Communication skills knowledge, understanding and OSCE performance in medical trainees: a multivariate prospective study using structural equation modelling
Communication skills knowledge, understanding and OSCE performance in medical trainees: a multivariate prospective study using structural equation modelling
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DOI：
10.1046/j.1365-2923.2002.01295.x
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发表时间：
2002-09-01
影响因子：
6
通讯作者：
Humphris, GM
中科院分区：
文献类型：
--
作者：
Humphris, GM
目的 测试医学生在 17 个月内通过客观结构化临床检查 (OSCE) 的表现表现出的沟通技能的稳定性，并通过初始知识和理解水平来确定这些技能的预测强度。 设计 这是一项使用 2 波队列的前瞻性研究。 参与者 对 2 年入学（1996 年和 1997 年）的医学本科生 (n = 383) 进行医学课程的前 3 年跟踪。 程序 研究程序涉及第一年在形成性考试和总结性考试中进行的客观结构化视频考试（OSVE）。采用了两项 OSCE 措施：专家检查员和模拟患者分别完成了利物浦沟通技能评估量表（LCSAS）和全球模拟患者评定量表（GSPRS）。 OSCE 数据在 1 级考试和 17 个月后的 2 级考试中收集。结果 测量模型遵循预测。使用潜在变量的因果模型符合 1 级 OSCE 和 OSVE 标记回归的 2 级 OSCE 性能。专家和模拟患者 OSCE 数据分别进行拟合并结合起来，根据专业和患者对学生技能的意见确定模型拟合的强度。模型的整体拟合度是可以接受的。沟通技巧表现表现出高度的稳定性。研究发现认知因素对未来技能表现有一定的负面影响。结论 沟通技能的早期发展在入门课程后表现出稳定的表现。沟通技巧知识对表现的影响虽小但很重要，具体取决于测试时间。对认知因素的新评估需要包括隐性知识和显性知识。
Aim To test the stability of medical student communication skills over a period of 17 months as exhibited by performance in objective structured clinical examinations (OSCEs) and to determine the strength of prediction of these skills by initial levels of knowledge and understanding.Design This is a prospective study using a 2-wave cohort.Participants Medical undergraduates (n = 383) from 2 years intake (1996 and 1997) were followed through the first 3 years of a medical curriculum.Procedure The study procedure involved the objective structured video examination (OSVE) conducted at formative and summative examinations during the first year. Two OSCE measures were employed: expert examiners and simulated patients completed the Liverpool Communication Skills Assessment Scale (LCSAS) and the Global Simulated Patient Rating Scale (GSPRS), respectively. The OSCE data were collected at Level 1 and 17 months later at Level 2 examinations.Results The measurement model followed prediction. A causal model using latent variables was fitted with Level 2 OSCE performance regressed on Level 1 OSCE and OSVE marks. Expert and simulated patient OSCE data were fitted separately and combined to determine strength of model fit according to professional and patient opinion of student skills. The overall fit of the models was acceptable. Communication skills performance showed a high level of stability. Some negative effect of cognitive factors on future skills performance was found.Conclusion Early development of communication skills shows stable performance following an introductory course. Knowledge of communication skills has a small but significant influence on performance, depending on the time of testing. New assessments of cognitive factors are required to include both tacit and explicit knowledge.