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.
The impact of group interaction on shared cognition: An analysis of small group communication