Clinical communication skills compared with written and oral examination performance

Purpose: To compare performance on knowledge-based written and oral examinations to faculty evaluation of communication skills.

Methods: For three consecutive years, a patient case-based oral examination was given to all second professional year pharmacy students enrolled in the cardiovascular therapeutics course in addition to traditional written examinations. Students were provided with a patient case 24-hours prior to the oral examination to allow adequate preparation time and the examination incorporated information also tested in written format. In addition to evaluation of pharmacotherapy knowledge on the oral examination, faculty used a standard rubric to assess students’ communication skills in the areas of rapport (confidence, non-verbal, tone of voice, eye contact) and presentation of therapeutic recommendations (concise, pronunciation, well-prepared, patient-focused). Students’ performance on the written and oral examinations were compared to faculty evaluation of their communication skills using descriptive statistics, 2-way ANOVA, and Pearson’s correlation.

Results: Over three years of this study, a total of 403 (97.8%) students provided informed consent for participation. A positive correlation was seen between performance on the oral examination and mean faculty communication evaluation scores (r=0.49, p<0.001). Little correlation was seen between written and oral exam performance (r=0.19, p<0.001) and between written exam performance and mean faculty communication scores (r=0.06, p=0.208). In addition, students who scored 90 or greater on the oral examination had higher mean(SD) faculty communication scores than those who scored less than 90 [3.65(0.36) vs. 3.35(0.43), respectively, p<0.001].  

Conclusion: Success as a pharmacist requires both therapeutics knowledge and effective communication skills. Identification of potential disparities between knowledge and communication skills may lead to a broader curricular focus on oral communication in therapeutics courses.