A literature review of instruments measuring communication skills in medical education

Abstract

Objectives: This study reviewed the literature on instruments measuring physician-patient communication skills in medical interviews. Our goal was to clarify the features of current instruments and problems in assessing physician-patient communication with them.
Methods: In 2012, we searched for published articles about instruments assessing physician-patient communication skills in the bibliographic databases PubMed, PsycINFO, and the Education Resources Information Center using the combination of search terms （“consultation skills” OR “doctor-patient communication” OR “physician-patient relations”） AND “medical education” AND （instruments OR measurement OR assessment）. Instruments designed for faculty observers and to be used in medical education were included in the study. To compare the instruments, we classified the items of each instrument on the basis of the framework of the Kalamazoo Consensus Statement （KCS）, an experts’ consensus statement on 7 essential elements of physician-patient communication.
Results: Ten instruments were included in the study. Eighty-three percent of all 277 items of the instruments were classified to any of the 7 elements identified in the KCS. Most of the instruments included more than 6 elements identified in the KCS, and some of the instruments had been constructed on the basis of the KCS. However, the instruments varied considerably in essential communication skills to understand the patient’s perspective, to share information, and to reach agreement on problems and plans.
Conclusions: Further study is needed to provide evidence for essential communication skills in physician-patient consultation. Because essential communication skills depend on the educational goals, culture, language, and other factors, ensuring the reliability and validity of tools administered to evaluate communication must be required.