Communication of clinical recommendations during oral examinations

Purpose: To compare students’ self-assessment and faculty evaluation of communication of clinical recommendations during therapeutics oral examinations.

Methods: For three consecutive years in the Cardiovascular / Renal therapeutics course, one individual and one group patient case-based oral examination were given to all second-year student pharmacists. Students were provided with patient cases prior to each oral examination. In addition to evaluation of pharmacotherapy knowledge, faculty evaluated students’ communication skills using a scoring rubric divided into two areas: rapport (confidence, non-verbal, tone of voice, eye contact) and presentation of therapeutic recommendations (concise, pronunciation, well-prepared, patient-focused). Faculty evaluated these skills on a 4-point Likert scale with 1=needs significant development and 4=accomplished. Immediately following each oral examination, students self-assessed their communication skills using the same rubric. This study was approved by the Institutional Review Board and students voluntarily signed informed consent prior to participation. Students’ self-assessments were compared to faculty evaluation of their communication skills using descriptive statistics and student’s t-tests.

Results: A total of 401 (97.3%) students completed communication self-assessments following each oral examination. For the individual oral examination, mean(SD) student self-assessment and faculty’s evaluation of communication were 3.16(0.52) and 3.51(0.42), respectively.  For the group oral examination, mean(SD) student self-assessment and faculty’s evaluation of communication were 3.35(0.47) and 3.52(0.34). Faculty evaluations in both the individual and group oral examinations were statistically significantly higher than the students’ self-assessments (p<0.001). In addition, students’ self-assessment of communication increased from the individual to the group examination (p<0.001).

Conclusion: Student pharmacists’ self-assessment of communication skills was consistently lower than the faculty’s evaluation scores. Students’ lower self-assessment may be due to a lack of practice in the verbal communication of clinical recommendations. Increased utilization of patient case-based oral examinations in therapeutic courses may help to improve student’s confidence and self-assessment of their communication skills.