Remediation Methods 2.0 for Professionalism and Interpersonal and Communication Skills Milestones: An Update
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SUBMITTER: Ehmann M
PROVIDER: S-EPMC11234317 | biostudies-literature | 2024 Apr
REPOSITORIES: biostudies-literature
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| S-EPMC4762325 | biostudies-literature
Project description:ObjectivesThe Association of American Medical Colleges Standardized Video Interview (SVI) was recently added as a component of emergency medicine (EM) residency applications to provide additional information about interpersonal communication skills (ICS) and knowledge of professionalism (PROF) behaviors. Our objective was to ascertain the correlation between the SVI and residency interviewer assessments of PROF and ICS. Secondary objectives included examination of 1) inter- and intrainstitutional assessments of ICS and PROF, 2) correlation of SVI scores with rank order list (ROL) positions, and 3) the potential influence of gender on interview day assessments.MethodsWe conducted an observational study using prospectively collected data from seven EM residency programs during 2017 and 2018 using a standardized instrument. Correlations between interview day PROF/ICS scores and the SVI were tested. A one-way analysis of variance was used to analyze the association of SVI and ROL position. Gender differences were assessed with independent-groups t-tests.ResultsA total of 1,264 interview-day encounters from 773 unique applicants resulted in 4,854 interviews conducted by 151 interviewers. Both PROF and ICS demonstrated a small positive correlation with the SVI score (r = 0.16 and r = 0.17, respectively). ROL position was associated with SVI score (p < 0.001), with mean SVI scores for top-, middle-, and bottom-third applicants being 20.9, 20.5, and 19.8, respectively. No group differences with gender were identified on assessments of PROF or ICS.ConclusionsInterview assessments of PROF and ICS have a small, positive correlation with SVI scores. These residency selection tools may be measuring related, but not redundant, applicant characteristics. We did not identify gender differences in interview assessments.
| S-EPMC6637001 | biostudies-literature
Project description:BackgroundProfessionalism and communication skills constitute important components of the integral formation of physicians which has repercussion on the quality of health care and medical education. The objective of this study was to assess medical graduates' professionalism and communication skills from the patients' perspective and to examine its association with patients' socio-demographic variables.MethodsThis is a hospital based cross-sectional study. It involved 315 patients and 105 medical graduates selected by convenient sampling method. A modified and validated version of the American Board of Internal Medicine's (ABIM) Patient Assessment survey questionnaire was used for data collection through a face to face interview. Data processing and analysis were performed using the Statistical Package for Social Science (SPSS) 16.0. Mean, frequency distribution, and percentage of the variables were calculated. A non-parametric Kruskal Wallis test was applied to verify whether the patients' assessment was influenced by variables such as age, gender, education, at a level of significance, p ≤ 0.05.ResultsFemale patients constituted 46% of the sample, whereas males constituted 54%. The mean age was 36 ± 16. Patients' scoring of the graduate's skills ranged from 3.29 to 3.83 with a mean of 3.64 on a five-point Likert scale. Items assessing the "patient involvement in decision-making" were assigned the minimum mean values, while items dealing with "establishing adequate communication with patient" assigned the maximum mean values. Patients, who were older than 45 years, gave higher scores than younger ones (p < 0.001). Patients with higher education reported much lower scores than those with lower education (p = 0.003). Patients' gender did not show any statistically significant influence on the rating level.ConclusionGenerally patients rated the medical graduates' professionalism and communication skills at a good level. Patients' age and educational level were significantly associated with the rating level.
| S-EPMC3923249 | biostudies-literature
Project description:BackgroundInterpersonal Communication Skills (IPCS) are one of the core clinical skills that should be developed by the Public Health Midwives (PHMs), who are grass-root level public healthcare providers in primary healthcare settings in Sri Lanka. This study aimed to develop and validate the Interpersonal Communication Assessment Tool (IPCAT), an observational rating scale, to assess the IPCS of PHMs.MethodsItem generation, item reduction, instrument drafting, and development of the tool's rating guide were made by an expert panel. A cross-sectional study was conducted in five randomly selected Medical Officer of Health (MOH) areas, the smallest public health administrative division in the district of Colombo, Sri Lanka, to identify the factor structure, which is the correlational relationship between a number of variables in the tool. A sample of 164 PHMs was recruited. The data on IPCS were collected by video-recording the provider-client interaction using simulated clients. All recorded videos were rated by a rater using the drafted IPCAT, which included a Likert scale of 1(poor) to 5 (excellent). Exploratory factor analysis was conducted using the Principal Axis Factoring extraction method and the Varimax rotation technique to explore the factors. Three independent raters were used to rate ten randomly selected videos to assess the tool's internal consistency and inter-rater reliability.ResultsThe IPCAT obtained a five-factor model with 22 items, and all five factors explained 65% of the total variance. The resulting factors were "Engaging" (six items on making rapport), "Delivering" (four items on paying respect), "Questioning" (four items on asking questions), "Responding" (four items on empathy), and "Ending" (four items to assess the skills of ending a conversation productively). The internal consistency, Cronbach's Alpha value, for all five factors was above 0.8, and the inter-rater reliability (ICC) was excellent (0.95).ConclusionsThe Interpersonal Communication Assessment Tool is a valid and reliable tool for assessing the interpersonal communication skills of Public Health Midwives.Trial registrationClinical Trial Registry, Sri Lanka. Ref No, SLCTR/2020/006(February 4th,2020).
| S-EPMC10210319 | biostudies-literature
Project description:BackgroundPhysician-patient communication is vital to patient care, and physician-nurse interactions are equally critical. Conflict between nurses and physicians can greatly impair communication, increasing the risk of treatment errors, yet physicians receive little education during training on recognizing and resolving professional conflicts.InnovationWe created and implemented the Standardized Professional (S-Pro) Encounter to improve training and provide opportunities to evaluate resident professionalism and communication with health care team colleagues.MethodsThe standardized patient model is well established for teaching and assessing clinical and communication skills. Using the standardized patient concept, we created a nurse-resident encounter with 2 professionally trained medical portrayers (1 "nurse," 1 "patient"), in which the nurse disagrees with the resident's treatment plan. Residents were surveyed for prior experience with nurse-physician conflict management, and we assessed postencounter for collaborative skills and conflict resolution.ResultsAll residents (n=18) observed at least 1 physician-nurse conflict in front of patients. Eleven (61%) reported being involved in at least 1 conflict. Twelve residents (67%) had 2 or fewer prior education experiences in interprofessional conflict management. Faculty assessment and S-Pro scores demonstrated high agreement, while resident self-assessment scores demonstrated low agreement with faculty and S-Pro scores.ConclusionsParticipants and evaluators found the encounter to be reasonably authentic. There was strong agreement between the faculty and S-Pro assessment of resident performance when using the Boggs scale. The S-Pro Encounter is easily adapted for other clinical situations or training programs, and facilitates the assessment of professionalism and communication skills between residents and other health care professionals.
| S-EPMC4512795 | biostudies-literature
Project description: Not available
| S-EPMC6008021 | biostudies-literature
Project description:Objectives:This study aimed to analyse the effect of a portfolio with three activities fostering students' reflection, self-efficacy and teaching of communication skills and professionalism. Methods:A cross-sectional study was applied with a sample of third- and fourth-year medical students in one Portuguese and three Brazilian universities. A three-activity portfolio (course evaluation and learning, self-efficacy activity and free reflective writing) was used during a two-month course on communication skills and professionalism. The 69 students enrolled in the course were invited to complete the three-activity portfolio via Likert-type questionnaires, open-ended questions and narrative. Content and lexical analysis and the Reflection Evaluation for Learners' Enhanced Competencies Tool (REFLECT) were used for assessing the qualitative data. The questionnaires were evaluated using principal components analysis and Cronbach's ?. Pearson's correlation was applied to portfolio activities. Results:Of the 69 participants, 85.5% completed at least one activity. Reflecting on what they learned in the communication module, the students did not mention professionalism themes. In the self-efficacy activity on communication, 25% of the fragments were related to professionalism themes. There was a negative correlation between students' self-efficacy and the REFLECT rubric score (r(19)=-0.744; p< 0.0001). Conclusions:Teachers must consider the activity's influence on the reflections when assessing the portfolio. This model of a three-activity portfolio provided diverse ways of encouraging and assessing reflections, supporting teaching improvement and adaptation, evaluating students' self-efficacy and showing that students' higher reflective capacity may promote feelings of low effectiveness.
| S-EPMC7252446 | biostudies-literature
Project description:IntroductionThe ethical skills fundamental to medical practice encompass a large portion of the Accreditation Council for Graduate Medical Education (ACGME) professionalism milestones. Yet many ethical practices are difficult to reduce to milestone frameworks given the variety of traditions of moral reasoning that clinician-trainees and their colleagues might properly employ.MethodsWe developed an observed standardized clinical examination (OSCE) simulation with standardized patients to assess the ethical skills captured in professionalism milestones in pediatrics. The OSCE included four vignettes based on actual cases that presented problems without a correct answer. Residents discussed ethically challenging issues with standardized patients and were evaluated on specific ethical tenets contained in the professionalism milestones. Our assessment guide for preceptors offered content for debriefing and assessment. We piloted this OSCE with seven preceptors and 17 pediatric residents in two different medical settings.ResultsResidents all agreed that the four cases were realistic. All but two residents agreed that OSCEs like this one are an appropriate or objective way of assessing the ACGME professionalism milestones. All preceptors reported that they strongly agreed the assessment improved their ability to assess the professionalism milestones.DiscussionThis OSCE offers a structured method to assess professionalism milestones and a forum to discuss ethical problem solving. It can also be used solely as a training exercise in ethical decision making and having difficult conversations.
| S-EPMC7062544 | biostudies-literature
Project description:BACKGROUND:Residents receive little information about how they interact with patients. OBJECTIVE:This pilot study assessed the feasibility and validity of a new 16-item tool developed to assess patients' perspectives of interns' communication skills and professionalism and the team's communication. METHODS:Feasibility was determined by the percentage of surveys completed, the average time for survey completion, the percentage of target interns evaluated, and the mean number of evaluations per intern. Generalizability was analyzed using an (evaluator:evaluatee) × item model. Simulated D studies estimated optimal numbers of items and evaluators. Factor analysis with varimax rotation was used to examine the structure of the items. Scores were correlated with other measures of communication and professionalism for validation. RESULTS:Most patients (225 of 305 [74%]) completed the evaluation. Each survey took approximately 6.3 minutes to complete. In 43 days over 18 weeks, 45 of 50 interns (90%) were evaluated an average of 4.6 times. Fifty evaluations would be required to reach a minimally acceptable coefficient (0.57). Two factor structures were identified. The evaluation did not correlate with faculty evaluations of resident communication but did correlate weakly (r = 0.140, P = .04) with standardized patient evaluations. CONCLUSIONS:A large number of patient evaluations are needed to reliably assess intern and team communication skills. Evaluations by patients add a perspective in assessing these skills that is different from those of faculty evaluations. Future work will focus on whether this new information adds to existing evaluation systems and warrants the added effort.
| S-EPMC3963799 | biostudies-literature
Project description:NoneThe Accreditation Council for Graduate Medical Education published the first sleep medicine milestones in 2015. However, these milestones were the same among all internal medicine fellowship programs; they were not specific to the specialty. Based on stakeholder feedback, the Accreditation Council for Graduate Medical Education called for the creation of specialty-specific milestones. Herein, we outline the history of Accreditation Council for Graduate Medical Education reporting milestones; the identification of knowledge, skills, and attitudes that define the practice of sleep medicine; and the creation of the supplemental guide and sleep medicine-specific milestones (Sleep Medicine Milestones 2.0) to assess developmental progression during fellowship training.
| S-EPMC7927340 | biostudies-literature