An investigation of construct validity of humanistic clinical skills on a medical licensure examination

Objective: To test construct validity of humanistic clinical skills measured by a medical licensure performance examination using multitrait-multimethod confirmatory factor analysis. Methods: Two hundred and twenty-seven third- and fourth-year undergraduate osteopathic medical students in 2007-2008 were randomly sampled. The Global Patient Assessment Tool (GPAT), designed to assess professionalism, interpersonal relationship, and doctor-patient communication was tested under two measurement methods: standard examination ratings and peer performance ratings of the same examinee. Two concurrent validity factors (data gathering and written patient notes) were included. Results: Convergent validity was supported under the two methods of scoring. Moderate to strong correlations among trait factors indicated weak discriminate validity. Method effects were indicated. The relationship between GPAT and two concurrent validity factors indicate measures of relatively different constructs. Conclusion: Evidence of construct validity for the GPAT indicate scores should be interpreted as measuring a humanistic clinical skills construct consisting of homogeneous measures of professionalism, interpersonal relationship, and physician-patient communication. Findings are consistent with the interpretation and use of the GPAT as an important part of medical licensure examinations. Practical implications: The implications to medical licensure standardized-patient examinations are discussed in terms of the GPAT as a valid measure of medical students' humanistic clinical skills. © 2010 Elsevier Ireland Ltd.