[Assessing therapeutic communication competence of university students in Germany: Lessons learned].

Abstract

The construct of therapeutic competence should enable measurement of therapist effectiveness, though this poses challenges. This study aimed to investigate the increase in students' competence in clinical communication skills through objective assessment, and to reflect on learning experiences with competence assessment.Communication techniques were taught over three seminar sessions, each using standardized 20-minute role plays. Between the second and third sessions, the participants received structured or unstructured video supervision. Competence was evaluated by two independent rater groups using an adapted Cognitive Therapy Rating Scale (CTRS).The videos of 82 students were analyzed. Interrater reliability was low in the first group of raters (ICC3,1=0.48) and non-existent in the second group (ICC3,1=0.00). A small main effect of assessment time point was observed, indicating a slight, non-significant increase in clinical communication skills from the first to the third session. Neither the effect of supervision nor the interaction effect was significance.Due to the chosen application of the CTRS, a standardized and objective assessment of therapeutic interviewing skills was not feasible, requiring cautious interpretation of the results regarding clinical communication skills. The fit of the measurement instrument, the standardization of the assessed situation and the lack of experience of the raters probably had affected interrater reliability negatively. These aspects can also be a challenge in the newly introduced parcours examination for the licence to practise psychotherapy and must be taken into account when planning and classifying the evaluation.