Mazor Kathleen M, Haley Heather-Lyn, Sullivan Kate, Quirk Mark E
Meyers Primary Care Institute and Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts 01605, USA.
Teach Learn Med. 2007 Spring;19(2):162-7. doi: 10.1080/10401330701333357.
The importance of assessing physician-patient communication skills is widely recognized, but assessment methods are limited. Objective structured clinical examinations are time-consuming and resource intensive. For practicing physicians, patient surveys may be useful, but these also require substantial resources. Clearly, it would be advantageous to develop alternative or supplemental methods for assessing communication skills of medical students, residents, and physicians.
The Video-based Test of Communication Skills (VTCS) is an innovative, computer-administered test, consisting of 20 very short video vignettes. In each vignette, a patient makes a statement or asks a question. The examinee responds verbally, as if it was a real encounter and he or she were the physician. Responses are recorded for later scoring. Test administration takes approximately 1 h.
Generalizability studies were conducted, and scores for two groups of physicians predicted to differ in their communication skills were compared. Preliminary results are encouraging; the estimated g coefficient for the communication score for 20-vignette test (scored by five raters) is 0.79; g for the personal/affective score under the same conditions is 0.62. Differences between physicians were in the predicted direction, with physicians considered "at risk" for communication difficulties scoring lower than those not so identified.
The VTCS is a short, portable test of communication skills. Results reported here suggest that scores reflect differences in skill levels and are generalizable. However, these findings are based on very small sample sizes and must be considered preliminary. Additional work is required before it will be possible to argue confidently that this test in particular, and this approach to testing communication skills in general, is valuable and likely to make a substantial contribution to assessment in medical education.
评估医患沟通技巧的重要性已得到广泛认可，但评估方法有限。客观结构化临床考试耗时且资源消耗大。对于执业医师而言，患者调查可能有用，但同样需要大量资源。显然，开发用于评估医学生、住院医师和医师沟通技巧的替代或补充方法将具有优势。
基于视频的沟通技巧测试（VTCS）是一种创新的计算机管理测试，由20个非常短的视频片段组成。在每个片段中，患者会做出陈述或提出问题。考生进行口头回应，就好像这是一次真实的会面且他/她是医师一样。回应被记录下来以供后续评分。测试管理大约需要1小时。
进行了可推广性研究，并比较了预计在沟通技巧方面存在差异的两组医师的分数。初步结果令人鼓舞；20个片段测试（由五名评分者评分）的沟通分数的估计g系数为0.79；在相同条件下个人/情感分数的g系数为0.62。医师之间的差异符合预期方向，被认为有沟通困难“风险”的医师得分低于未被如此认定的医师。
VTCS是一种简短、便于携带的沟通技巧测试。此处报告的结果表明分数反映了技能水平的差异且具有可推广性。然而，这些发现基于非常小的样本量，必须被视为初步的。在能够有信心地认为这种测试，特别是这种测试沟通技巧的方法有价值并且可能对医学教育评估做出重大贡献之前，还需要进行更多工作。
