"Soft Skills" May Be the Biggest Challenge in Medical Education

Teaching an effective and caring bedside manner may be one of the more difficult tasks in medical education, with the evaluation of residents on this all-important trait proving an even greater challenge.

Pertinent Points

- Medical educators have proposed a better way to evaluate medical residents on their bedside manner.

- The proposed exam steps away from pen and paper and instead uses case-based scenarios offered at clinical stations.

- The exam, which participants said effectively reflected the realities of general practice, was given to orthopedic surgery residents but could be applied to other specialties.

Researchers in Toronto, Canada, have developed a test they say objectively measures just how well a medical resident handles the critical communications that take place between clinician and patient.

Publishing in the Canadian Journal of Surgery, the researchers outlined an exam that moves away from a paper test and instead embraces a series of clinical scenarios. The new system successfully evaluated how well residents use their skills as a communicator, professional, manager, collaborator, health advocate, and scholar-or soft skills-the authors reported.

The test consisted of six 10-minute stations, each testing two intrinsic roles using case-based scenarios (some with and some without standardized patients).

To study the effectiveness of the test, 25 orthopedic residents participated. The results revealed an effective tool for objectively evaluating the multiple soft skills required for having a quality bedside manner, said Tim Dwyer, MD, orthopedic surgeon at Women's College Hospital and lead author of the study.

In evaluating the process, nearly 90% of the residents who were surveyed on the effectiveness of the tool thought that the scenarios given during the exam reflected the reality of what they would encounter in general practice.

"For decades, medical residents' soft skills were examined on paper," Dwyer said. "Our study shows that this tool offers a better, more objective exam alternative, and it has a potential to spread beyond orthopedic surgery to other specialties."