Comparing narrative and multiple-choice formats in online communication skill assessment

Area of Science:

• Medical Education
• Clinical Communication Skills
• Patient-Centered Care

Background:

• Assessing medical students' clinical skills is crucial for effective patient care.
• Integrating sexual risk assessment and behavior change discussions requires specific communication competencies.
• Web-based tools offer innovative methods for medical education and assessment.

Purpose of the Study:

• To compare the effectiveness of multiple-choice versus open-ended response formats in assessing medical students' clinical communication skills.
• To evaluate students' ability to integrate patient-centered communication and behavior change strategies.
• To identify educational needs in primary care settings.

Main Methods:

• 111 Year 3 medical students utilized a web-based tool ('Case for Change').
• Students responded to video vignettes of patient encounters using both open-ended text and multiple-choice selections.
• Responses were analyzed to compare the nature of student-generated statements versus selected statements.

Main Results:

• Open-ended responses frequently demonstrated doctor-centered communication, including premature questioning and neglecting patient perspectives.
• Students often selected patient-centered statements from multiple-choice options, contradicting their narrative responses.
• A discrepancy exists between students' expressed communication styles and their actual clinical reasoning.

Conclusions:

• Open-ended questions provide deeper insights into students' learning needs but are labor-intensive to score.
• Multiple-choice questions allow for efficient assessment and feedback but may not fully capture students' thought processes.
• Both assessment methods have unique strengths and limitations in evaluating clinical communication skills.