Academic journal article American Journal of Pharmaceutical Education

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

Academic journal article American Journal of Pharmaceutical Education

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

Article excerpt

INTRODUCTION

Effective 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). (3)

Studies 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 assessment of the student through methods such as self-assessment, course evaluation questionnaires, and student satisfaction. (7-28) The majority of these studies utilized simulated or standardized patients (SPs) as part of the activity, both as an educational tool and as an assessment method. In general, much of the published research describe innovative additions to courses, however, there is no systematic assessment of whether any of the activities result in increased learning and if multiple activities were used, what the optimal order or combination of activities should be. The authors also note that inconsistencies in assessments are due to a lack of skilled evaluators. This highlights the need for further research to develop and evaluate more accurate assessment methods and the importance of training evaluators. Additionally, many communication tools have been developed and validated for other health professions such as nursing and medicine, however, these tools are generally specific to the discipline and do not contain the necessary criteria to fully assess a student pharmacist on all components of a patient-pharmacist encounter. (29,30)

Prior to development of our instrument, a validated communication framework for student pharmacists had not yet been published. In the absence of a pharmacist-based instrument for students, the faculty at St. Louis College of Pharmacy previously used the Four Habits Model (FHM), which is a framework designed for use by physicians. The FHM contains 23 aspects of clinician communication behaviors organized into four "habits." (31-33) The FHM was chosen because of its significant emphasis on relationship-building behaviors within a patient-provider interaction. This framework was used to teach and assess student pharmacists' communication abilities with SPs from 2009-2012. While useful for general communication behaviors, our experience with the FHM highlighted the need for a validated instrument specifically designed to teach and assess student pharmacists in a pharmacist-patient encounter since many of the criteria within the FHM relate to skills specific to physician scope of practice. …

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