Abstracts Communications and the Arts

The assessment of surgeon-patient communication: An examination of validity

by Rebecca Williams

The ability to communicate competently is essential in medicine since it is integral to the provision of effective healthcare. This dissertation investigates how a surgeon’s communication skills are assessed within the context of Part B of the Membership of the Royal College of Surgeons (MRCS) examination. Through an exploration of perceived authenticity, this study examines if the communication skills component of the MRCS Part B is a valid reflection of clinical practice and whether it is a worthwhile assessment of surgeon-patient communication. An online questionnaire was completed by 63 junior surgical trainees who sat the MRCS Part B between October 2018 and February 2022. In addition, semi-structured interviews were conducted with seven consultant surgeons and three senior surgical registrars, all of whom work in the UK’s National Health Service (NHS). The responses were analysed with descriptive statistics, inferential statistics, and inductive thematic analyses. It was found that certain variables, such as the behaviour of simulated patients and the scenarios that frame the communication skills stations, shape how candidates communicate. Some candidates do not necessarily communicate in the exam as they communicate in clinical practice, which threatens the validity of the interpretations made and the actions taken based on the outcomes. This study highlights several benefits of the communication skills component of the MRCS Part B, including its attempt to corroborate that a Core Surgical Trainee is competent to progress to Specialty Training. However, the impact on the patient must be brought to the forefront. If the exam confirms a candidate can communicate effectively, its outcomes must be valid to reflect this.