Abstract Title | Discrepancy between faculty and simulated patient scores for communication and interpersonal skills


  1. Masami Tagawa
  2. Kazunori Ganjitsuda
  3. Kenichi Ikeda


Simulation and Simulated Patients


Simulated Patients


Center for Innovation in Medical and Dental Education, Kagoshima University


For the assessment of communication and interpersonal skills (CI) of medical students and residents, scores of checklists rated by physicians and SPs have been discussed regarding whether they reflect competency and patient s’ perspectives (ref. 1-8).  In our previous study, total scores for CI by faculty raters (physicians) and SPs were weakly correlated, but the different perspectives of both were not clearly identified.


In our study, using the instruments of CI, which have equivalent items but are expressed as observable behaviors for faculty raters and SPs, paired scores of the same examinees showed a discrepancy at item levels.  Those scores were rarely identical or showed positive correlations, especially for the items of listening and understanding the patients, expressing empathy, and global rating of an examinee as a medical graduate.


Take-home Messages

Faculty and SP raters have different perspectives on CI, and do not complement each other.


Summary of Work

Fifteen SP cases in OSCE encountered by sixth-year medical students at Kagoshima University in 2010 and 2011 were analyzed.  Faculty raters scored the CI as well as history taking (content), physical examination, informing of diagnosis and plan for SPs in the examination room.  After 20 minutes, SPs scored CI in the SP rating room.



Five items of listening (L), five of explaining and decision-making (ED), and 4 of attitude and the whole process (AW) were scored by a faculty rater and an SP for each examinee using equivalent instruments (see Details).  Scores were analyzed using the Pearson correlation coefficient and paired t-test.


Summary of Results

1. Items showed a positive correlation between faculty and SP scores by the Pearson correlation coefficient (p<0.05) were 34 among 14 items of 15 cases (16 %).



2. We classified items into psychometric criteria (Figure 2), and each item’s psychometric property of each case is shown in Figure 3.


Significant score differences were detected for items of listening behaviors and understanding the patients (Items 1, 2, and 5), expressing empathy (Item 11), and examinee’s attitude such as enthusiasm and confidence for the medical students expecting graduation (Item 12).



The authors thank the sixth-year medical students, faculty members, Kagoshima SP group members, and staff who participated in the OSCE and this research.


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Take-home Messages
Summary of Work

Items for scoring CI were created based on a communication process required in this OSCE as well as the Common Achievement Test organization instrument and previous publications (ref. 9-14).   They were written as examinee’s observable behaviors for faculty raters.  For SPs, items were expressed as patient s’ recognition, understanding, and feeling (Table 1).  



Scores were rated using a 3-point likert scale, such as completely agree (satisfactorily done, competent)(1 point), agree but inadequate (done but incomplete /unsatisfactory) (0.5 points), and disagree (not done or very bad) (0 points).


Summary of Results
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