Dominique Piquette¹
Briseida Mema² and Anne Kawamura
1 Sunnybrook Health Sciences Centre
2 Critical Care Medicine Department, Hospital for Sick Children

It is imperative that physicians communicate effectively. Good communication is an essential component of healthcare and impacts positively patients and families, healthcare professionals, and healthcare systems. Educators and clinical supervisors therefore have the responsibility not only to teach communication skills to their trainees, but also to assess their progress and level of competence. Communication skill training has been the object of multiple, mostly descriptive studies across various disciplines.[1] Simulation and simulated patients mainly have been used to demonstrate its feasibility and effectiveness. In comparison, communication skill assessment has been remarkably understudied.[1] 

The existing literature on communication skill assessment has failed to articulate a comprehensive framework useful to assess communication competencies across disciplines, to produce validity evidence for an assessment strategy transferrable to different contexts, and to address the complexity of communication skill assessment in real clinical environments.[2] Emerging evidence has just begun to explore who should assess trainees’ communication skills (real patients, supervisors, expert raters)[3], but the need to further discuss and understand the what, when, where, and how of communication skill assessment is ongoing. 

As CBME and programmatic assessment are being adopted by an increasing number of training programs worldwide, assessment data about trainees’ performance is being required to evaluate trainees’ competence in different domains, including communication. Certain domains of competence, like procedural skills, appear to have been easier to integrate into programmatic assessment than others, such as communication skills, possibly because of a lack of understanding and evidence on how to assess these skills. Yet, ensuring excellent communication skills among their graduates is a key objective for all postgraduate programs. 

3. Workshop format, including participant engagement methods
Part 1: Existing and proposed frameworks to assess communication skills 
Small group exercise: Discussion of existing frameworks guiding communication skill assessment. 
Mini lecture & large group discussion: Discussion of a new framework 

Part 2: Validity considerations 
Small group exercise: Review of existing validity studies and gaps in communication assessment validity evidence 
Mini lecture & large group discussion: Discussion of strategies to address gaps in validity evidence 

Part 3: Considerations in integrating simulation-based assessments and workplace-based assessments 
Mini lecture & large group discussion: Key factors to consider in SBA/WBA integrations 
Small group exercise: Designing an assessment strategy including SBA/WBA for a specific communication activity. 

3. Who should participate?
Supervisors, educators, program directors interested in communication assessment. 

4. Level of workshop (beginner / intermediate / advanced)
Intermediate

5. Take-home messages / workshop outcomes / implications for further research or practice
By the end of this workshop, participants will be able to:
a) Compare different frameworks to guide the design of communication assessment;
b) Explain validity considerations in the assessment of communication skills; 
c) Describe productive strategies to integrate SBA and WBA for communication assessment. 

6. Maximum number of participants:
40

References (maximum three) 

1. Tan XH, Foo MA, Lim SLH, Lim MBXY, Chin AMC, Zhou J, Chiam M, Krishna LKR. Teaching and assessing communication skills in the postgraduate medical setting: a systematic scoping review. BMC Med Educ. 2021 Sep 9;21(1):483. doi: 10.1186/s12909-021-02892-5. 

2. Niglio de Figueiredo M, Krippeit L, Freund J, Ihorst G, Joos A, Bengel J, Wuensch A. Assessing Communication Skills in Real Medical Encounters in Oncology: Development and Validation of the ComOn-Coaching Rating Scales. J Cancer Educ. 2019 Feb;34(1):73-81. doi: 10.1007/s13187-017-1269-5. 

3. Khalife R, Gupta M, Gonsalves C, Park YS, Riddle J, Tekian A, Horsley T. Patient involvement in assessment of postgraduate medical learners: A scoping review. Med Educ. 2022 Jun;56(6):602-613. doi: 10.1111/medu.14726. 

Conor Gilligan¹
Maria Magdalena Bujnowska-Fedak², Guert Essers³, Wiebke Frerichs⁴, Desirée Joosten-ten Brinke⁵, Ragnar Martin Joakimsen⁶, Noelle Junod Perron⁷, Claudia Kiessling⁸, Peter Pype⁹, Zoi Tsimtsiou¹⁰, Marc Van Nuland¹¹, Tim Wilkinson¹² and Marcy Rosenbaum¹³
1 EACH
2 Wroclaw Medical University
3 National Network for GP training programs in the Netherlands
4 University Medical Center Hamburg-Eppendorf (UKE), Department of Medical Psychology 5 Maastricht University, Department Educational Development and Research and the School of Health Professions Education
6 University Hospital of North Norway/The Arctic University of Norway – University of Tromso
7 Geneva University Hospitals and Geneva Faculty of medicine
8 Witten/Herdecke University, Witten, Germany
9 Department of Public Health and Primary Care Ghent University
10 Department of Hygiene, Social - Preventive Medicine and Medical Statistics, School of Medicine, Aristotle University of Thessaloniki
11 KU Leuven – University of Leuven. Department of Public Health and Primary Care
12 University of Otago
13 EACH: International Assocation for Communication in Healthcare 

In recent decades, the importance of the communication skills of health professionals has been increasingly recognised, and training in these skills is now included in curricula and accreditation standards across health fields, and across the continuum of training from pre- registration to CPD. The assessment of these skills is, however, far less developed, with challenges faced in the integration of communication components into various forms of assessment, the standardisation of assessors, and the varied expectations for communication in different clinical contexts. Previous publications (1, 2) have presented guiding principles for the assessment of communication skills. Since these publications, expectations from the public and the health professions have evolved, with much change occurring in both the healthcare communication, and the assessment fields. For example, emerging technologies, resource pressures, and increasing cultural diversity affect both clinical and education fields. Shifts in assessment systems towards a programmatic structure, in which teaching and assessment are more intertwined, and increasing reliance on workplace-based assessments pose both challenges and opportunities for the teaching and assessment of the complex range of skills involved with communication. 

We have brought together a group of experts in the fields of healthcare communication and assessment to establish a consensus relating to these contemporary and future challenges and opportunities, and to provide some suggested solutions for how they might be addressed through curricula and assessment optimisation. This workshop will present the key concepts being considered in our consensus, and seek feedback from the group as to the appropriateness and adequacy of the consensus statement. We will challenge participants to critique our draft, identify priorities and gaps, and consider the practical application of our proposed strategies. 

Workshop format 

10 minutes – brief introduction of the consensus reached by the group to date (which will be pre-circulated to participants) 

3 x 20 minutes – tasks in small groups. We will pose questions for discussion and activity in small groups which will each be facilitated by one of the authors. 

15 minutes – feedback from small group tasks (5 minutes per task) 5 minutes – closing and summary of next steps


Who should participate? 

Participants will be those with practical experience and expertise in the teaching and/or assessment of communication skills specifically, or those involved in other forms of assessment who are interested in more explicitly addressing communication skills. We welcome those involved in both undergraduate health professional training as well as in continuing professional development and quality improvement among practicing clinicians. 

The workshop is open to intermediate and advanced practitioners (educators/assessors/clinicians of various healthcare fields, e.g., nursing professionals, physical therapists) 

The workshop will contribute to the finalisation of the consensus statement document in preparation for submission. Workshop participants will be acknowledged for their contribution in the publication. 

References (maximum three) 

1. Kiessling C, Tsimtsiou Z, Essers G, et al. General principles to consider when designing a clinical communication assessment program. Patient Educ Couns. 2017;100(9):1762-8. 

2. Laidlaw A, Hart J. Communication skills: an essential component of medical curricula. Part I: Assessment of clinical communication: AMEE Guide No. 51. Med Teach. 2011;33(1):6- 8.