Measuring medical students' communication skills: Development and evaluation of an interview rating scale

To effectively interview patients, elicit relevant data and derive a correct diagnosis, medical students require a number of interpersonal and interviewing skills. These include putting patients at ease, eliciting essential historical data, listening, interviewing logically, observing and responding to patients' cues and generally using facilitative communication techniques. In traditional medical education curricula, these skills were addressed by teaching students the history-taking procedure embodied in the clinical method. Comparisons of students trained via this traditional method and those given specialised interviewing skills training have utilised a variety of measurement techniques, most notably interview rating scales which are used to evaluate medical students' performance in actual patient interviewing. In the present study, videotaped history-taking interviews were conducted by two groups of students pre-training and following communication skills training given to one student group. Videotapes were rated by trained psychologists, using a history-taking rating scale developed to evaluate general practitioners' interviews with their patients. A comparison of the ratings given by the two observers showed significant differences between the student groups on their interviewing effectiveness. The rating scale developed as part of this study appears to be an effective means for evaluating the communication skills displayed by students in their patient interviewing. It also provides a means by which students' interviewing patterns as well as actual interviewing behaviours can be categorised and observed. In this way, interviewing deficiencies and skills can be identified as a necessary prelude to the introduction of appropriate communication skills training for students.