Defining competency-based evaluation objectives in family medicine: communication skills.

Objective: To provide a pragmatic approach to the evaluation of communication skills using observable behaviours, as part of a multiyear project to develop competency-based evaluation objectives for Certification in family medicine.

Design: A nominal group technique was used to develop themes and subthemes and to identify positive and negative observable behaviours that demonstrate competence in communication in family medicine.

Setting: The College of Family Physicians of Canada in Mississauga, Ont.

Participants: An expert group of 7 family physicians and 1 educational consultant, all of whom had experience in assessing competence in family medicine. Group members represented the Canadian context with respect to region, sex, language, community type, and experience.

Methods: The group used the nominal group technique to derive a list of observable behaviours that would constitute a detailed operational definition of competence in communication skills; multiple iterations were used until saturation was achieved. The group met several times a year, and membership remained unchanged during the 4 years in which the work was conducted. The iterative process was undertaken twice--once for communication with patients and once for communication with colleagues.

Main Findings: Five themes, 5 subthemes, and 106 positive and negative observable behaviours were generated. The subtheme of charting skills was defined using a key-features analysis.

Conclusion: Communication skills were defined in terms of themes and observable behaviours. These definitions were intended to help assess family physicians' competence at the start of independent practice.