TY - JOUR
T1 - High-Value, Cost-Conscious Communication Skills in Undergraduate Medical Education
T2 - Validity Evidence for Scores Derived from Two Standardized Patient Scenarios
AU - Natt, Neena
AU - Starr, Stephanie R.
AU - Reed, Darcy A.
AU - Park, Yoon Soo
AU - Dyrbye, Liselotte N.
AU - Leep Hunderfund, Andrea N.
N1 - Publisher Copyright:
© Lippincott Williams & Wilkins.
PY - 2018/10/1
Y1 - 2018/10/1
N2 - Introduction Training in high-value, cost-conscious care (HVCCC) is increasingly being incorporated into medical school curricula, but students may have limited opportunities to engage patients in HVCCC conversations. The aim of this study was to develop two standardized patient scenarios with associated checklists, hypothesizing that resulting scores would allow for valid formative assessments of HVCCC communication skills. Methods Scenarios were designed to generate a less-is-more conversation (in response to a patient requesting an unnecessary test) and a shared decision-making conversation (in response to a patient choosing between multiple effective treatment options). Checklists were developed by experts and informed by the existing literature. Validity evidence was collected from content, response process, internal structure, relations to other variables, and consequences of testing. Results Ninety-three third-year medical students participated during 2014-2015. Mean checklist scores were 79% (SD = 18, Cronbach = 0.72) and 72% (SD = 13, Cronbach = 0.62) for the less-is-more and shared decision-making scenarios, respectively. Checklist scores correlated with global ratings of performance (r = 0.65 and 0.54, respectively, both P < 0.001), and overall interrater reliability was good (r = 0.66). Checklist scores discriminated between higher and lower performers (discrimination indices of 0.84 and 0.65, respectively, both P < 0.001). Most students (83/90, 92%) agreed that the session improved their HVCCC communication skills. Conclusions This study provides validity evidence supporting the use of scores derived from two standardized patient scenarios for formative assessment of HVCCC communication skills among third-year medical students. These scenarios can help equip students with practical, patient-centered strategies for promoting value in clinical encounters.
AB - Introduction Training in high-value, cost-conscious care (HVCCC) is increasingly being incorporated into medical school curricula, but students may have limited opportunities to engage patients in HVCCC conversations. The aim of this study was to develop two standardized patient scenarios with associated checklists, hypothesizing that resulting scores would allow for valid formative assessments of HVCCC communication skills. Methods Scenarios were designed to generate a less-is-more conversation (in response to a patient requesting an unnecessary test) and a shared decision-making conversation (in response to a patient choosing between multiple effective treatment options). Checklists were developed by experts and informed by the existing literature. Validity evidence was collected from content, response process, internal structure, relations to other variables, and consequences of testing. Results Ninety-three third-year medical students participated during 2014-2015. Mean checklist scores were 79% (SD = 18, Cronbach = 0.72) and 72% (SD = 13, Cronbach = 0.62) for the less-is-more and shared decision-making scenarios, respectively. Checklist scores correlated with global ratings of performance (r = 0.65 and 0.54, respectively, both P < 0.001), and overall interrater reliability was good (r = 0.66). Checklist scores discriminated between higher and lower performers (discrimination indices of 0.84 and 0.65, respectively, both P < 0.001). Most students (83/90, 92%) agreed that the session improved their HVCCC communication skills. Conclusions This study provides validity evidence supporting the use of scores derived from two standardized patient scenarios for formative assessment of HVCCC communication skills among third-year medical students. These scenarios can help equip students with practical, patient-centered strategies for promoting value in clinical encounters.
KW - High-value cost-conscious care
KW - Standardized patient scenarios
KW - communication
KW - medical students
KW - validity
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U2 - 10.1097/SIH.0000000000000316
DO - 10.1097/SIH.0000000000000316
M3 - Article
C2 - 29771817
AN - SCOPUS:85054439568
SN - 1559-2332
VL - 13
SP - 316
EP - 323
JO - Simulation in Healthcare
JF - Simulation in Healthcare
IS - 5
ER -