Use of the Kalamazoo Essential Elements Communication Checklist (Adapted) in an Institutional Interpersonal and Communication Skills Curriculum

Abstract

Background This study examined the psychometric properties of the Kalamazoo Essential Elements Communication Checklist (Adapted) (KEECC-A), which addresses 7 key elements of physician communication identified in the Kalamazoo Consensus Statement, in a sample of 135 residents in multiple specialties at a large urban medical center in 2008–2009. The KEECC-A was used by residents, standardized patients, and faculty as the assessment tool in a broader institutional curriculum initiative. Methods Three separate KEECC-A scores (self-ratings, faculty ratings, and standardized patient ratings) were calculated for each resident to assess the internal consistency and factor structure of the checklist. In addition, we analyzed KEECC-A ratings by gender and US versus international medical graduates, and collected American Board of Internal Medicine Patient Satisfaction Questionnaire (PSQ) scores for a subsample of internal medicine residents (n = 28) to examine the relationship between this measure and the KEECC-A ratings to provide evidence of convergent validity. Results The KEECC-A ratings generated by faculty, standardized patients, and the residents themselves demonstrated a high degree of internal consistency. Factor analyses of the 3 different sets of KEECC-A ratings produced a consistent single-factor structure. We could not examine the relationship between KEECC-A and the PSQ because of substantial range restriction in PSQ scores. No differences were seen in the communication scores of men versus women. Faculty rated US graduates significantly higher than international medical graduates. Conclusion Our study provides evidence for the reliability and validity of the KEECC-A as a measure of physician communication skills. The KEECC-A appears to be a psychometrically sound, user-friendly communication tool, linked to an expert consensus statement, that can be quickly and accurately completed by multiple raters across diverse specialties.

Resident Ratings of Communication Skills Using the Kalamazoo Adapted Checklist

“…Although ratings in the current study and in the study by Joyce et al 5 between SPs and observers/ faculty both exceeded a medium effect size, differences were found between resident self-ratings and ratings by both observers and SPs. In the current study, both correlations were statistically significant and within a small-to-medium effect size, while both correlations in the study by Joyce et al 5 were nonsignificant and of a small effect size.…”

“…Observers provided a unique opportunity to evaluate the communication scoring of resident selfratings and SPs, as they are naturally less biased. In contrast to the faculty observers in the study by Joyce et al, 5 the observers in this study received extensive training and achieved a good level of interrater reliability. Nonfaculty observers also may have more time available to learn the coding systems and participate in the process, as they may have lower clinical and educational demands than physician faculty.…”

“…1,2 OSCEs are used to provide feedback to residents and medical students following standardized patient (SP) encounters. 3,4 Resident self-ratings with the Kalamazoo Essential Elements Communication Checklist-Adapted (KEECC-A) 5 are used at Wayne State University School of Medicine, Detroit, Michigan, as part of the OSCE to promote resident selfreflection.…”

Communication to promote physical activity in family case study in community medicine for under graduate medical students

“…According to Barbara L et al, the KEECC-A is a psychometrically sound and user-friendly communication tool. 15 The faculty also found it easy to use this tool in the community. Since the checklist has seven domains, faculty found it easier to give constructive feedback on each domain.…”

Beyond Must: Supporting the Evolving Role of the Designated Institutional Official

“…The articles in this volume of the journal, particularly those in the section on institutional matters provide invaluable information to permit the DIO to build confidence and trust among the GME stakeholders. Examples include the work by Dine et al 10 on how to make residents aware of their resource use and link this to patient outcomes, the description by Joyce and colleagues 11 of the use of the Kalamazoo Essential Elements Communication Checklist in an institutional communication curriculum, and the analysis by Guille et al 12 of the factors depressed residents perceive as barriers to obtaining mental health services.…”