Teacher Decision Making : While assessing a student during a simulated patient-student interaction

Prior research demonstrates that communication skills significantly impact healthcare quality and the doctor-patient relationship (Jackson & Calman, 2006; Rider & Keefer, 2006; Silverman, 2009; Stewart, 1995). To equip Technical Medicine students with these vital skills, universities worldwide emphasize communication training in medical consultation (Brown, 2012; Lovink et al., 2021; Zayyan, 2011). Simulated patients are a crucial component of these teaching curricula. This study aimed to investigate the factors influencing communication skills teachers' decision-making during the assessment of student interactions with simulated patients. Utilizing a qualitative research design, the study incorporated a think-aloud approach and follow-up interviews based on a theoretical framework. Participants included nine communication skills teachers from the University of Twente (n=6) and TU/Delft (n=3). Findings revealed multiple factors affecting the teachers' decision-making. Assessor expertise emerged as the most prominent factor, with experienced teachers more adept at articulating the reasons behind their evaluations of students' performances. Over time, teachers shifted their focus from minute details to the overall quality of the interaction. Ensuring the validity of assessments was another key factor, influenced by elements such as consensus building, personal and patient norms and values, previous experiences with the student, and the educational goals set by the university. In conclusion, the study highlighted the evolving nature of teachers' expertise and the complex interplay of factors ensuring accurate and fair assessments of students' communication skills.