Linda Dorrestein¹
Caroline Ritter², Zoë de Mol³, Maureen Wichtel², Julie Cary⁴, Courtney Vengrin⁵, Elpida Artemiou⁵, Cindy Adams¹ and Kent Hecker^1,5
1 Faculty of Veterinary Medicine, University of Calgary
2 Atlantic Veterinary College, University of Prince Edward Island
3 Faculty of Veterinary Medicine, Ghent University
4 Faculty of Veterinary Medicine, Washington State University
5 International Council on Veterinary Assessment
6 Faculty of Veterinary Medicine, Texas Tech University

Background.
Communication skills (CS) are indispensable for health care providers and are related to better clinical outcomes; patient safety, satisfaction and compliance of patients and clients (1,2). However, psychometric evidence from scores of communication skills and knowledge assessment methods are typically housed within respective health professions, such as nursing, veterinary medicine, medicine, pharmacy. Therefore, the purpose of this systematic review was to consolidate reports of validity evidence by addressing following questions: What validity and reliability evidence of CS assessment methods to support high and low stakes decision making processes have been reported? And, what are the reported CS constructs, and associated assessment methods, that report validity evidence within and across health professions? 

Summary of work.
Medline, PsychINFO, Embase, CAB Abstracts, CINAHL, ERIC and Scopus databases, focussing on peer-reviewed journals in English, were searched for years 1990-2023 (3). Two authors independently screened articles for inclusion and extracted information on assessment features and validity evidence. 

Results.
17,000+ studies were screened, data were extracted from 161 studies. Assessment modalities featured simulated in person (67%) and virtual (15%) interactions, written tests (7%) and workplace-based assessments (7%). Validity was reported based on content (42%), internal structure (65%), and relationships with other variables (55%). 

Discussion.
CS assessment methods for knowledge and performance across health professions report varying levels of validity evidence across assessment methods for low and high stakes decision making. 

Conclusions.
Given content and case specificity issues, which reduces validity of performance- based exam scores, health professions are supplementing in person assessment methods with activities that could assist with validity concerns. 

Implications for further research or practice.
A synthesis of assessment methods that demonstrate reliable and valid scores could assist health professional programs, organizations, and licensure board in determining what CS components could be assessed given their respective jurisdictions and objectives. 

References (maximum three) 

1. Street RL, Makoul G, Arora NK, Epstein RM. How does communication heal? Pathways linking clinician–patient communication to health outcomes. Patient Educ Couns. 2009 Mar 1;74(3):295–301. 

2. Kanji N, Coe JB, Adams CL, Shaw JR. Effect of veterinarian-client-patient interactions on client adherence to dentistry and surgery recommendations in companion-animal practice. J Am Vet Med Assoc. 2012 Feb 15;240(4):427–36. 

3. Reed DA, Cook DA, Beckman TJ, Levine RB, Kern DE, Wright SM. Association Between Funding and Quality of Published Medical Education Research. JAMA . 2007 Sep 5;298(9):1002–9. 

Yen-Ming Huang
Hsun-Yu Chan and Yunn‐Fang Ho 

Background:
We devised a teaching program incorporating a blended multimedia learning approach to facilitate medication consultation learning among pharmacy students. The study aimed to evaluate the impact of a blended learning program on students’ self-efficacy and skills in medication counseling. 

Methods:
This study utilized the multimedia learning theory to create instructional materials and assess skill development among two sets of undergraduate students (Class of 2025 and 2026) enrolled in Introduction to Community Pharmacy separately in 2022 and 2023. In the control group (Class of 2025), students underwent a 4-week PowerPoint-based communication skills instruction. Then, we developed 6 videos illustrating common scenarios of over-the- counter (OTC) medication counseling in community pharmacies. For the intervention group (Class of 2026), a 3-week PowerPoint instruction was followed by a week-long video-enhanced communication skills training. To gauge effectiveness of the interventions, a pre-to-post survey measured students' self-efficacy in OTC counseling. Practical skills were evaluated through role-playing with standardized patients, using a structured checklist. Additionally, semi- structured interviews were conducted to gather insights into students' perceptions of the medication counseling approach. 

Results:
After the courses, the intervention group students showed higher self-efficacy and improved OTC counseling skills compared to the control group (p < 0.05). Blended multimedia teaching resulted in better OTC counseling skills than traditional lecture-based teaching (p < 0.05). The students emphasized the value of scenario-based videos in aiding their conceptualization of rich and dynamic simulated situations. These videos simplified language and synchronized visuals with audio, enabling students to enhance their OTC counseling approaches in complex social settings. The students found these videos especially useful for grasping vital communication skills like active listening and empathy, as they facilitated the visualization of crucial yet abstract concepts. 

Conclusion: 
The blended multimedia approach improves communication performance, suggesting potential improvements in the pharmacy practice course for better medication consultation. 

References (maximum three) 

Andy Ward¹
Conor Gilligan², Amylee Walker², Emma Hayward¹ and Caroline Woodley¹
1 University of Leicester
2 University of Newcastle

Background
SBAR (situation, background, assessment, recommendation) is a structured form of communication that can increase the safety of patient handovers (1). The use of SBAR was included in communication skills and patient safety teaching in the early years of medical schools in Leicester (UK) and Newcastle (Australia), but not included in associated OSCEs. 

Summary of Work
A scenario was developed that involved the student listening to a short recording of a telephone consultation, reviewing the associated medical record and then performing a handover. A complimentary marking schedule was developed. A small pilot OSCE was held in Newcastle, before the station was used as part of a 12-station summative OSCE in Leicester. The acceptability of the station was evaluated via tutor and examiner feedback. Post intervention student focus groups were held in both schools. Psychometric testing of the OSCE results was carried out in Leicester. 

Results 
Examiners were positive about the format of the station. Students thought the station provided a fair test of their learning and that the marking schedule was objective. Psychometric testing showed the station performed well and contributed to the overall reliability of the OSCE. 

Discussion
Poor handover can lead to errors and patient harm and the use of SBAR has been shown to reduce this (1). Including the use of this tool in summative assessment can emphasise its importance and ease of use to students. 

Conclusions
This collaboration allowed the effective development and evaluation of a new OSCE station assessing the use of the SBAR tool. The station was acceptable to students and examiners and performed well. 

Take-home messages
Students should understand the use of the SBAR tool 
Students should be assessed on their use of SBAR 
A collaboratively developed OSCE station provided a fair test that was acceptable to students and examiners. 

References (maximum three) 

1. Merten H, van Galen L S, Wagner C. Safe handover BMJ 2017; 359 :j4328 doi:10.1136/bmj.j4328 

Sari Dewi^1,2,3
Conor Gilligan³ and Amanda Wilson⁴
1 Australian National University
2 Universitas Padjadjaran
3 University of Newcastle
4 UTS

Evidence indicates that communication skills teaching learnt in the classroom are not always applied in the clinical environment and assessment tasks. An observational study was conducted to objectively evaluate students’ communication skills in different learning environments. The study sought to investigate (1) the extent to which the communication skills demonstrated by students in classroom, clinical, and assessment settings align; and (2) the extent to which communication skills practised in the classroom and clinical environment prepares students for the Objective Structured Clinical Examination (OSCE) assessment. 

A mixed methods observational study was conducted to observe and evaluate students during the fourth year of a five-year medical program. Participants were video-recorded during structured classroom ‘interactional skills’ sessions, as well as clinical encounters with patients and an OSCE station calling upon communication skills. The Calgary Cambridge Communication Guide was used to evaluate students in different settings. 

This study observed 28 students, and findings revealed that, while in the classroom, students were able to practise all communication skills tasks; in the clinical environment information- gathering and relationship-building with patients were the focus of their encounters. In the OSCEs, limited time and high-pressure scenarios caused the students to rush to complete the task, which focussed solely on information-gathering and/or explanation, diminishing the opportunity for rapport-building with the patient. 

These findings indicate a poor alignment between the skills practised across learning environments. Further research is needed to investigate the development and application of students’ skills over the long term to understand supports for and barriers to effective teaching and learning of communication skills in different learning environments. 

References (maximum three) 

Gilligan C, Powell M, Lynagh MC, Ward BM, Lonsdale C, Harvey P, et al. Interventions for improving medical students' interpersonal communication in medical consultations. Cochrane Database Syst Rev. 2021(2) 

Kurtz, Silverman, Draper. Teaching and learning communication skills in medicine. 2nd ed. Oxford: Radcliffe Publishing; 2005. 576 p. 

Rosenbaum ME. Dis-integration of communication in healthcare education: workplace learning challenges and opportunities. Patient Educ Couns. 2017;100:2054-61 

Jessica Bellamy¹
Rachel Ward and Brooke Russell
1 University of Wollongong

Background:
To be a successful Exercise Scientist and Exercise Physiologist, one must not only have an understanding of the evidence-based prescriptive guidelines, but also the ability to effectively communicate with patients, health professionals and colleagues. Providing students with the opportunity to gain individualised feedback on their communication skills can be difficult, particularly given increasing cohort sizes. Additionally, engaging in reflective practice is a key professional standard all allied health practitioners should be engaged in. The increased capability of the online peer assessment platforms, such as the Moodle Workshop tool, allowed us to reconceptualise our communication assessment options (Cox et.al., 2012). 

Summary of work:
We utilised the Moodle Workshop Tool for two 2nd year Exercise Science/Exercise Physiology subjects, 1) movement instruction, and 2) initial consult/interview. Following Hughes et.al., (2007) learning model, students were introduced to their respective concepts and theories through a series of short online modules. Students were required to submit a short 3-min video demonstrating their ability to either prescribe an exercise or complete an initial consult/interview (dependent on subject enrolment). The Moodle Workshop Tool allowed for calibration of student marking before commencing the peer evaluation phase. Students were required to assess two randomly allocated peer submissions, using the same rubric utilised in the calibration phase. 

Results/Discussion/Conclusion:
Peer assessment assisted students to reflect on both their theoretical understanding and implementation of key communication techniques. The use of the calibration phase, coupled with multiple peer assessments, not only increased individualised student feedback provided in a timely manner, but allowed stronger reflective practices. This assessment task encapsulates the process of concept introduction, practice, feedback, reflection and adjustment before trying again. 

References (maximum three) 

Nurul Ain Mohd Salim¹
Nurhanis Syazni Roslan², Rafidah Hod¹ and Siti Khadijah Adam¹
1 Faculty of Medicine and Health Sciences, Universiti Putra Malaysia
2 School of Medical Sciences, Universiti Sains Malaysia

Background:
Simulated patients (SPs) are commonly being used during the assessment of history taking and communication skills in objective structured clinical examination (OSCE) for medical students. However, recruiting reliable and highly-committed SPs can be quite challenging. Virtual simulated patient (vSP), a computerised virtual patient may offer several advantages over actual SPs by providing a controllable, standardised and safe learning environment, especially involving sensitive issues. The aim of this study is to explore the perception of medical students and examiners on using vSP during OSCE.

Methodology:
We developed a vSP prototype based on our preliminary data on the critical components of doctor- patient communication. We conducted content, face and construct validities on the developed vSP. The vSP was then used during OSCE to assess communication skills in medical students. We conducted focus group discussion among the students and in depth interview among the examiners to explore their experience and perception on using vSP during the assessment. The sessions were audio-recorded, transcribed, and analysed thematically.

Results and Discussion:
Three themes emerged from the focus group and interview: advantages over actual SPs, limitations and added value of vSP. Both students and examiners highlighted that vSP has a great potential to be used in assessment. It provides standardisation and can be used repetitively. However, technical issues were their main concern.

Conclusion:
This study demonstrates that using virtual patient helps to address the challenges of using real SPs during OSCE. We identified several technical issues that must be addressed before it can be effectively used for actual practice.

Future recommendations:
The vSP prototype opens up more opportunities for future research to evaluate the feasibility and practicality of using virtual patients in training medical and other health professions students. It also promotes further development of immersive virtual reality tools to be used in health professions education. 

Mark Lee¹
Terry Hudgins² and Stephen Miller₂
1 Rocky Vista University - Montana College of Osteopathic Medicine
2 Rocky Vista University

Background
Assessment of clinical communication and professionalism continues to be challenging in medical education. Although OSCEs were developed as a method of summative assessment, it is limited by cost, frequency, and synchronous orchestration. Formative assessment through a preceptor-learner model is limited by subjectivity, content inconsistency, and paucity of standardization. There remains a need for an objective formative assessment process to facilitate training in clinical communication, while remaining sensitive to fiscal, geographic, and temporal constraints. 

Objective
To assess 3rd year medical student’s communication and professionalism skills longitudinally using a video based, Standardized Oral Presentations (SOP). 

Methods
289 3rd year medical students at Rocky Vista University School of Osteopathic Medicine, underwent six different, formative SOP assessments over an academic year. Each SOP assessment consisted of standardized clinical data and a simulated physician-patient video encounter. Students were given 24-hours to submit a self-recorded, oral case presentation. ThreetrainedevaluatorsassessedvideosusingaPatientPresentationRatingTool (PPR). 

Results
Between the period of July 2022 – May 2023, 1,436 SOP assessments were performed. Longitudinally, students’ clinical communication scores increased 46.9% and professionalism scores increased 43.1%. Inter-rater reliability scores improved through the academic year as compared to preceptor-student based evaluations. 

Discussion
The advantages of the SOP model include the ability to implement the assessment in a synchronic period, regardless of learner location. The self-directed synthesis of the clinical case enabled students to reflectively prepare their best example prior to submission. These assessments demonstrated a normal probability distribution as compared to subjective preceptor-learner assessments. Limitations of the SOP model include internet-video constraints and time to grade videos. 

Conclusion
Implementing the SOP model enabled the objective assessment of communication and professionalism competency domains as compared to preceptor-learner evaluations and is an alternative to frequent OSCE evaluations, without the limitations of cost, location, and complexity in orchestration. 

References (maximum three) 

1. Harden et al. Assessment of clinical competence using an objective structured clinical examination (OSCE). Med Educ 1979 Jan;13(1):41-45. 

2. https://www.abp.org/publications/patient-presentation-rating-tool-oral-case- presentations