Design and Validation of Patient-Centered Communication Tools (PaCT) to Measure Students’ Communication Skills

Abstract

Objective. To develop a comprehensive instrument specific to student pharmacist-patient communication skills, and to determine face, content, construct, concurrent, and predictive validity and reliability of the instrument. Methods. A multi-step approach was used to create and validate an instrument, including the use of external experts for face and content validity, students for construct validity, comparisons to other rubrics for concurrent validity, comparisons to other coursework for predictive validity, and extensive reliability and inter-rater reliability testing with trained faculty assessors. Results. Patient-centered Communication Tools (PaCT) achieved face and content validity and performed well with multiple correlation tests with significant findings for reliability testing and when compared to an alternate rubric. Conclusion. PaCT is a useful instrument for assessing student pharmacist communication skills with patients.Keywords: communication tools; provider-patient relationship; patient-centered; pharmacist-patient instrument INTRODUCTIONEffective communication requires active participation by patients and health care providers to ensure that messages are received and interpreted accurately by all parties. This is especially true for pharmacists as evidenced by a World Health Organization (WHO) report indicating that one of the seven roles of the pharmacist is "communicator."1 The 2016 Accreditation Council for Pharmacy Education (ACPE) guidelines for Doctor of Pharmacy degree programs explicitly define expectations for communication in the standards.2 Standard 3 (Approach to Practice and Care), Key Element 3.6 outlines that "graduates must be able to effectively communicate verbally and nonverbally when interacting with individuals, groups, and organizations." Additionally, professional communication is described as a required element of the didactic curriculum in Appendix 1 of the Standards. 2 The Center for the Advancement of Pharmacy Education (CAPE) is recognized by schools and colleges of pharmacy, the American Association of Colleges of Pharmacy (AACP), and ACPE as the foundational driver for curricular design, mapping, and setting program expectations. Updated outcomes were released by CAPE in 2013 that specifically mention communication in Domain 3 (3.6 Communicator) and indirectly within the description of collaboration (3.4 Collaborator). 3Studies have shown that pharmacist communication skills can be improved with education and training.4,5 A recent literature review of communications training and assessment in pharmacy education by Wallman and colleagues revealed that the majority of education and training occurs with patient-focused communication activities, such as learning interviewing techniques, patient counseling or public health promotion.6 Several published articles describe objective assessment of student pharmacist oral communication with a patient, such as structured exam, pre/post evaluations, and expert/professor assessment of skills. Other articles describe subjective a...

The Community Pharmacist: Perceived Barriers and Patient-Centered Care Communication

“…In this regard, Wallman et al revealed that in pharmacy education, good training occurs with patient-focused communication activities (e.g., learning interviewing techniques, patient counseling, or public health promotion) [28]. Other literature describes the introduction of student pharmacist assessments on oral patient communication (e.g., structured exam, pre/post evaluations) [70][71][72][73][74].…”

“…The outcomings from the FHM application in the pharmacy field raised the need for the ideation of a new instrument, specific to student pharmacist-patient communication skills, able to both measure communication and to assess the pharmacist-patient relationship. This framework, called the Patient-centered Communication Tools (PaCT), includes 23 skills organized into five general "tools" to be taught to students at an academic level [43,74].…”

Determination of Interrater Reliability of a Universal Evaluator Rubric to Assess Student Pharmacist Communication Skills

“…Previous studies have demonstrated the challenge of developing a communication rubric with a high level of interrater reliability. [10][11] The Patient-Centered Communication Tools (PaCT) developed by Grice and colleagues demonstrated a statistically significant correlation in interrater scores on two out of five assessment tools but no significant correlation on overall scores. The authors concluded that the interrater scores were not strongly correlated.…”

“…[5][6] There are also numerous rubrics that have been proposed to assess communication skills within various environments. [7][8][9][10][11] To our knowledge, no study has utilized a coordinated evaluator training with a standardized codebook in an effort to increase reliability of a communication evaluation tool. Previously published studies have described methods for testing and achieving interrater reliability, however these were limited to single evaluator types.…”

Validation of Health Education Material for Youth: A Step to Ensure Implementation Fidelity in Community-Based Interventions

“…Some of the evidence comes from education aids developed for patient-centered care in hospitals such as leaflets, brochures, etc. [28][29][30]. These validated education materials have the advantage of standardizing information to be shared with the participants and relieving discontent due to contradictory information [31].…”