A Description of the Use of a Communications Skills Global Rating Scale Based on the Essential Elements of Communication Kalamazoo Consensus Statement

Introduction: Providing instructive feedback and measuring growing expertise in a task as complex as communication skills is both important and challenging. Using the Essential Elements of Communication in Medical Encounters: The Kalamazoo Consensus Statement (Acad. Med. 2001;76:390-393) as its framework, and building on an earlier scale that had been in use for a number of years, the communication skills group at the University of New Mexico School of Medicine developed the Essential Elements of Communication Skills Global Rating Scale (EEC-GRS). Method: The seven item scale is scored on a 4 point behaviorally-anchored likert scale. It is introduced to students during their initial physical diagnosis and interviewing course. Course faculty are trained in its use in small groups where they review the scale and then use it to score videotaped scenarios. Scoring differences are discussed and then faculty are directed toward consensus. Faculty use the scale to provide formative feedback to the students. Standardized patients receive much more extensive training, initially on the use of the instrument in general and again each time they portray a specific case. Before each of the ten summative performance examinations faculty use the modified angoff method to set communication skills standards. Results: The EEC-GRS was implemented in the fall of 2002 and is used across all four years of the curriculum and into residency. Faculty and students, used to percentage scores, were initially confused by scoring based on points. Standardized patients who used a communication skills checklist in the interim between the EEC-GRS and our earlier global rating scale appreciate the renewed opportunity to reflect the quality of the students communication interventions as opposed to whether or not a specific task was done or not done. Discussion: Our Essential Elements of Communication Skills Global Rating Scale is used both for teaching communication skills and for providing formative and summative feedback based on performance tests. Instructing faculty in how to use the scale has resulted in the important side-effects of valuable self-reflection and general faculty development in the area of communication skills. We are in the process of gathering data to evaluate how the performance of students changes as they move through the curriculum and to see if our optimism that it will prove useful in preparing our students for taking the USMLE Step II CS is warranted.\u2