Communication skills instruction: an analysis of self, peer-group, student instructors and faculty assessment

Peer overmarking and insufficient diagnosticity: the impact of the rating method for peer assessment

The present study explores two rating methods for peer assessment (analytical rating using criteria and comparative judgement) in light of concurrent validity, reliability and insufficient diagnosticity (i.e. the degree to which substandard work is recognised by the peer raters). During a second-year undergraduate course, students wrote a one-page essay on an air pollutant. A first cohort (N = 260) relied on analytical rating using criteria to assess their peers' essays. A total of 1297 evaluations were made, and each essay received at least four peer ratings. Results indicate a small correlation between peer and teacher marks, and three essays of substandard quality were not recognised by the group of peer raters. A second cohort (N = 230) used comparative judgement. They completed 1289 comparisons, from which a rank order was calculated. Results suggest a large correlation between the university teacher marks and the peer scores and acceptable reliability of the rank order. In addition, the three essays of substandard quality were discerned as such by the group of peer raters. Although replication research is warranted, the results provide the first evidence that, when peer raters overmark and fail to identify substandard work using analytical rating with criteria, university teachers may consider changing the rating method of the peer assessment to comparative judgement.

The Role of Teachers' Interpersonal Behaviors in Learners' Academic Achievements

In the context of English as a foreign language classroom, affections that form between teacher and students may affect the teaching/learning process. This review aimed to investigate the related studies on the effect of teacher-learner interpersonal relationships on learners' educational performance in English as a Foreign Language (EFL) educational contexts. This review concluded that there is a significant constructive correlation between teacher-learner interpersonal relationships and learners' academic achievement. Learners are required to have some sense of belonging to improve their educational performance. Moreover, other positive emotional factors such as grit, wellbeing, self-efficacy, academic engagement, motivation, and foreign language enjoyment can mediate the association between teacher-learner interpersonal relationships and learners' academic success. The study concludes with some implications for English learners, English language teachers, and English language teacher trainers. The ideas can improve their awareness of teacher-student interpersonal relationships, including teacher stroke, rapport, and teacher immediacy and their role in improving learners' foreign language learning.

Bridging the gap between self-assessment and faculty assessment of clinical performance in restorative dentistry: A prospective pilot study

Purpose/Objectives

The current study was undertaken to investigate whether self‐assessment of clinical skills of undergraduate dental students could be bridged with faculty assessment by deliberate training over an extended period. A secondary aim was to explore students' perception of self‐assessment and its effect on their learning and motivation.

Material and Methods

A prospective pilot study was conducted at the Department of Restorative Dentistry at Damascus University. Sixteen students participated in the study, ranging in age between 22 and 23 years. A modified Direct Observation of Procedural Skills form with a grading rubric was used to register and guide students' self‐assessment; both were pretested on four students before the study. In total, four clinical encounters were completed by each student. Students were trained on how to conduct proper self‐assessment before and after each clinical encounter. A postcourse questionnaire was used to investigate students' perception of self‐assessment.

Results

Bias in self‐assessment decreased consistently after each encounter, and the difference in bias between the first (bias = 0.77) and the last encounter (bias = 0.21) was significant with a medium effect size (p = .022, d = 0.64). The percentage of disconfirming performance dimensions decreased from 39.7% to 26.9%. Students' ability to exactly pinpoint strengths improved consistently and significantly. However, their ability to pinpoint areas of improvement was volatile and showed no significant difference. Bland–Altman graph plots showed higher levels of agreement between self‐assessment and faculty assessment. Moreover, students' perception of self‐assessment was very positive overall.

Conclusions

These findings suggest the possibility that the gap between self‐assessment and faculty assessment could be bridged through deliberate training. Future longitudinal research using a larger sample size is still required to further explore whether self‐assessment can be actively bridged with faculty assessment by deliberate training.

Asia-Pacific Students' Awareness and Behaviour Regarding Social Networking in the Education Sector

Social networking (SN) technology has been presented to human beings as a means of communicating, collaborating, connecting, and cooperating to exchange knowledge, skills, news, chat, and to maintain contact with peers world-wide. This article examines SN awareness in the Asia-Pacific (AP) education sector (ES) with a specific focus on the advantages and disadvantages of SN; and investigated whether AP culture influences SN adoption by the ES. An online survey was distributed to 1014 AP students and a total of 826 students responded. Several new advantages of adoption emerged from the data analysis. SN enabled students to accomplish their study tasks more quickly; it allowed them to communicate and collaborate with peers world-wide; and it fostered sustainability. The disadvantages perceived by students include depression, loneliness, and distraction, lack of interest in pursuing traditional activities, and security and privacy concerns. Finally, culture does influence SN adoption by ES institutions in AP countries.

Reliability of peer assessment of patient education simulations

BACKGROUND

At Belmont University College of Pharmacy, the final introductory pharmacy practice experience (IPPE) course in the IPPE series, IPPE V, is designed to assess readiness for advanced pharmacy practice experiences and includes three patient counseling simulations. These simulations have required greater resources. The objective of our study was to determine if student performance on patient counseling simulations can be accurately assessed by peers.

EDUCATIONAL ACTIVITY

Students were required to participate in patient counseling simulations throughout the semester. For each simulation, students were assigned one role: pharmacist, patient, or peer-evaluator. Each pharmacist counseled the patient on a specific product while the peer-evaluator assessed the accuracy and completeness of the counseling using a detailed checklist. The patient used a checklist to assess the pharmacist's communication skills. Faculty assessed the student evaluators and the patients by counting the number of discrepancies between the student evaluator's and the live faculty checklists. Students were surveyed at the end of the semester regarding their beliefs and perceptions of peer assessment for the communication simulations.

CRITICAL ANALYSIS OF THE EDUCATIONAL ACTIVITY

Of 65 students enrolled in the spring 2018 course, complete recordings and checklists were available for 54 simulations (83.1%). Interrater reliability was high with all correlation coefficients exceeding 0.86. Students agreed that they were comfortable assessing patient education content (82.14%) and communication skills (82.14%). Our results indicate that peer evaluation during patient education simulation is reliable and acceptable to students.

Teaching and Assessment of Dentist-Patient Communication Skills: A Systematic Review to Identify Best-Evidence Methods

Dentist-patient communication skills are important aspects of contemporary oral health care, as shared decision making with patients becomes more common. The aim of this systematic review of the literature on teaching and assessment methodologies for communication skills in dental practice was to categorize those skills most relevant to dental practice and determine the best-evidence teaching and assessment methods. The systematic review was conducted using MEDLINE, EBM-Cochrane Libraries, Embase, ERIC, BIOSIS, CAB Abstracts, and PsycINFO using the OVID search engine, together with manually searching relevant journal articles. Relevant data were extracted from all included articles, and thematic analysis, categorization, and quality review of the articles was performed. Fifty articles published between 2000 and 2016 were identified as relevant to this study. Most were comparative design studies. The largest numbers were single group studies with before and after tests and cross-sectional studies. A total of 26 communication skills were identified and grouped into four major categories: generic skills, case-specific skills, time-specific skills, and emerging skills. Review of the teaching methods described in those articles showed that educators used a combination of passive and active strategies. All the assessment measures were considered to be valid and reliable. This categorization of essential dentist-patient communication skills reported in the literature may be used to assist in curriculum design along with use of tested teaching methods and validated assessment measures. The review highlights the need for more robust study designs for research in this important aspect of dental education.

Learning through multiple lenses: analysis of self, peer, near-peer and faculty assessment of a clinical history taking task in Australia

PURPOSE

Peer assessment may offer a framework for expected skill development and feedback appropriate to the learner level. Near-peer (NP) assessment may elevate expectations and motivate student learning. Feedback from peers and NPs may offer a sustainable approach to enhancing student assessment feedback. The aim was to analyze the relationship and attitudes of self, peer, NP and faculty marking of an assessment.

METHODS

A cross sectional study design was used. Year 2 osteopathy students (n = 86) were invited to self and peer assess a clinical history-taking and communication skills assessment. Near-peers and faculty also marked the assessment. Year 2 students also completed a peer/NP attitudes questionnaire. Descriptive statistics and Spearman's rho were used to evaluate the relationships across marker groups.

RESULTS

Year 2 students (n=9), near-peers (n=3) and faculty (n=5) were recruited. Correlations between self and peer (r=0.38) and self and faculty (r = 0.43) marks were moderate. A weak correlation was observed between self and near-peer marks (r = 0.25). Perceptions of peer and near-peer marking were varied with over half of the cohort suggesting peer or NP assessments marks should not contribute to a grade.

CONCLUSION

Framing peer and NP assessment as another feedback source may offer a sustainable method for enhancing feedback without overloading faculty resources. Multiple sources of feedback may assist in developing assessment literacy and calibrate a students' self-assessment capability. The small number of students recruited may indicate some acceptability of peer and NP assessment however further work is required to increase its acceptability.

Efficient undergraduate learning of liver transplant: building a framework for teaching subspecialties to medical students

BACKGROUND

Liver recipients may develop various diseases after transplant. However, because of inadequate study of liver transplant during undergraduate education, the quality of post-transplant care provided to these patients remains suboptimal. Herein, we introduce an innovative and integrated multimodal pedagogical approach to effectively disseminate key information regarding liver transplant to undergraduate students. The goal is to examine this approach through students' assessment in multiple dimensions.

METHODS

This prospective observational study evaluated student reactions to our pedagogical approach. Fifth-year medical students during the academic year 2015-2016 attended a 2-h session on what nontransplant doctors should know about liver transplants. The pedagogical strategy consisted of an online preclass self-learning exercise, an in-class interactive discussion (facilitated by the class teacher who is a liver transplant specialist to avoid distractions within the short-time frame), and a postclass essay assignment (to integrate and apply concepts). After the class, questionnaires were distributed to individual students to collect data, if returned, concerning the students' learning experience and feedback to improve teaching quality. Descriptive statistics, Mann-Whitney U tests, chi-squared tests, and McNemar's tests were used to analyze quantitative data. Qualitative data were content-coded through a descriptive approach using thematic analysis.

RESULTS

Of the 266 attendees, 263 (98.9%) completed the questionnaires and 182 (69.2%) provided comments. Student feedback indicated they "felt better" and "more satisfied" compared with problem-based learning (PBL) (51.0 and 63.1%, respectively) or large-lecture class (92.0 and 88.6%, respectively) approaches. Regarding confidently managing liver transplant patients in future, 80 (30.4%) and 246 (93.5%) students expressed preclass and postclass confidence, respectively (p < 0.001). The bell curve of the postclass self-assessment score of learning shifted toward right and became steeper compared with that of the preclass score (p < 0.001), suggesting students acquired considerable knowledge. The course was typically perceived to be cost-effective, practical, tension-free, and student-friendly.

CONCLUSION

This pedagogical approach effectively propagated knowledge concerning liver transplant to medical students, who expressed considerable satisfaction with the approach.

Student perspectives on using egocentric video recorded by smart glasses to assess communicative and clinical skills with standardised patients

INTRODUCTION

This exploratory study evaluated student perceptions of their ability to self- and peer assess (i) interpersonal communication skills and (ii) clinical procedures (a head and neck examination) during standardised patient (SP) interactions recorded by Google Glass compared to a static camera.

METHODS

Students compared the Google Glass and static camera recordings using an instrument consisting of 20 Likert-type items and four open- and closed-text items. The Likert-type items asked students to rate how effectively they could assess specific aspects of interpersonal communication and a head and neck examination in these two different types of recordings. The interpersonal communication items included verbal, paraverbal and non-verbal subscales. The open- and closed-text items asked students to report on more globally the differences between the two types of recordings. Descriptive and inferential statistical analyses were conducted for all survey items. An inductive thematic analysis was conducted to determine qualitative emergent themes from the open-text questions.

RESULTS

Students found the Glass videos more effective for assessing verbal (t₂₂ = 2.091, P = 0.048) and paraverbal communication skills (t₂₂ = 3.304, P = 0.003), whilst they reported that the static camera video was more effective for assessing non-verbal communication skills (t₂₂ = -2.132, P = 0.044). Four principle themes emerged from the students' open-text responses comparing Glass to static camera recordings for self- and peer assessment: (1) first-person perspective, (2) assessment of non-verbal communication, (3) audiovisual experience and (4) student operation of Glass.

DISCUSSION AND CONCLUSION

Our findings suggest that students perceive that Google Glass is a valuable tool for facilitating self- and peer assessment of SP examinations because of students' perceived ability to emphasise and illustrate communicative and clinical activities from a first-person perspective.

Determining Recommendations for Improvement of Communication Skills Training in Dental Education: A Scoping Review

Professional communication skills have a significant impact on dental patient satisfaction and health outcomes. Communication skills training has been shown to improve the communication skills of dental students. Therefore, strengthening communication skills training in dental education shows promise for improving dental patient satisfaction and outcomes. The aim of this study was to facilitate the development of dental communication skills training through a scoping review with compilation of a list of considerations, design of an example curriculum, and consideration of barriers and facilitators to adoption of such training. A search to identify studies of communication skills training interventions and programs was conducted. Search queries were run in three databases using both text strings and controlled terms (MeSH), yielding 1,833 unique articles. Of these, 35 were full-text reviewed, and 17 were included in the final synthesis. Considerations presented in the articles were compiled into 15 considerations. These considerations were grouped into four themes: the value of communication skills training, the role of instructors, the importance of accounting for diversity, and the structure of communication skills training. An example curriculum reflective of these considerations is presented, and consideration of potential barriers and facilitators to implementation are discussed. Application and evaluation of these considerations are recommended in order to support and inform future communication skills training development.

Self-evaluation and peer-feedback of medical students' communication skills using a web-based video annotation system. Exploring content and specificity

OBJECTIVE

Self-evaluation and peer-feedback are important strategies within the reflective practice paradigm for the development and maintenance of professional competencies like medical communication. Characteristics of the self-evaluation and peer-feedback annotations of medical students' video recorded communication skills were analyzed.

METHOD

Twenty-five year 4 medical students recorded history-taking consultations with a simulated patient, uploaded the video to a web-based platform, marked and annotated positive and negative events. Peers reviewed the video and self-evaluations and provided feedback. Analyzed were the number of marked positive and negative annotations and the amount of text entered. Topics and specificity of the annotations were coded and analyzed qualitatively.

RESULTS

Students annotated on average more negative than positive events. Additional peer-feedback was more often positive. Topics most often related to structuring the consultation. Students were most critical about their biomedical topics. Negative annotations were more specific than positive annotations. Self-evaluations were more specific than peer-feedback and both show a significant correlation. Four response patterns were detected that negatively bias specificity assessment ratings.

CONCLUSION

Teaching students to be more specific in their self-evaluations may be effective for receiving more specific peer-feedback.

PRACTICE IMPLICATIONS

Videofragmentrating is a convenient tool to implement reflective practice activities like self-evaluation and peer-feedback to the classroom in the teaching of clinical skills.

(Re)Introducing communication competence to the health professions

Despite the central role that communication skills play in contemporary accounts of effective health care delivery in general, and the communication of medical error specifically, there is no common or consensual core in the health professions regarding the nature of such skills. This lack of consensus reflects, in part, the tendency for disciplines to reinvent concepts and measures without first situating such development in disciplines with more cognate specialization in such concepts. In this essay, an integrative model of communication competence is introduced, along with its theoretical background and rationale. Communication competence is defined as an impression of appropriateness and effectiveness, which is functionally related to individual motivation, knowledge, skills, and contextual facilitators and constraints. Within this conceptualization, error disclosure contexts are utilized to illustrate the heuristic value of the theory, and implications for assessment are suggested. Significance for public healthModels matter, as do the presuppositions that underlie their architecture. Research indicates that judgments of competence moderate outcomes such as satisfaction, trust, understanding, and power-sharing in relationships and in individual encounters. If the outcomes of health care encounters depend on the impression of competence that patients or their family members have of health care professionals, then knowing which specific communicative behaviors contribute to such impressions is not merely important - it is essential. To pursue such a research agenda requires that competence assessment and operationalization becomes better aligned with conceptual assumptions that separate behavioral performance from the judgments of the competence of that performance.

Peer-assessment of medical communication skills: the impact of students' personality, academic and social reputation on behavioural assessment

OBJECTIVE

Peer-assessment of communication skills may contribute to mastery of assessment criteria. When students develop the capacity to judge their peers' performance, they might improve their capacity to examine their own clinical performance. In this study peer-assessment ratings are compared to teacher-assessment ratings. The aim of this paper is to explore the impact of personality and social reputation as source of bias in assessment of communication skills.

METHODS

Second year students were trained and assessed history taking communication skills. Peers rated the students' personality and academic and social reputation.

RESULTS

Peer-assessment ratings were significantly correlated with teacher-ratings in a summative assessment of medical communication. Peers did not provide negative ratings on final scales but did provide negative ratings on subcategories. Peer- and teacher-assessments were both related to the students' personality and academic reputation.

CONCLUSION

Peer-assessment cannot replace teacher-assessment if the assessment should result in high-stake decisions about students. Our data do not confirm the hypothesis that peers are overly biased by personality and reputation characteristics in peer-assessment of performance.

PRACTICE IMPLICATIONS

Early introduction of peer-assessment in medical education would facilitate early acceptance of this mode of evaluation and would promote early on the habit of critical evaluation of professional clinical performance and acceptance of being evaluated critically by peers.

Long-term effect of communication training on the relationship between physicians' self-efficacy and performance

OBJECTIVE

To examine the long term impact of a communication skills intervention on physicians' communication self-efficacy and the relationship between reported self-efficacy and actual performance.

METHODS

62 hospital physicians were exposed to a 20-h communication skills course according to the Four Habits patient-centered approach in a crossover randomized trial. Encounters with real patients before and after the intervention (mean 154 days) were videotaped, for evaluation of performance using the four habits coding scheme. Participants completed a questionnaire about communication skills self-efficacy before the course, immediately after the course, and at 3 years follow-up. Change in self-efficacy and the correlations between performance and self-efficacy at baseline and follow-up were assessed.

RESULTS

Communication skills self-efficacy was not correlated to performance at baseline (r=-0.16; p=0.22). The association changed significantly (p=0.01) and was positive at follow-up (r=0.336, p=0.042). The self-efficacy increased significantly (effect size d=0.27). High performance after the course and low self-efficacy before the course were associated with larger increase in communication skills self-efficacy.

CONCLUSION

A communication skills course led to improved communication skills self-efficacy more than 3 years later, and introduced a positive association between communication skills self-efficacy and performance not present at baseline.

PRACTICE IMPLICATIONS

Communication skills training enhances physicians' insight in own performance.