Adapting Small-Group Medical Education by Fostering Early Clinical Integration: A Student Perspective

Evidence demonstrates that medical students have limited experience in developing ‘higher-order communication skills’ (Kaufman et al. 2000). Anecdotally many do not feel confident in their ability to conduct difficult conversations often due to a lack of exposure to such scenarios in practice or a pervasive notion that these scenarios are inappropriate for students and beyond the scope of a junior doctor’s role and thus not a focus of curriculums (Noble et al. 2007). There is however a correlation between level of clinical experience and improved confidence for medical students (Morgan and Cleave-Hogg 2002).We surveyed a group of final year medical students to assess their confidence using a 10-point Likert scale in tackling common palliative and end of life care scenarios. Our intervention comprised a study day of 10 practical small-group teaching simulation and OSCE-style stations designed to provide exposure to common experiences in a controlled setting. We reassessed the confidence of students after delivery and objectively explored the impact of the day by asking participants to complete a validated assessment before and after the course. All results showed significant improvement on t-testing: confidence in end of life communication in an OSCE setting improved by 42.2% and assessment marks improved by 24.7% (p=0.039).Palliative care is an area in which students approaching the end of undergraduate training feel underprepared. Our findings demonstrate that small group sessions improve confidence by facilitating communication practice in a controlled environment and providing crucial exposure to common palliative care scenarios they will face as doctors.References. Kaufman D, Laidlaw T, Macleod H. Communication skills in medical school: Exposure confidence and performance. Academic Medicine [online] 2000;75(10):S90–S92. Available at https://journals.lww.com/academicmedicine/Fulltext/2000/10001/Communication_Skills_in_Medical_School__Exposure.29.aspx [Accessed: 30 May 2018]. Morgan P, Cleave-Hogg D. Comparison between medical students’ experience confidence and competence. Medical Education [online] 2002;36(6):534–539. Available at https://doi.org/10.1046/j.1365-2923.2002.01228.x [Accessed: 30 May 2018]. Noble L, Kubacki A, Martin J, Lloyd M. The effect of professional skills training on patient-centredness and confidence in communicating with patients. Medical Education [online] 2007;41(5):432–440. Available at https://doi.org/10.1111/j.1365-2929.2007.02704.x [Accessed: 30 May 2018]

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Does locally delivered small group continuing medical education (CME) meet the learning needs of rural general practitioners?

Education for Primary Care ◽

10.1080/14739879.2019.1573109 ◽

2019 ◽

Vol 30 (3) ◽

pp. 145-151 ◽

Cited By ~ 3

Author(s):

S. Dowling ◽

J. Last ◽

H. Finnegan ◽

K. O’Connor ◽

W. Cullen

Keyword(s):

Medical Education ◽

Small Group ◽

General Practitioners ◽

Continuing Medical Education ◽

Learning Needs

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Adapting a Small Group Communication Quality Assessment to New Contexts

International Research in Higher Education ◽

10.5430/irhe.v3n2p61 ◽

2018 ◽

Vol 3 (2) ◽

pp. 61 ◽

Cited By ~ 1

Author(s):

Lauren Jodi Van Scoy ◽

Whittney Darnell ◽

Tara Watterson ◽

Vernon M Chinchilli ◽

Emily J Wasserman ◽

...

Keyword(s):

Medical Education ◽

Small Group ◽

Quality Analysis ◽

Communication Quality ◽

Small Group Communication ◽

Group Settings ◽

Communication Assessment ◽

Communication Goals ◽

The Individual ◽

The Impact

Objectives: Small group learning is a well-established medical education strategy for cultivating essential communication skills. Yet, how best to measure communication quality in these groups remains understudied. This study aimed to adapt a communication assessment to medical education small group settings. Methods: This was an observational study of Preclinical Medical Humanities group discussions. Audio-recordings of 12 sessions (3 groups; n=22 students and 3 facilitators) were analyzed using Communication Quality Analysis. Three coders assessed communication quality by assigning numeric scores based on how well participants accomplished communication goals within five domains: content, engagement, relationship, emotion and identity. Coder reliability was assessed using intra-class correlations. Variance components were assessed using a generalized linear model.Results: High inter-rater reliability was established for each of five communication quality domains (ICC range 0.875 to 0.98). Variability in content, emotion, and engagement domains was primarily driven by the individual subjects (nested within the three communication groups)–accounting for 49%, 57% and 78% of the variability respectively; relational and identity domain score variability was accounted for by duration of class (accounting for 66% and 47% of the variability, respectively). Considerable variability was observed between participants, suggesting that the assessment is sensitive enough to detect nuanced differences between participants.Conclusions: Our study shows that CQA is reliable when adapted to medical education small groups.With further refinement, CQA provides an important measure that could be used in medical education to evaluate the impact of novel curricular activities or varied facilitation techniques on communication quality and other educational outcomes.

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