Assessment of Communication and Interpersonal Skills Competencies

Abstract

Excellent communication and interpersonal (C-IP) skills are a universal requirement for a well-rounded emergency physician. This requirement for C-IP skill excellence is a direct outgrowth of the expectations of our patients and a prerequisite to working in the increasingly complex emergency department environment. Directed education and assessment of C-IP skills are critical components of all emergency medicine (EM) training programs and now are a requirement of the Accreditation Council for Graduate Medical Education (ACGME) Outcome Project. In keeping with its mission to improve the quality of EM education and in response to the ACGME Outcome Project, the Council of Emergency Medicine Residency Directors (CORD-EM) hosted a consensus conference focusing on the application of the six core competencies to EM. The objective of this article is to report the results of this consensus conference as it relates to the C-IP competency. There were four primary goals: 1) define the C-IP skills competency for EM, 2) define the assessment methods currently used in other specialties, 3) identify the methods suggested by the ACGME for use in C-IP skills, and 4) analyze the applicability of these assessment techniques to EM. Ten specific communication competencies are defined for EM. Assessment techniques for evaluation of these C-IP competencies and a timeline for implementation are also defined. Standardized patients and direct observation were identified as the criterion standard assessment methods of C-IP skills; however, other methods for assessment are also discussed.

Development of a Communication Curriculum for Emergency Medicine Residents

“…11−13 In our review, we found that establishing and building a therapeutic relationship with patients is a key communication task for physicians, 1−4,7−10 including for the specialty of EM. 5,13,14 Likewise, the demonstration of empathy is important in the patient care encounter. 3,4,8,10,14 However, rapport building is challenging for EM physicians because of time constraints in a busy emergency department (ED); the possibility of a rapidly changing patient status, often of a deteriorating and critical nature; and/or the absence of an established relationship with the patient.…”

“…3,4,8,10,14 However, rapport building is challenging for EM physicians because of time constraints in a busy emergency department (ED); the possibility of a rapidly changing patient status, often of a deteriorating and critical nature; and/or the absence of an established relationship with the patient. 5,14 We therefore chose to include basic interpersonal skills and empathy in our CIPS curriculum to teach residents how to develop this key physician-patient connection in the ED environment.…”

“…Advantages of checklists include easy recognition and less subjective assessment of performance, which is particularly helpful for the less experienced and less trained observer. 1,10,14 In addition, checklists direct the observer to the important skills and can be utilized for performance improvement tracking. 2,17 As our curriculum included learning from assessment, we endeavored to create behavioral items that would be easy to recognize and assist residents during self-assessment.…”

Critical care recognition, management and communication skills during an emergency medicine clerkship

“…We did not find any instrument that was comprehensive enough to meet all of our learning objectives. Therefore we elected to develop a checklist based on available tools in the literature (Rosenzweig et al 1999;Makoul 2001;Hobgood et al 2002;Residorff et al 2003;Chapman et al 2004;Duffy et al 2004;Kalet et al 2004;Lang et al 2004;CORD 2005;Schirmer et al 2005;Shayne et al 2006). The CIPS checklist we developed consists of 22 behaviorally based skills in one of five categories in which the evaluator notes whether the skill was performed or not (Table 3).…”

“…Our review of the literature on communication and interpersonal skills (CIPS) revealed that much of the communication instruction that medical schools offer does not focus on communication tasks specific, even unique, to caring for the critically ill patient (Makoul 2001;Hobgood et al 2002;Duffy et al 2004;Kalet et al 2004;Lang et al 2004). In addition, the Initiative to Transform Medical Education provided by the American Medical Association (AMA) challenged educators to address the following medical education gaps: the physician's ability to rapidly synthesize information while simultaneously caring for patients, the physician's role as a member of the healthcare team, and the physician's ability to communicate effectively in difficult situations and demonstrate a caring manner (AMA 2007).…”