title: Assessment of Surgery Residents' Interpersonal Communication Skills: Validation Evidence for the Communication Assessment Tool in a Simulation Environment.
abstract: OBJECTIVE
  Although development of trainees' competency in interpersonal communication is essential to high-quality patient-centered surgical care, nontechnical skills present assessment challenges for residency program directors. The Communication Assessment Tool (CAT) demonstrated internal reliability and content validity for general surgery residents, though the tool has not yet been applied in simulation. The study provides validation evidence for using the CAT to assess surgical residents' interpersonal communication skills in simulation scenarios.
  
  
  METHODS
  Simulations of delivering bad news were completed by 21 general surgery residents during a mandatory communication curriculum. Upon completion of the 10-minute scenario, standardized participants (SPs) assessed performance using the 14-item CAT rating scale and individually provided feedback to residents. Discrete communication behaviors were recorded on video review by a trained blinded observer. The traits emotional intelligence questionnaire short form (TEIQue-SF) was completed by the residents 6 months later. SP-CAT ratings are evaluated with respect to learner characteristics, observed behaviors, and TEIQue results.
  
  
  METHODS
  Surgical simulation center in a 900-bed tertiary care hospital.
  
  
  METHODS
  General surgery residents were targeted learners. Trauma survivors network volunteers served as SPs, acting as a family member of a patient who developed an intracerebral hemorrhage following a small bowel procedure.
  
  
  RESULTS
  Discrete communication behaviors were reliably assessed by the observer (interrater reliability with trainer: 89% agreement, κ = 0.77). SP-CAT ratings ranged from 34 to 61. Higher SP-CAT ratings were correlated with positive communication behaviors (Spearman ρ = 0.42, p = 0.056). Total TEIQue was positively related to SP-CAT ratings (ρ = 0.42, p = 0.061). The TEIQue emotionality factor was strongly correlated with SP-CAT ratings (ρ = 0.52, p = 0.016).
  
  
  CONCLUSIONS
  The CAT demonstrates content validity in a simulation environment with former patients acting as SPs. This study provides validation evidence relating the SP-CAT to discrete observations of communication behaviors by a trained, reliable observer as well as residents' self-reported emotional intelligence traits.
authors.affiliation: Department of Surgery, Advanced Surgical Technology and Education Center, Inova Fairfax Hospital, Falls Church, Virginia. Electronic address: Amber.Trickey@inova.org.
authors.forename: Amber W
authors.initials: AW
authors.lastname: Trickey
authors.affiliation: Division of Trauma, Department of Surgery, Inova Fairfax Hospital, Falls Church, Virginia.
authors.forename: Anna B
authors.initials: AB
authors.lastname: Newcomb
authors.affiliation: Division of Trauma, Department of Surgery, Inova Fairfax Hospital, Falls Church, Virginia.
authors.forename: Melissa
authors.initials: M
authors.lastname: Porrey
authors.affiliation: Department of Surgery, Advanced Surgical Technology and Education Center, Inova Fairfax Hospital, Falls Church, Virginia.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Wright
authors.affiliation: Division of Trauma, Department of Surgery, Inova Fairfax Hospital, Falls Church, Virginia.
authors.forename: Jordan
authors.initials: J
authors.lastname: Bayless
authors.affiliation: Department of Surgery, Advanced Surgical Technology and Education Center, Inova Fairfax Hospital, Falls Church, Virginia.
authors.forename: Franco
authors.initials: F
authors.lastname: Piscitani
authors.affiliation: Department of Surgery, Advanced Surgical Technology and Education Center, Inova Fairfax Hospital, Falls Church, Virginia.
authors.forename: Paula
authors.initials: P
authors.lastname: Graling
authors.affiliation: Department of Surgery, Advanced Surgical Technology and Education Center, Inova Fairfax Hospital, Falls Church, Virginia.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Dort
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D004503:Education, Medical, Graduate / Q000379:methods*; D056348:Emotional Intelligence; D005260:Female; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency / Q000379:methods; D007398:Interpersonal Relations; D008297:Male; D016544:Patient Simulation; D010817:Physician-Patient Relations; D015203:Reproducibility of Results; D000066908:Simulation Training / Q000379:methods*; D014768:Virginia
keywords: Interpersonal and Communication Skills; Patient Care; Professionalism; general surgery; interpersonal and communication skills; residency; simulation training