Preclinical medical students’ performance in and reflections on integrating procedural and communication skills in a simulated patient consultation

Abstract

Background. An effective patient-centred consultation requires the seamless integration of procedural (technical) and communication skills. Research has shown that the two sets of skills should not be taught or assessed separately; yet, clinical communication education has become separated from other parts of medical education.
Objectives. To assess students’ performance of integrated procedural and clinical communication skills in a simulated consultation, and analyse and interpret their reflections on the value and challenges of these integrated assessments.
Methods. A mixed-method study was conducted to assess a convenience sample of 207 third-year medical students’ integration of procedural and consultation skills in a simulated patient consultation and explore their self-assessment and reflections on the value of the assessment.
Results. The average percentages scored for procedural and communication checklist items were compared. Facilitators and participants scored procedural skills significantly higher, indicating poor integration of communication skills. A thematic analysis of written reflections revealed that students learned by: (i) experiencing an authentic consultation; (ii) integrating their procedural and communication skills as well as their knowledge and skills; (iii) experiencing the assessment as learning; and (iv) becoming aware of the effects of emotion.
Conclusion. Although the majority of students were not able to integrate their skills in performing a simulated consultation, they nonetheless appreciated the value of the assessment as a learning experience.