Developing an institution-based assessment of resident communication and interpersonal skills

Abstract

Purpose: The authors describe the development and validation of an institution-wide, cross-specialty assessment of residents' communication and interpersonal skills, including related components of patient care and professionalism.

Method: Residency program faculty, the department of medical education, and the Clinical Performance Center at the University of Illinois at Chicago College of Medicine collaborated to develop six standardized patient-based clinical simulations. The standardized patients rated the residents' performance. The assessment was piloted in 2003 for internal medicine and family medicine and was subsequently adapted for other specialties, including surgery, pediatrics, obstetrics-gynecology, and neurology. We present validity evidence based on the content, internal structure, relationship to other variables, feasibility, acceptability, and impact of the 2003 assessment.

Results: Seventy-nine internal medicine and family medicine residents participated in the initial administration of the assessment. A factor analysis of the 18 communication scale items resulted in two factors interpretable as "communication" and "interpersonal skills." Median internal consistency of the scale (coefficient alpha) was 0.91. Generalizability of the assessment ranged from 0.57 to 0.82 across specialties. Case-specific items provided information about group-level deficiencies. Cost of the assessment was about $250 per resident. Once the initial cases had been developed and piloted, they could be adapted for other specialties with minimal additional effort, at a cost saving of about $1,000 per program.

Conclusion: Centrally developed, institution-wide competency assessment uses resources efficiently to relieve individual programs of the need to "reinvent the wheel" and provides program directors and residents with useful information for individual and programmatic review.