Prior experiences associated with residents’ scores on a communication and interpersonal skill OSCE Rachel Yudkowsky a, * , Steven M. Downing a , Dennis Ommert b a Department of Medical Education, University of Illinois at Chicago College of Medicine, United States b Department of Internal Medicine, University of Illinois at Chicago College of Medicine, United States Received 2 November 2005; received in revised form 9 February 2006; accepted 1 March 2006 Abstract Objective: This exploratory study investigated whether prior task experience and comfort correlate with scores on an assessment of patient- centered communication. Methods: A six-station standardized patient exam assessed patient-centered communication of 79 PGY2-3 residents in Internal Medicine and Family Medicine. A survey provided information on prior experiences. t-tests, correlations, and multi-factorial ANOVA explored relationship between scores and experiences. Results: Experience with a task predicted comfort but did not predict communication scores. Comfort was moderately correlated with communication scores for some tasks; residents who were less comfortable were indeed less skilled, but greater comfort did not predict higher scores. Female gender and medical school experiences with standardized patients along with training in patient-centered interviewing were associated with higher scores. Residents without standardized patient experiences in medical school were almost five times more likely to be rejected by patients. Conclusions: Task experience alone does not guarantee better communication, and may instill a false sense of confidence. Experiences with standardized patients during medical school, especially in combination with interviewing courses, may provide an element of ‘‘deliberate practice’’ and have a long-term impact on communication skills. Practice Implications: The combination of didactic courses and practice with standardized patients may promote a patient-centered approach. # 2006 Elsevier Ireland Ltd. All rights reserved. Keywords: Patient-centered communication; Medical education; Graduate medical education; Assessment; Communication and interpersonal skills; Standardized patients 1. Introduction Communication and interpersonal skills are physician competencies essential to patient care [1,2]. The purpose of this exploratory study was to identify factors associated with scores on an assessment of medical residents’ communication skills; isolating such elements could inform the development of more effective curricula to enhance these essential skills. Based on prior studies, candidate factors included task specific experience, training in patient-centered interviewing, exposure to standardized patients and gender. The literature on expertise [3–6] suggests that extensive practice is necessary for the acquisition of skills. In particular, the development of expertise requires a systematic focus on sub-optimal performance areas with deliberate practice and immediate feedback. Without such focus, many practitioners plateau at a ‘‘minimally acceptable level of performance’’ that is never exceeded [4]. In fields such as sports and music, a coach observes performance and helps performers identify specific behaviors to practice and improve. Traditional medical training provides few comparable opportunities for direct observation and coaching. Medical school faculties expect clinical rotations to provide www.elsevier.com/locate/pateducou Patient Education and Counseling 62 (2006) 368–373 * Corresponding author at: Department of Medical Education MC 591, University of Illinois College of Medicine, 808 S. Wood Street, Chicago, IL 60612, USA. Tel.: +1 312 996 3598; fax: +1 312 413 2048. E-mail address: rachely@uic.edu (R. Yudkowsky). 0738-3991/$ – see front matter # 2006 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.pec.2006.03.004