Communication Skills Assessment and Perceived Barriers of Effective Communication Among Medical Undergraduate Students During Family Adoption Program Visits in a Government Medical College of Assam, India: A Mixed-Method Study

Introduction The Family Adoption Program (FAP), introduced by the National Medical Commission (NMC) under the competency-based medical education (CBME) curriculum, aims to provide experiential learning opportunities, including effective communication skills among Bachelor of Medicine and Bachelor of Surgery (MBBS) students. This study assessed communication skills among MBBS students during FAP visits, addressed inter-rater variability, and explored perceived barriers to communication while engaging with the adopted families. Methods A mixed-methods study was conducted in which the communication skills of 100 MBBS students were assessed using the Gap-Kalamazoo Communication Skill (GKCS) assessment forms (self and faculty versions) from January to June, 2025. Inter-rater variability was addressed using Cohen's Kappa. Also, focus group discussions (FGD) were held among 27 MBBS students to identify barriers to communication during FAP visits. Results While students rated their communication skills as "good" across all GKCS competencies, with the highest rating (56%) for opening a discussion, faculty assessed six out of nine competencies as "good," with the highest rating (42%) for building a relationship. Seven out of the nine competencies demonstrated slight agreement beyond chance, with kappa values ranging from 0.038 to 0.150. Some of the perceived barriers of communication faced by the students during FAP visits included inadequate knowledge and understanding, differences in attitude, and linguistic and cultural differences. Conclusion The study highlights the need for formal communication skills training and structured feedback among MBBS students. Also, the usage of the local language and prior public awareness about FAP can be recommended to overcome the barriers of communication during FAP visits. The program would be more impactful if one or two families were allotted per student, facilitating meaningful interactions and improving communication skills.