Determining the validity and reliability of clinical communication assessment tools for dental patients and students

A shortcoming identified in the dental education literature is the scarcity of patient assessment of the quality of communication between student clinicians and patients. This study, the second in a series, attempts to address this scarcity by testing the communication components deemed critical to patients identified in the first article. Two instruments were tested: the Patient Communication Assessment Instrument (PCAI) and the Student Communication Assessment Instrument (SCAI). Item-to-total correlations and Cronbach's alpha were used to determine internal consistency reliability. Construct validity was examined through principal components factor analysis with varimax rotation using a total of 820 participants (410 patients and 410 students), who completed communication skills questionnaires collected in the 2006-07 school year as part of dental and dental hygiene clinical courses. Each component in the assessment instruments demonstrated internal consistency (alpha range=0.779-0.960). Based on a principal components analysis, six new factors were found to be significantly associated with communication skills: being caring and respectful, sharing information, interacting with team members, tending to comfort, professional relationship-building, and appointment preparation/follow-up. Correlational analysis demonstrated a core of critical instrument items to be considered for future assessment of the quality of communication between student clinicians and patients. Adequate estimates of reliability and validity for the PCAI and SCAI were demonstrated. Further research is needed in other countries and cultures to test and confirm the constructs.