Effectively using patients as teachers to provide authentic feedback is an underused strategy in dental education, but it has potential for integrating the teaching of therapeutic communication skills within the dental clinic setting. This study focuses on the absence of patient input into the design of instruments used to assess students' clinical communication skills and demonstrates how a holistic approach, with input from key stakeholders including patients, was used to produce two such instruments. The development of complementary communication assessment instruments, one for patient use and one for student use, took place in three phases. In Phase I the authors reviewed a sample of existing patient satisfaction surveys; in Phase II they captured input from stakeholders; and Phase III resulted in the generation of the patient communication assessment instrument and the student communication self-assessment instrument. This article highlights communication skill issues relevant to the education of oral health professionals and describes the rationale and process for the development of the first iteration of the patient assessment and student self-assessment clinical communication instruments. Ms. Wener is Clinical Communications Skills Coordinator,Journal of Dental Education ■ Volume 75, Number 12 poration of self-awareness and reflection into clinical practice 26 and is the crux of the educational approach described in this article.The interprofessional educational research team at the University of Manitoba Faculty of Dentistry that developed this approach consisted of an educational psychologist, a dental hygienist educator, and a dental educator. They identified five educational research goals that provided the impetus and guidance for this project: 1. To provide a strategy for developing competence in communication for dental and dental hygiene students to become skilled, caring, and collaborative communicators using patients as teachers, self-assessment, and reflection. 2. To meaningfully and cost-effectively integrate classroom teaching into clinical care. 3. To reinforce students' communication strengths and to identify and address areas in the student's communication that require improvement. 4. To inform development of the dental and dental hygiene communication skills curricula at the University of Manitoba by identifying key communication skills as well as identifying any curricular gaps that need to be addressed. 5. To provide the Faculty of Dentistry with feedback from patients and students about the overall clinical experience.To address these goals, two communication skills instruments were developed: one for patients to assess their dental and dental hygiene student clinicians' communication, referred to as the Patient Communication Assessment Instrument (PCAI); and one for student clinicians to self-assess their communication with their patients, referred to as the Student Communication Assessment Instrument (SCAI). To promote learning, the PCAI and SCAI results were integrated into a combin...

A shortcoming identiied 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 identiied in the irst 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 signiicantly 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.

Research on the development of effective therapeutic communication skills for oral health providers is slowly evolving. One of the initial steps in this research is to identify and address gaps in the work of previous researchers. Ultimately, the educational goal of competence in communications skills development is to provide improved patient care including improved patient satisfaction. This article is the third in a series describing the development of and indings from the new complementary Patient Communication Assessment Instrument (PCAI) and Student Communication Assessment Instrument (SCAI). The aim of the study reported here was to look at the relationship between communication skills and patient and student clinician gender interactions, sociodemographic factors (e.g., age, income), and changes in these interactions with length of treatment. A total of 410 patient assessments (PCAI) and 410 matching student self-assessments (SCAI) were used for further data analysis. Patients of female student clinicians, female patients, patients of a higher and the lowest income range, and older patients reported statistically signiicant higher student communication scores. The PCAI identiied that certain groups of patients consistently report higher scores than other groups, whereas the SCAI identiied differences between male and female student clinicians. The results have implications for educational protocols, communication strategies, and the need for continued research regarding sociodemographic factors and their relationship to patient satisfaction.

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The development of appropriate communication skills by healthcare providers is central to providing quality patient-centred care. Patients can provide valuable feedback to practitioners about their clinical communication. However, in oral health care, their involvement is uncommon and instruments specific for communication in oral health care have not been available. Recently, two complementary instruments have been developed by the Faculty of Dentistry, University of Manitoba for evaluating student-clinicians' clinical communication: one for patient evaluation and one for student self-evaluation. The aim of the current study was to provide validity evidence for the scores related to the internal structure of the revised 2007 versions of these instruments in two dental clinical/education contexts, namely the Universities of Manitoba, Canada (UM) and Adelaide, Australia (UA). The proposed factor structure and loadings, and their stability across contexts were assessed using confirmatory factor analysis, and the adequacy of the internal consistency reliability of the scores was analysed using Cronbach's alpha. The factor structure of the current 2007 versions of the patient and student instruments, derived from the previously developed longer versions of these instruments, was confirmed and was consistent across the two clinical/educational contexts. A model of partial invariance provided the best fit for these data due to variations in the magnitude of the factor loadings between sites. The internal consistency reliability of scores was high with a range of 0.88-0.97. In conclusion, the current study provides preliminary evidence regarding the validity of the scores of the current 2007 instruments, in terms of the internal structure, as measuring the five factors well. Replication of the factor structure of these instrument scores with more participants at both UA and other institutions is required.