An examination of the validity of EPSCALE using factor analysis

Area of Science:

• Medical Education Research
• Clinical Communication Skills Assessment
• Psychometrics in Healthcare

Background:

• The Explanation and Planning Scale (EPSCALE) is frequently used to evaluate clinicians' explanation and planning abilities during patient interviews.
• Assessing these skills is crucial for effective medical education and patient care.
• Ensuring the validity and utility of assessment tools like EPSCALE is paramount.

Purpose of the Study:

• To rigorously examine the construct validity and practical utility of the EPSCALE instrument.
• To determine the optimal factor structure of the EPSCALE for reliable assessment.
• To provide evidence supporting the use of EPSCALE in evaluating clinical communication skills.

Main Methods:

• Exploratory factor analysis was conducted on data from 124 medical students across 4 Objective Structured Clinical Examination (OSCE) stations.
• Single-factor, two-factor (theory-based), and six-factor (empirically derived) models were tested.
• Parallel analysis guided the selection of the most appropriate factor model.

Main Results:

• A single-factor model showed a poor fit, indicating limited explanatory power.
• A two-factor model, with 'Explanation' and 'Planning' factors, offered an improved fit.
• A six-factor model provided the best fit, aligning with the domains of the Calgary-Cambridge guide, suggesting a more nuanced structure.

Conclusions:

• The factor analysis results provide strong evidence for the construct validity of the EPSCALE.
• The findings support the justifiable use of EPSCALE in assessing shared-decision making skills in medical professionals.
• The study validates EPSCALE as a robust tool for evaluating complex clinical communication competencies.