The Results of the Evaluation of Communication Skills With the Patient at the Practice-Oriented Stage of Accreditation of Healthcare Professionals

Physicians must be competent communicators to effectively practice medicine, and communication is one of six required competencies identified by the Accreditation Council on Graduate Medical Education (ACGME). 1 Elements of competent communication are featured in four of the six ACGME competencies.The Association of American Medical Colleges (AAMC) also published recommendations for communication in the Medical School Objective Project, Paper III. 2 The National Board of Medical Examiners (NBME) is requiring Objective Standardized Clinical Examinations (OSCEs) to assess interviewing and communication skills.The Institute of Medicine, in its 2004 report, "Im-proving Medical Education: Enhancing the Behavioral and Social Science Content of Medical School Curricula," names communication skills as one of six curricular domains. 3The strong agreement about the importance of competent communication in medical practice challenges medical educators to develop effective tools to determine competence.Assessing communication competence is complex.Skills that require performance are difficult to assess through disembodied means (such as written tests) but require in-vivo demonstration. 4 Further, competence is not defined solely by the presence or absence of specific behaviors but rather by the presence and timing of effective verbal and nonverbal behaviors within the context of individual interactions with patients or families. 5Effective communication includes the ability to adapt, to be responsive, and to manage self-awareness during the process of talking and listening.Additionally, effective communication is not only dependent on the observable behaviors of the physician but also on the behaviors and perceptions of patients.What constitutes effective communication in one setting or with