The SEGUE Framework for teaching and assessing communication skills
Abstract
This article examines uses and characteristics of the SEGUE Framework, a research-based checklist of medical communication tasks. A recent survey of US and Canadian medical schools indicates that the SEGUE Framework is the most widely used structure for communication skills teaching and assessment in North America. Student and faculty response to the SEGUE Framework as a teaching tool has been positive. Data drawn from clinical skills assessments with standardized patients provide evidence of concurrent and construct validity. Analysis of visits between general internists and their patients reinforces validity of the SEGUE Framework in an actual practice setting. Interrater reliability is high when standardized patients are recording student performance immediately after a live encounter, and when coders are evaluating videotaped or audiotaped encounters; intrarater reliability is strong as well. The SEGUE Framework has a high degree of acceptability, can be used reliably, has evidence of validity, and is applicable to a variety of contexts. Studies of predictive validity are needed.
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To our knowledge, this is the first study to generate such triangulated, rubric-based evidence in Spanish-speaking medical students, within a Latin American setting.
“To our knowledge, this is the first study to generate such triangulated, rubric-based evidence in Spanish-speaking medical students, within a Latin American setting (Makoul, 2001a, 2001b).”
From DIALOGUE: A Generative AI-Based Pre–Post Simulation Study to Enhance Diagnostic Communication in Medical Students Through Virtual Type 2 Diabetes Scenarios (2025) · cites this paper as Makoul, 2001b
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- Authors
- Makoul, G.
- Affiliations
- Northwestern University (US)
- Corresponding author
- Makoul, Gregory
- ORCID
- Makoul, Gregory
- Venue
- Patient Education and Counseling
- Publisher
- Elsevier BV
- Published
- 2001-10
- Volume
- 45
- Issue
- 1
- Pages
- 23-34
- ISSN
- 0738-3991 (ISSN-L)
- OpenAlex
- W1964919450
- Cited by
- 457
- References
- 36
- Citations by year
- 2026: 22 · 2025: 22 · 2024: 22 · 2023: 25 · 2022: 20 · 2021: 20 · 2020: 22 · 2019: 28 · 2018: 13 · 2017: 27 · 2016: 21 · 2015: 40 · 2014: 22 · 2013: 18 · 2012: 22
- FWCI
- 5.40
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Patient Education and Counseling (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Arthur Vining Davis Foundations
- Northwestern University
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Health Sciences › Medicine › Psychiatry and Mental health › Empathy and Medical Education
- Keywords
- medical communication skills, communication skills assessment, standardized patients, clinical skills assessment, inter-rater reliability, construct validity, concurrent validity, medical education, physician-patient communication
- MeSH terms
- Clinical Competence, Communication, Education, Medical, Undergraduate, Humans, Physician-Patient Relations, Predictive Value of Tests, Teaching, Videotape Recording, Observer Variation, Models, Educational
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