpose to better prepare graduates for the health care of the future [3,6,7]. Training programs are structured to cater these competencies in both undergraduate and postgraduate programs. In all

Assessing communication

The term “constructive alignment” refers to the alignment of the assessment approach to the educational approach [29]. In case of a misalignment, the assessment approach will prevail and learning might actually be hampered. The insights on how we learn a complex skill such as communication is sketched above, the assessment would be constructively aligned when the assessment would be:

  • -

    longitudinally oriented

  • -

    as authentic as possible

  • -

    provide meaningful feedback

  • -

    be able to make valid (pass/fail or

Discussion and conclusion

The assessment literature has long been dominated with a psychometric approach [40]. Due to the move towards competency-based education, complex skills needed to be learned and assessed. Communication is one of them. Assessment has moved from this exclusive psychometric orientation to a more learning-oriented assessment. Instead of assessment driving learning, now learning is driving assessment. As is clear from the above, we recommend an assessment approach to communication where assessment

Funding

This paper did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Declaration of Competing Interest

None.

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