How should the ABR test communication skills? Isn’t that up to the residency programs? The ACGME maintains 6 core competencies. Only 1 of those 6 (medical knowledge) can be tested by board exams. Others like professionalism and interpersonal/communication skills cannot.
Anonymous Attending
Great Question!
Testing Communication Skills
I believe that testing and standardizing some basic communication skills prior to graduation is a necessity. As it stands right now, there is significant variability in the quality of communication teachings in different residencies. We certainly don’t want to create new graduates of residency programs that don’t feel comfortable relaying information expeditiously to clinicians or dictating a case. To that end, there are many ways that the ABR could test communication skills.
First, the resident may be able to answer questions in an appropriate dictation format to demonstrate he/she understands the mechanics of dictation. (At least that would ensure that graduating residents understand the basics) Grading would be a bit more challenging, but there is no reason why the ABR cannot create such a scheme for a grading system. Second, the previous oral boards, albeit imperfect, did test residents’ ability to communicate the examination, the findings, the impression/differential, and management.
So, to say that ABR can’t test communication skills does not make sense. I’m sure we could come up with a new and improved oral board type of examination to specifically test the skill of communicating radiological findings to clinicians and patients in a much-improved way. Perhaps, we could create a part 2 to the core examination. If the USMLE examination can do it, why can’t the ABR test for the same things but directed toward the needs of radiologists?
Professionalism
I agree that testing professionalism is tougher nut to crack. Furthermore, unlike communication, professionalism is not really a skill set but a way of acting ethically within the profession. You can’t standardize minimum requirements for professionalism in a test format. As you hinted, let’s leave that to the individual programs. But, you can certainly standardize basic minimum competencies for communication skills. And, I think that should be the responsibility of the ABR if they want to establish the minimum skills of a graduating radiology resident.
Final Thoughts
I believe that we create excuses for ourselves to say it is not possible to test communication skills. It is certainly possible and it is done in the field of medicine as well as other fields. To say that it is impossible or too hard is just pure laziness. It would just take time, rededication of funds, and getting together some intelligent radiologists and educators to figure it out. If called upon, I would be happy to give my input!!!
Director1
