Optimizing the Reliability of Communication Skills Assessment in Clinical Dentistry: A Generalizability Study

<ns3:p>Introduction Communication skills are universally recognised as a core competency. This study aims to develop and validate an CCG-adapted instrument for communication skills in clinical settings that can be used by trainees themselves (self-assessment). Methods This study was conducted at Damascus University Dental School, Syria in 2024 within authentic clinical settings. Based on Calgary Cambridge Guide, a 31-item assessment instrument was developed, translated and cross-culturally validated for the Syrian Arabic context. An assessment comprised six consultation sessions with six patients (three real and three standardized) was conducted. After each consultation, students and patients completed the assessment form. A balanced, fully crossed, three-facet design Generalizability (G) and decision (D) studies were used to assess reliability for student and patient assessments. Structural validity was evaluated using exploratory factor analysis (EFA) . Results Self-assessment demonstrated excellent reliability (G-coefficient = 0.93), reaching &gt;0.90 with four cases. Patient assessments showed moderate reliability (G = 0.66), with Decision studies projecting improvements to 0.72 with 8 raters, 0.80 with 13 raters, and ~0.90 with ≥30 raters. Reliability estimates for real patients (G = 0.51) were comparable to standardized patients (G = 0.55), with differences narrowing as rater numbers increased. Exploratory factor analysis indicated a one-factor solution explaining 52.1% of the variance. Conclusion A validated self-assessment tool can foster communication skills development, while real patients provide reliability comparable to standardized patients, offering cost-effective, authentic, and participatory approaches. This first Arabic version of the tool addresses training gaps in communication skills in the Arab region.</ns3:p>