The relationship between physical therapy students’ communication skills during a standardized patient examination and professionalism domain performance on a first full-time clinical experience: an exploratory cohort study
Main Article Content
Abstract
Purpose: Physical therapy education lacks validated tools for assessing student communication and professional behavior skills before clinical experiences (CE). The Gap Kalamazoo Communication Skills Assessment Form (GKCSAF) has been used in medical education to assess student communication skills. This study investigated: (1) the relationship between scores on a modified GKCSAF (mGKCSAF) during a standardized patient (SP) examination and professionalism domain scores on the Clinical Performance Instrument 2.0 (CPI) during a first full-time CE1 and (2) differences in mGKCSAF ratings across SPs, clinical instructors (CIs), and student self-assessments.
Methods: This retrospective study examined data from 73 first-year physical therapy students who completed a SP examination and were scored using the mGKCSAF before CE1. The mGKCSAF was scored by SPs, CIs, and the students themselves. At the end of CE1, students were assessed using the CPI. Spearman’s rank-order correlations were used to determine the relationship between mGKCSAF scores and five professionalism domain scores on the CPI. A one-way Analysis of Variance (ANOVA) was performed to compare mGKCSAF ratings across rater groups. Post hoc Tukey’s Honest Significant Difference (HSD) tests further explored differences among rater groups. G*Power analysis confirmed sufficient sample size.
Results: Small statistically significant correlations existed between mGKCSAF SP ratings and CI CPI ratings during CE1 in professionalism domain categories. Student mGKCSAF self-assessment scores were significantly lower than assessments by SPs and CIs.
Conclusion: The mGKCSAF may be an effective tool to assess physical therapy student communication skills before CE1 when it is scored by SPs.
References
2. Timmerberg JF, Dole R, Silberman N, et al. Physical therapist student readiness for entrance into the first full-time clinical experience: a Delphi study. Phys Ther (2019) 99(2): 131–46. doi: 10.1093/ptj/pzy134
3. Silberman N, LaFay V, Hansen RL, et al. Physical therapist student difficulty in clinical education settings: incidence and outcomes. J Phys Ther Educ (2018) 32(2): 175–82. doi: 10.1097/JTE.0000000000000046
4. May WW, Morgan BJ, Lemke JC, et al. Model for ability-based assessment in physical therapy. J Phys Ther Educ (1995) 9(1): 3–6. doi: 10.1097/00001416-199501000-00002
5. Jette DU, Portney LG. Construct validation of a model for professional behavior in physical therapist students. Phys Ther (2003) 83(5): 432–43. doi: 10.1093/ptj/83.5.432
6. Hayward LM, Blackmer B. A model for teaching and assessing core values development in doctor of physical therapy students. J Phys Ther Educ (2010) 24(3): 16–26. doi: 10.1097/00001416-201007000-00003
7. Young A, Handlery K, Kahl D, et al. A survey of the prevalence of impostor phenomenon among US entry-level Doctor of Physical Therapy students. J Phys Ther Educ (2024) 38(1): 19–24. doi: 10.1097/JTE.0000000000000313
8. Richardson MV, Miller H, Papa E, et al. Perfectionism, stress, and the entry-level Doctor of Physical Therapy student: a cross-sectional, observational study. J Phys Ther Educ (2022) 36(1): 9–16. doi: 10.1097/JTE.0000000000000213
9. Stelling BE, Andersen CA, Suarez DA, et al. Fitting in while standing out: professional identity formation, imposter syndrome, and burnout in early-career faculty physicians. Acad Med (2023) 98(4): 514–20. doi: 10.1097/ACM.0000000000005049
10. Thomas M, Bigatti S. Perfectionism, impostor phenomenon, and mental health in medicine: a literature review. Int J Med Educ (2020) 11: 201. doi: 10.5116/ijme.5f54.c8f8
11. Stockert B, Silberman N, Rucker J, et al. Simulation-based education in physical therapist professional education: a scoping review. Phys Ther (2022) 102(12): 133. doi: 10.1093/ptj/pzac133
12. Donaldson MB, Tyler K, Carroll A. The effect of standardized patients for physical therapy students on behaving and communicating as a professional: a systematic review. Phys Ther Rev (2022) 27(6): 464–76. doi: 10.1080/10833196.2022.2141039
13. Riopel MA, Litwin B, Silberman N. Promoting professional behaviours in physical therapy students using standardized patient feedback. Physiother Can (2019) 71(2): 160–7. doi: 10.3138/ptc.2018-0
14. Roach KE, Frost JS, Francis NJ, et al. Validation of the revised physical therapist clinical performance instrument (PT CPI): version 2006. Phys Ther (2012) 92(3): 416–28. doi: 10.2522/ptj.20110129
15. Makoul G. Essential elements of communication in medical encounters: the Kalamazoo consensus statement. Acad Med (2001) 76(4): 390–3. doi: 10.1097/00001888-200104000-00021
16. Rider EA, Nawotniak RH. Interpersonal and communication skills. In: Rider EA, Nawotniak RH, eds. A practical guide to teaching and assessing the ACGME core competencies. 2nd ed. Chicago, IL: HCPRo, Inc; 2010, pp. 1–37.
17. Peterson EB, Calhoun AW, Rider EA. The reliability of a modified Kalamazoo Consensus Statement Checklist for assessing the communication skills of multidisciplinary clinicians in the simulated environment. Patient Educ Couns (2014) 96(3): 411–8. doi: 10.1016/j.pec.2014.07.013
18. American Physical Therapy Association. A normative model of physical therapist professional education: version 2004. Alexandria, VA: American Physical Therapy Association; 2004.
19. American Physical Therapy Association. Code of ethics for the physical therapist (HOD S06-20-28-25). Available from: https://www.apta.org/siteassets/pdfs/policies/codeofethicshods06-20-28-25.pdf [cited 19 June 2024].
20. American Physical Therapy Association. Core values for the physical therapist and physical therapist assistant (HOD P09-21-21-09). Available from: https://www.apta.org/apta-and-you/leadership-and-governance/policies/core-values-for-the-physical-therapist-and-physical-therapist-assistant [cited 19 June 2024].
21. Brown T, Yu ML, Etherington J. Are listening and interpersonal communication skills predictive of professionalism in undergraduate occupational therapy students? Health Prof Educ (2020) 6(2): 187–200. doi: 10.1016/j.hpe.2020.01.001
22. Panzarella K, Manyon A. Using the integrated standardized patient examination to assess clinical competence in physical therapist students. J Phys Ther Educ (2009) 22(3): 24–32. doi: 10.1097/00001416-200810000-00004
23. American Psychological Association. APA dictionary of psychology. n.d. Available from: https://dictionary.apa.org/face-validity [cited 26 November 2024].
24. Recker-Hughes C, Dungey J, Miller S, et al. A novel approach to clinical instructor professional development: a multi-session workshop with application of skills in a student standardized patient exam. J Phys Ther Educ (2015) 29(1): 49–59. doi: 10.1097/00001416-201529010-00009
25. Benjamini Y, Hochberg Y. Controlling the false discovery rate: a practical and powerful approach to multiple testing. J R Stat Soc Series B Stat Methodol (1995) 57(1): 289–300. doi: 10.1111/j.2517-6161.1995.tb02031.x
26. Faul F, Erdfelder E, Buchner A, et al. Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behav Res Methods (2009) 41(4): 1149–60. doi: 10.3758/BRM.41.4.1149
27. Goldhamer ME, Cohen A, Brooks M. Use of an objective structured clinical exam (OSCE) for early identification of communication skills deficits in interns. Med Teach (2018) 40(1): 40–4. doi: 10.1080/0142159X.2017.1387646
28. Sakulku J. The impostor phenomenon. Int J Behav Sci (2011) 6(1): 75–97.
29. Mayne J. Addressing attribution through contribution analysis: using performance measures sensibly. Can J Program Eval (2001) 16(1): 1–24. doi: 10.3138/cjpe.016.001
30. Fan SC, Tsai ST, Wang YC, et al. Reliability of the Gap–Kalamazoo communication skills assessment form in occupational therapy. BJOT (2024) 87(7): 424–33. https://doi.org/10.1177/03080226241239574
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.