Purpose. Clinical communication influences health outcomes, so medical schools are charged to prepare future physicians with the skills they need to interact effectively with patients. Communication leaders at The University of New Mexico School of Medicine (UNMSOM) developed The Essential Elements of Communication-Global Rating Scale (EEC-GRS) to teach and assess patient-centered communication skills. The instrument contains seven, behaviorally anchored Elements, which support the validity and reliability of scores. This study evaluated new validity evidence that supports the interpretation and use of scores resulting from the instrument. Method. Two methods were utilized to evaluate validity evidence. (1) Correlation studies were conducted that compared the relationship between EEC-GRS scores with both Patient Satisfaction and the National Board of Medical Examiners Step 2 Communication and Interpersonal Skills (CIS) scores. (2) Exploratory Factor Analysis was conducted to determine how many constructs the instrument measured, and how these constructs were related. Results. Results suggested correlation (r = 0.76) and predictive strength (r[superscript 2] = 0.58) between EEC-GRS and Patient Satisfaction scores. There was also evidence of outcomes from the EEC-GRS to predict scores on Step 2 CIS (r[superscript 2] = 0.16). In addition, Patient Satisfaction was correlated with Step 2 CIS scores (r = 0.44) and predictive of Step 2 CIS scores (r[superscript 2] = 0.19). Subsequently, factor analysis resulted in a 2-factor structure. To explain the factor structure, key descriptive words were extracted from the each element in the factor cluster and linguistic themes were evaluated. Words defining Factor-one described interaction with the patient, whereas words associated with Factor-two suggested one-directional communication from the clinician to the patient. Conclusions. This study produced new validity evidence supporting the usefulness of the EEC-GRS at UNMSOM. Results suggest that the instrument has both curricular and assessment value to scaffold the development of medical students' patient-centered communication skills and thus prepare them for the clinical environment. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com.bibliotheek.ehb.be/en-US/products/dissertations/individuals.shtml.]