RESUMEN
St. George's University School of Medicine matriculates two separate classes of 250 students each year. Clinical interviewing and communication skills are taught in "small groups" of 9-11 students by experienced physician educators using standardized simulated patients. During each 90-minute session, a student acts as the interviewer and receives feedback from both physician and patient as well as also observing interviews by colleagues. Nine such sessions occur over a 9-month period. There is evidence of overall efficacy of the Clincial Skills course from an OSCE administered at the end of the two-year course in Basic Sciences, but this study attempts to define the efficacy of these small group sessions. The study compares, by means of videotaped recordings, the skills of volunteer freshmen medical students before and after 3 small group sessions, and compares this group to a similar group of students who had completed all 9 sessions. These recordings were rated by two independent observers, unaware of the students experience, using a new interview rating scale derived from a combination of three previously validated scales. The characteristics of this scaleproved to be reliable and valid within the limits of this study. Student performance improved significantly after three sessions in terms of interview content, non-verbal communication and interpersonal skills. Further improvement occured in the first two at the end of the course, but there appeared to be a deterioration in interpersonal skills. This was similar to the results in previous studies. The focussed small group course in interviewing and communication skills at St. George's University is effective in improving student skills, but continuing efforts are needed to ensure that their interpersonal skills are optimized and maintained. (AU)