title: Summative assessment of undergraduates' communication competence in challenging doctor-patient encounters. Evaluation of the Düsseldorf CoMeD-OSCE.
abstract: OBJECTIVE
  To evaluate the summative assessment (OSCE) of a communication training programme for dealing with challenging doctor-patient encounters in the 4th study year.
  
  
  METHODS
  Our OSCE consists of 4 stations (breaking bad news, guilt and shame, aggressive patients, shared decision making), using a 4-item global rating (GR) instrument. We calculated reliability coefficients for different levels, discriminability of single items and interrater reliability. Validity was estimated by gender differences and accordance between GR and a checklist.
  
  
  RESULTS
  In a pooled sample of 456 students in 3 OSCEs over 3 terms, total reliability was α=0.64, reliability coefficients for single stations were >0.80, and discriminability in 3 of 4 stations was within the range of 0.4-0.7. Except for one station, interrater reliability was moderate to strong. Reliability on item level was poor and pointed to some problems with the use of the GR.
  
  
  CONCLUSIONS
  The application of the GR on regular undergraduate medical education shows moderate reliability in need of improvement and some traits of validity. Ongoing development and evaluation is needed with particular regard to the training of the examiners.
  
  
  CONCLUSIONS
  Our CoMeD-OSCE proved suitable for the summative assessment of communication skills in challenging doctor-patient encounters.
authors.affiliation: Institute of General Practice, Medical Faculty of the Heinrich-Heine-University Düsseldorf, Düsseldorf 40225, Germany. Electronic address: achim.mortsiefer@med.uni-duesseldorf.de.
authors.forename: Achim
authors.initials: A
authors.lastname: Mortsiefer
authors.affiliation: Institute of General Practice, Medical Faculty of the Heinrich-Heine-University Düsseldorf, Düsseldorf 40225, Germany.
authors.forename: Janine
authors.initials: J
authors.lastname: Immecke
authors.affiliation: Deanery of Study and Department for Endocrinology and Diabetes, Medical Faculty of the Heinrich-Heine-University Düsseldorf, Düsseldorf 40225, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Rotthoff
authors.affiliation: Clinical Institute of Psychosomatic Medicine and Psychotherapy, Medical Faculty of the Heinrich-Heine-University Düsseldorf, Düsseldorf 40225, Germany.
authors.forename: André
authors.initials: A
authors.lastname: Karger
authors.affiliation: Clinical Institute of Psychosomatic Medicine and Psychotherapy, Medical Faculty of the Heinrich-Heine-University Düsseldorf, Düsseldorf 40225, Germany.
authors.forename: Regine
authors.initials: R
authors.lastname: Schmelzer
authors.affiliation: Clinical Institute of Psychosomatic Medicine and Psychotherapy, Medical Faculty of the Heinrich-Heine-University Düsseldorf, Düsseldorf 40225, Germany.
authors.forename: Bianca
authors.initials: B
authors.lastname: Raski
authors.affiliation: Institute of General Practice, Medical Faculty of the Heinrich-Heine-University Düsseldorf, Düsseldorf 40225, Germany.
authors.forename: Jürgen In der
authors.initials: JI
authors.lastname: Schmitten
authors.affiliation: Institute of General Practice, Medical Faculty of the University of Rostock, Rostock 18057, Germany.
authors.forename: Attila
authors.initials: A
authors.lastname: Altiner
authors.affiliation: Institute of General Practice, Medical Faculty of the Heinrich-Heine-University Düsseldorf, Düsseldorf 40225, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Pentzek
mesh_terms: D002983:Clinical Competence; D003142:Communication; D003479:Curriculum; D004504:Education, Medical, Undergraduate / Q000458:organization & administration*; D004521:Educational Measurement / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D010817:Physician-Patient Relations; D015397:Program Evaluation; D015203:Reproducibility of Results; D013337:Students, Medical / Q000523:psychology*
keywords: Assessment; Communication skills; Feasibility; Global rating scale; Medical education; OSCE; Reliability; Validity