Measuring the Effectiveness of Small-Group and Web-Based Training Methods in Teaching Clinical Communication: A Case Comparison Study

Abstract

Current teaching approaches in human and veterinary medicine across North America, Europe, and Australia include lectures, group discussions, feedback, role-play, and web-based training. Increasing class sizes, changing learning preferences, and economic and logistical challenges are influencing the design and delivery of communication skills in veterinary undergraduate education. The study's objectives were to (1) assess the effectiveness of small-group and web-based methods for teaching communication skills and (2) identify which training method is more effective in helping students to develop communication skills. At the Ross University School of Veterinary Medicine (RUSVM), 96 students were randomly assigned to one of three groups (control, web, or small-group training) in a pre-intervention and post-intervention group design. An Objective Structured Clinical Examination (OSCE) was used to measure communication competence within and across the intervention and control groups. Reliability of the OSCEs was determined by generalizability theory to be 0.65 (pre-intervention OSCE) and 0.70 (post-intervention OSCE). Study results showed that (1) small-group training was the most effective teaching approach in enhancing communication skills and resulted in students scoring significantly higher on the post-intervention OSCE compared to the web-based and control groups, (2) web-based training resulted in significant though considerably smaller improvement in skills than small-group training, and (3) the control group demonstrated the lowest mean difference between the pre-intervention/post-intervention OSCE scores, reinforcing the need to teach communication skills. Furthermore, small-group training had a significant effect in improving skills derived from the initial phase of the consultation and skills related to giving information and planning.

One Size Does Not Fit All: Toward an Evidence-Based Framework for Determining Online Course Enrollment Sizes in Higher Education

“…The equivalence of learning online versus face-to-face in the cognitive domain is wellsupported by research. Learning efficacy is less established for skills learning, role modeling, or student socialization into a discipline, and for lower performing students (Artemiou, Adams, Vallevand, Violato, & Hecker, 2013;Jones, 2015).…”

Standardised clients as assessors in a veterinary communication OSCE: a reliability and validity study

“…Consequently, the assessment of communication skills is also being taken up as an essential component of veterinary medical education curricula. As such, veterinary schools in North America, UK, Ireland, Australia and the Caribbean have developed communication skills programmes that span across the entire veterinary curriculum (Shaw and others 2004, Shaw and others 2006, Adams and Kurtz 2006, Gray and others 2006, Mills and others 2006, Hargie and others 2010, Artemiou and others 2013). Veterinary communication ­curricula reflect the successful approaches established in human medical education, though paying attention to the animal patient-­client-veterinarian relationship (Kurtz and others 2005, Adams and Kurtz 2006, Hodgson and others 2013).…”

Leading a Clinical Communication Program in a Remote Setting: Practical Considerations from ROSS University School of Veterinary Medicine, St. Kitts

“…The RUSVM communication program was initiated in 2010, and following the premises of outcome based programs the first OSCE was introduced in August 2012 (Please contact corresponding author for an outline of the RUSVM Communication Program) (Artemiou, Adams, Vallevand, Violato, & Hecker, 2013). Although the associated costs for developing, delivering and enhancing the RUSVM communication program are funded by DeVry Medical Institution, there are still challenges of program design and delivery in light of being remotely geographically located.…”

“…For example, we acknowledge that when we developed and implemented our first communication OSCE, there were concerns with surrounding noise and lack of a private and individualized space for students to demonstrate their skills in privacy. Though the setting was not ideal, it was functional and cost effective (Artemiou et al, 2013;Artemiou et al, 2014).…”

“…We share a specific example in regards to the assessment of communication skills where we identified and used rubrics that had already been developed and standardized in human medicine and adapted these for the specific goals and learning objectives of our program. We purposely used a 21-item rubric that was based on the Calgary Cambridge Guide (CCG) and an adapted form of the Liverpool Undergraduate Communication Assessment Scale (LUCAS); both instruments are validated in human medicine to evaluate students' communication skills and we adapted these for veterinary communication OSCEs (Artemiou et al, 2013). Likewise, we also implement the validated approach in human medicine of engaging standardized clients in portraying their assigned roles as well as being trained in the role of the assessor for our veterinary communication OSCE (Artemiou et al, 2014).…”