Assessing physicians' interpersonal skills: do patients and physicians see eye-to-eye?

To determine the level of agreement between standardized patient ratings and resident physician self-ratings of physician interpersonal skills and the level of agreement between faculty observer and standardized patient ratings of resident physicians' interpersonal skills.

Structured clinical evaluation. A total of 25 resident physicians in physical medicine and rehabilitation conducted a 10-min interview of a standardized patient to obtain a history. A resident physician, a standardized patient, and a faculty observer rated the resident physician's interpersonal skills immediately after the interview. The main outcome measure was a modification of the patient assessment measure from the American Board of Internal Medicine, a 9-item rating scale assessing communication (score range, 9-45).

There was a low level of agreement between standardized patient ratings and the resident physicians' self-ratings of interpersonal skills (Lin's concordance coefficient, rc = 0.11, P = 0.58). Conversely, there was a statistically significant degree of agreement between the standardized patient and faculty observer ratings of resident physician interpersonal skills (rc = 0.50, P = 0.006).

Some resident physicians have significant difficulty accurately assessing how well they communicate with patients. Physicians in training rarely get feedback regarding their interpersonal skills and may have difficulty using social comparison. Conversely, standardized patients and faculty observers may have insight into interpersonal skills about which resident physicians are unaware.