ABSTRACT
Background: Communication is a core clinical skill that is essential for clinical competence. Practical assessments, such as Objective Structured Clinical Examinations (OSCEs) commonly assess communication skills among undergraduates; however organizing an OSCE is an expensive and complex process. Faculty of Medicine Unjani University uses essay format tests in communication skills assessments of the first year communication block. The evidence of written assessment in communication skills is still very limited. Objective: To study the correlation between written and practical assessments of communication skills among the first year medical students; to study the validity and reliability of written assessments to assess communication skills. Methods: A cross sectional study was conducted among the first year students in the Faculty of Medicine, Unjani University. At the end of the communication block, students faced a written assessment comprised of Modified Essay Questions (MEQ) and a practical assessment in one station with a simulated patient where the performance at the station was videotaped. There were two examiners for each assessment. Result: Kappa coefficient for inter-rater reliability of MEQ was 0.707 and practical assessment was 0.735. The correlation coefficient between written and practical assessments from the two examiners ranged between 0.063 – 0.127, n=120, p>0.01. On the item level, correlation coefficient in building initial rapport was -0,067, identifying the reason(s) for consultation was 0.030 and gathering information was 0.107. This result showed a low concurrent validity of the written test in assessing communication skills. Conclusion: Written assessments cannot predict the students‘ communication skills competence. Written assessments have a high reliability, nevertheless they have a low validity to assess communication skills.